Ozempic vs Wegovy vs Rybelsus: Comparative Analysis (2023 Update)

By Dr. Frank Yap, MD -

Semaglutide, known by the brand names Ozempic, Wegovy, Rybelsus and others, is the latest weight-loss craze to hit Hollywood and beyond. The prescription drug, which is administered via a weekly injection, is intended to treat Type 2 diabetes, but it’s widely used off-label for weight loss.

They all belong to the same medication class — glucagon-like peptide-1 (GLP-1) agonists (GLP-1 receptor agonists). 

GLP-1 agonists work by triggering insulin release, blocking sugar production in your liver, and making you feel full.

But with all of these brands out there, how do you decide which is right for you? Let’s get to know some of the differences between these major GLP-1 agonist drugs.

A 2021 study funded by Novo Nordisk, the drug’s maker, found using semaglutide once a week led to a 14.9% reduction in body weight among adults with obesity.1 There’s been such a rush on the drugs that the U.S. Food and Drug Administration lists both Ozempic and Wegovy as “currently in shortage.” This, despite the drug’s hefty price tag of about $1,400 a month.2

But quick fixes are rarely the answer when it comes to better health, especially in the case of complex issues like maintaining a healthy weight, which has mental, emotional and physical elements. A weight loss drug, even if it’s seemingly effective, cannot address the underlying emotional drivers that may lead to overeating, for instance, and it won’t save your health if you continue to eat an unhealthy diet — no matter how thin your outward appearance may be.

By relying on medication to get thin, you rob your body of the chance to balance its weight naturally, in the way biologically intended, and expose yourself to untold side effects in the process.

Ozempic

Ozempic (semaglutide) is a once-weekly injection for adults with Type 2 diabetes. It comes in a multi-dose pre-filled pen. You can inject Ozempic at any time of day, with or without food. But you should inject it on the same day each week.

Your healthcare provider may recommend Ozempic if you have Type 2 diabetes and heart disease. That’s because Ozempic can help lower the risk of heart attack and stroke. There’s also some evidence suggesting potential kidney benefits, too.

Ozempic isn’t approved for weight loss. But you may notice weight loss as a side effect. On average, those taking it lost 8 to 10 lbs during clinical trials. Wegovy, a higher-dose product, is approved specifically for weight loss.

Related: Weight-loss stocks soar up to 15% after obesity-drug study shows an added benefit that may be a ‘huge win’ for future sales (Fortune)

Wegovy

Wegovy is another once-weekly semaglutide injection. But it’s only approved for weight loss in certain adults and adolescents ages 12 and older. It’s not used to treat diabetes, and you don’t need to have a diabetes diagnosis to use it. Like Ozempic, you can inject it at any time of day.

Wegovy is approved for adults with a body mass index (BMI) of 30 mg/kg² or greater. You can also use Wegovy if you have a BMI of at least 27 mg/kg² with one or more weight-related health conditions (such as high blood pressure, high cholesterol, diabetes).

Wegovy is also approved for adolescents ages 12 and older. People within this age group may qualify for Wegovy if they have a BMI at or above the 95th percentile for sex and age.

In clinical trials, adults taking Wegovy saw an average weight loss of nearly 15% of their initial body weight. And adolescents saw an average weight loss of about 16% of their initial body weight. For the best results, combine Wegovy with a healthy diet and exercise.

Rybelsus

Don’t like injections? Rybelsus is an oral version of semaglutide used for Type 2 diabetes. Currently, it's the only medication in the GLP-1 agonist class that isn’t injected.

Rybelsus is taken by mouth once daily. To get the best results, take it first thing in the morning with no more than 4 ounces of water. Wait 30 minutes before eating, drinking, or taking other medications. This will allow the medication to be fully absorbed.

It’s possible to switch from Ozempic to Rybelsus (and vice versa). But if your Ozempic dose is 1 mg or greater, this may not be an option for you. Additionally, Rybelsus isn’t approved for the same heart-related benefits.

Ozempic vs Wegovy vs Rybelsus: What's the Difference?

Ozempic, Wegovy and Rybelsus contain the active ingredient semaglutide. They all belong to the same medication class — glucagon-like peptide-1 (GLP-1) agonists.

Rybelsus and Ozempic have different FDA-approved uses, but they’re both used to treat type 2 diabetes when used in combination with diet and exercise.

These drugs haven’t been directly compared in clinical studies. However, both Rybelsus and Ozempic have been found effective for helping improve blood sugar levels in people with type 2 diabetes when used with diet and exercise. For information about how these drugs performed in clinical studies, see the prescribing information for Rybelsus and Ozempic.

Rybelsus and Ozempic are both a type of drug called a glucagon-like peptide-1 (GLP-1) agonist. GLP-1 agonists such as Rybelsus and Ozempic are included in American Diabetes Association (ADA) guidelines for treating type 2 diabetes. These guidelines recommend GLP-1 agonists as an additional treatment option when metformin doesn’t lower blood sugar enough.

The ADA guidelines also recommend a GLP-1 agonist for people who have type 2 diabetes in addition to heart disease. However, the ADA recommends only drugs with proven heart benefits and FDA-approval for this use. Rybelsus is not FDA-approved for this purpose.

The right GLP-1 agonist drug for you will likely come down to a few key factors, including:
  • Age. All GLP-1 agonists are approved for use in adults. But some can also be used in children as young as 10 years old.
  • Treatment goals. Each GLP-1 agonist has specific approved uses and potential benefits to help you meet your treatment goals.
  • Underlying conditions. If you have existing heart disease or heart disease risk factors, one with proven heart-related benefits may be preferred.
  • Preferences. Don’t like injections? An oral pill is available. If dosing frequency is a concern, there are once-weekly options to choose from.
  • Insurance coverage. Your insurance plan may only cover certain GLP-1 agonists. And whether one is covered may depend on why you’re taking it. So, it’s best to check with your specific plan about coverage.
Your healthcare provider can help you navigate your options and answer any questions you have. And if you can’t tolerate one GLP-1 agonist, they may have you try a different one. 

Ozempic vs Wegovy vs Rybelsus
Credit: GoodRx Health

Key Takeaway

Ozempic, Wegovy, and Rybelsus all share the active ingredient semaglutide, placing them within the same medication category known as GLP-1 agonists.

Differences among these medications may encompass dosing frequency, administration methods, and potential advantages.

To select the most suitable GLP-1 agonist for your needs, consult your healthcare provider who can offer guidance and personalized recommendations.

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