Many people want a medicine that can help them lose weight fast and easily. This has created a big business for products that do not work well. Semaglutide (the medicine sold as Ozempic, Wegovy, and others) is not like them: It is effective, and it works in a short time. This amazing solution for a very large need has made people around the world want to get the medicine. But there is a problem, and it is a serious one: no one knows what the long-term effects of using semaglutide for weight loss are in healthy people, and there are good reasons to think that the effects could be very bad. I am not a doctor who studies hormones; I work at a school for business and I know how to do research on new things. So you may keep that in mind when you read what I write next.
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In 2016, I wrote a big study about how diabetes and Alzheimer’s disease are related in the Journal of Alzheimer’s Disease. I started the study when I saw some big differences in what different researchers said and I wanted to know how the different ways they did their research caused this weird result. I looked at hundreds of studies on Alzheimer’s disease and found out what the researchers did that made their results different, and this showed me which results were more likely to be true. The results of my study suggest that it could be very risky for healthy people to use semaglutide-based medicines for weight loss.
Rybelsus is a pill that has semaglutide in it. It is similar to Ozempic, which is a type of medicine called GLP-1RA. Rybelsus is used once a day to help control blood sugar with diet and exercise in people who have type 2 diabetes.
GLP-1 is a chemical that your body makes in your gut, says Leon I. Igel, M.D., a doctor who specializes in obesity and hormone problems. He is also the head of Intellihealth, a health company. “Semaglutide (the main part of Rybelsus) acts like this chemical and makes more of it in your body, which makes your stomach empty slower so you feel full sooner when you eat and stay full longer after you eat,” he says. Semaglutide is not like the natural chemical, which does not last long. Semaglutide can last for many hours.
Rybelsus also makes your pancreas release more insulin when you eat and lowers the amount of sugar that your liver makes, which improves your blood sugar levels, says Florence Comite, M.D., a doctor who studies hormones and the founder of the Comite Center for Precision Medicine and Health in New York City.
Ozempic is a shot that also has semaglutide in it and is a GLP-1RA medicine. It is used to treat type 2 diabetes (with diet and exercise), says Dr. Comite. It can also lower the chance of having serious heart problems (like stroke, heart attack or death) in people who have type 2 diabetes and heart disease.
Ozempic is sometimes used for weight loss in people who are overweight or obese.
Like Rybelsus, Ozempic makes your pancreas release more insulin when you eat and stops your liver from making and releasing too much sugar, says Dr. Comite. “It also makes your stomach empty slower (the time it takes food to leave your gut) so you feel full longer,” she says.
"Rybelsus vs. Ozempic: How Are They Different?
Rybelsus and Ozempic are both made by the same drug company, Novo Nordisk, according to Dr. Comite. They have different ways of taking them, how often they are taken, and how strong they are.
How to Take Them
“Rybelsus is a pill that you take by mouth once a day, while Ozempic is a shot that you give yourself under the skin once a week,” says Dr. Igel.
Rybelsus: A daily pill that you take by mouth in the morning 30 minutes before you eat anything with 4 ounces of water or less. You have to swallow the pills whole (do not break, cut or chew them).
Ozempic: A weekly shot that comes in a ready-to-use pen that you can use any time on the same day each week, with or without food.
Both drugs have a starting dose that may change over time depending on how well they work and how you feel. The Rybelsus dose is higher than Ozempic, says Dr. Comite. That is because semaglutide, the main ingredient in both drugs, is not absorbed as well by the stomach as it is by the skin, she says.
Rybelsus: Comes in 3 milligram, 7 milligram and 14 milligram doses; you start with 3 milligrams daily for 30 days, then you increase to 7 milligrams. The highest dose is 14 milligrams daily. Ozempic: Comes in 0.25 milligram, 1 milligram and 2 milligram doses; you start with 0.25 milligrams for four weeks, then you increase to 0.5 milligrams. You can increase your dose by 0.5 milligrams every 30 days, up to a maximum of 2 milligrams per week.
Rybelsus is a medicine that you need a doctor’s prescription for. It helps control blood sugar levels in people with type 2 diabetes. It was approved by the U.S. government agency that regulates drugs (FDA) in 2019, and it is the first diabetes medicine that you can take as a pill instead of a shot.
Novo Nordisk, the company that makes Rybelsus, also makes Ozempic and Wegovy. These drugs have the same main ingredient as Rybelsus, called semaglutide.
Semaglutide is a type of drug called a glucagon-like peptide-1 receptor agonist. These drugs act like GLP-1, a hormone that your body makes in your gut when you eat. When you eat, your gut releases GLP-1, which tells your pancreas to release insulin. Insulin helps your body use glucose (sugar) from your blood for energy or storage. GLP-1 makes sure insulin is released when you need it, especially after meals when your blood sugar levels go up.
Also, GLP-1 lowers the amount of another hormone made by your pancreas called glucagon, which does the opposite of insulin by raising blood sugar levels. By lowering glucagon, GLP-1 stops too much glucose from coming out of your liver, which can cause high blood sugar levels.
GLP-1 drugs like Rybelsus may also make your stomach empty slower (gastric emptying). This helps control how fast the nutrients from your food get into your blood, avoiding sudden rises in blood sugar levels after eating. Slower stomach emptying can also make you feel full longer, which may help you eat less calories.
Rybelsus is a medicine that the FDA says is safe to use for people with type 2 diabetes. It is not a medicine for losing weight on purpose. But some people who use it with healthy eating and exercise lose weight. This is good because most people with type 2 diabetes also have too much weight, which can cause other health problems. Rybelsus can help with both diabetes and weight.
Rybelsus can help you lose weight in two ways.
Rybelsus has semaglutide, which makes the pancreas make more insulin. Insulin is a hormone that helps sugar go from the blood to the cells, where it is used for energy. This keeps the blood sugar level stable and lowers the risk of sudden changes in energy that can make you want to eat more.
Semaglutide also stops another hormone called glucagon, which makes the blood sugar level go up by telling the liver to release stored sugar into the blood. By stopping glucagon, Rybelsus keeps the blood sugar level even and avoids too much hunger from low blood sugar.
Rybelsus does more than just control blood sugar; it also controls hunger.
There are GLP-1 receptors in the brain, especially in a part called the hypothalamus, that tell us when we are hungry or full. When GLP-1 attaches to these receptors, it tells the brain to lower hunger and cravings. This means you will feel less hungry and more full with smaller meals.
Rybelsus also makes the stomach empty slower into the small intestine. This means food stays in your stomach longer after you eat, making you feel full for a longer time and stopping you from eating more.
Rybelsus is given with lifestyle changes like eating less and moving more. It is not a medicine for obesity by itself.
As of December 2023, Rybelsus is only a medicine to help people with type 2 diabetes manage their blood sugar levels. Novo Nordisk, the company that makes Rybelsus, has been testing how well Rybelsus works as a medicine for weight loss.
Novo Nordisk has shared the main results from the OASIS 1 phase 3a trial, which is part of a bigger program called OASIS. The trial lasted 68 weeks and had 667 adults who had too much weight and health problems because of it. It compared a once-a-day 50 mg dose of Rybelsus, with lifestyle changes, to a fake medicine for weight loss. The trial met its main goal, showing that semaglutide 50 mg by mouth led to more and better weight loss than the fake medicine.
In particular, people who took the medicine by mouth lost a lot of weight, 17.4%, after 68 weeks, while those who took the fake medicine lost very little, 1.8%. Also, 89.2% of the people who took the medicine by mouth lost 5% or more of their weight, compared to only 24.5% of the people who took the fake medicine.
When looking at how well people followed the treatment, those who took the medicine by mouth 50 mg dose still lost a lot of weight, 15.1%, compared to a little, 2.4%, in the fake medicine group. Also, 84.9% of the people who took the medicine by mouth reached a 5% or more weight loss, compared to 25.8% with the fake medicine.
The trial also found that a higher dose of Rybelsus was safe and easy to take, with the most common side effects being mild to moderate stomach problems. Novo Nordisk wants to get approval soon.
To sum up, Rybelsus is not a medicine for weight loss. Right now, it is only a medicine for type 2 diabetes. But it has been shown to help people lose weight when they take it with lifestyle changes. This extra effect is why it is sometimes given for weight loss or used for weight loss in people who also have type 2 diabetes.
Rybelsus is a new kind of pill for diabetes that the FDA approved in 2019. It has semaglutide, which is a medicine that helps lower blood sugar and weight. The FDA said yes to Rybelsus after looking at the results of 10 studies with 9,543 people. They compared Rybelsus with other diabetes pills and sugar pills. Rybelsus helped lower A1C levels and weight.
Most people who took Rybelsus did not have any problems. But some people may have side effects.
The most common side effects of Rybelsus are stomach problems like feeling sick, throwing up, loose stools, hard stools, acid reflux, and belly pain.
Some side effects may be more serious, but they do not happen often.
Faster heartbeat Low blood sugar (hypoglycemia) Allergic Reactions: Redness, swelling, trouble breathing Pancreatitis (swelling of the pancreas) Gallbladder problems, like gallstones Higher chance of thyroid cancer
If you have any side effects while taking Rybelsus, call your doctor right away.
Wegovy and Rybelsus are used for different things
Wegovy and Rybelsus have the same medicine: semaglutide. They work the same way in your body, but they are used for different things.
Wegovy is a higher dose of semaglutide that is used for losing weight. It is for some adults and teens who are 12 years or older. It depends on how much they weigh for their height and age (BMI):
Adults: A BMI of 30 or more, or a BMI of 27 or more with one or more health problems related to weight (e.g., Type 2 diabetes, high blood pressure, high cholesterol)
Teens who are 12 years or older: A BMI that is very high for their sex and age Rybelsus is used for treating Type 2 diabetes in adults. There is another form of semaglutide that you inject, called Ozempic, that can also prevent heart attacks and strokes if you have diabetes and heart disease. But Rybelsus has not been shown to do that yet. We will tell you more about this later.
Good to know: Rybelsus is not for losing weight, but it is being tested for that. It is possible that higher doses may help you lose weight like Wegovy.
Wegovy is an injection, while Rybelsus is a pill
Most medicines like semaglutide, called GLP-1 agonists, are injections. This is because they do not get into your body well if you swallow them. But Rybelsus is the first and only medicine of this kind that is a pill.
Rybelsus has a special ingredient that helps it get into your body from your stomach. But you still need to follow some rules when you take it. Take Rybelsus at least 30 minutes before your first food, drink, and medicines of the day, with no more than 4 oz of water. This helps you get the most out of your dose.
You need to take Rybelsus every day, but you only inject Wegovy once a week
Semaglutide stays in your body for a long time, no matter how you take it. That is why you only need to inject Wegovy and Ozempic once a week.
But when you swallow semaglutide, you only get a little bit of it into your body. And it may vary how much you get each time you take it. That is why you need to take Rybelsus every day to keep a steady amount of medicine in your body. If you take it less often, it may not work as well.
"4. Wegovy could also protect you from dying or getting sick from heart problems
Wegovy and Rybelsus are two different drugs that have not been tested against each other. But some recent research shows that Wegovy could also protect you from dying or getting sick from heart problems. This has not been proven with Rybelsus.
The SELECT study followed people who took Wegovy for 5 years. It showed that Wegovy reduced the chance of having serious heart problems by 20% compared to a fake injection. Serious heart problems include dying from heart issues, having a heart attack, or having a stroke.
The PIONEER 6 study followed people who took Rybelsus for about a year, on average. Rybelsus reduced the chance of dying from heart issues or any other cause by almost 50% compared to a fake pill. But it did not show a clear difference in serious heart problems. More studies are being done to check if Rybelsus has any benefits for the heart.
Your insurance may pay for Wegovy and Rybelsus differently
Wegovy is only approved for helping people lose weight and keep it off. Your insurance may not pay for it. So you should check your insurance plan and how much you have to pay yourself before you get it. It is possible that your insurance pays for some of Wegovy, but you have to pay more yourself.
Rybelsus is approved for treating Type 2 diabetes. Most insurance plans pay for it. But you should still check your insurance plan. It is possible that your insurance prefers other drugs that work like Rybelsus. Or your doctor may have to show your insurance that you have tried other diabetes drugs first.
Rybelsus is safe and works well for most people, but it can cause side effects in some people. It can also react badly with some medical conditions or things in your body.
Before you start taking any prescription drug, you should tell your doctor about any medical conditions you have, any drugs or supplements you take, and any allergies you have. This will help prevent any bad reactions or serious side effects.
A history of pancreatitis Gallbladder problems Kidney problems Personal or family history of MTC (a type of thyroid tumor) MEN2 (a condition that causes tumors in different glands) Diabetic retinopathy (eye problems) Any digestive disorders
Rybelsus may not be given to women who are pregnant, want to get pregnant, or are breastfeeding.
Rybelsus is FDA-approved to control blood sugar levels in people with type 2 diabetes. It is not approved to treat type 1 diabetes. Its use for losing weight is off-label, meaning that weight loss is not the main purpose of this drug.
Some people may be given Rybelsus for its off-label weight loss effects. It may be used by health care in adults who are obese (with a BMI of 30 kg/m2 or more) or overweight (with a BMI of 27 kg/m2 or more) who also have health problems related to their weight such as high blood pressure, high cholesterol, or sleep apnea.
Note that the use of Rybelsus for weight loss is up to the doctor who prescribes it.
Rybelsus, Ozempic, and Wegovy are all drugs made by the same company, Novo Nordisk. They have different uses for your health.
Rybelsus is for people with type 2 diabetes who need to keep their blood sugar levels under control. You take it as a pill by mouth. Rybelsus helps your body use sugar better and also helps you lose weight.
Ozempic is also for people with type 2 diabetes who need to lower their blood sugar levels. You inject it under your skin. You do this once a week. Ozempic can help you lower your blood sugar, lose weight, and prevent heart problems from diabetes.
Wegovy is for people who are overweight or obese, with or without diabetes. You inject it under your skin once a week. Wegovy can help you lose weight by making you feel less hungry and more full with less food.
To sum up, Rybelsus is for blood sugar and weight control in people with type 2 diabetes, Ozempic is mainly for blood sugar and weight loss in people with diabetes, and Wegovy is only for weight loss in people who are overweight or obese. These drugs have different ways of taking them (pill or injection) and different effects on your health. Your doctor can help you choose the best one for you based on your health situation and goals.
Wegovy and Rybelsus can have similar side effects, like feeling sick, having diarrhea, and being constipated. But Rybelsus can also make it harder for your body to absorb and digest food, because you take it by mouth. In the study they mentioned above, they also found that people did not report side effects as often as with semaglutide that you inject under your skin.
Some people may have mild-to-moderate stomach problems when they take Rybelsus, like stomach ache, feeling bloated, and having gas. These side effects usually go away after a while as your body gets used to the drug.
Wegovy can also have more serious side effects, like inflammation of the pancreas and cancer of the thyroid. But these side effects are rare and you have to compare them with the benefits of the drug.
You should not take Wegovy or Rybelsus if you or your family have had a type of thyroid cancer called medullary thyroid cancer or a genetic condition that causes tumors in different glands called multiple endocrine neoplasia type 2 (MEN-2). You should also not take these drugs if you have eye problems from diabetes or if you are on insulin, because they can make your blood sugar too low."
The price of Wegovy and Rybelsus may change based on things like insurance and where you live. As of March 2023, the average price of Wegovy is about $1,200 every month, while the average price of Rybelsus is about $950 every month. Since Wegovy has been approved by the FDA for weight loss, it may be easier to get insurance for it.
It is important to ask your insurance company if they cover either medicine, and how much you have to pay yourself. You may find cheaper options for Wegovy or Rybelsus online.
Both Rybelsus and Wegovy are good medicines for losing weight that work in a similar way but have some differences. Rybelsus is a tablet that you take once a day, while Wegovy is a shot that you take once a week. Both medicines have been proven to lower body weight in many studies, but Wegovy seems to be better at weight loss right now. However, more people had side effects from Wegovy than from Rybelsus. You should talk to your doctor to see which medicines you can get, as they both can cost a lot.
You should also know that these medicines work best when you also eat healthy and exercise. You should have a conversation with your doctor to decide what medicine suits your lifestyle.
If you want to learn more about GLP-1 medicines or see if you can get help with losing weight from medicine, check out Mochi Health, where doctors who specialize in obesity can help you with this!