Are there Ozempic alternatives for weight loss?

Key Points

• There are several Ozempic alternatives for weight loss.
• There are other semaglutide weight loss drugs, while others utilize different active ingredients like liraglutide or tirzepatide.
• All of these drugs come with their own risks and side effects. They also range in efficacy when it comes to weight loss and other factors, like improving A1C levels.

Ozempic has transformed the world of weight loss and diabetes treatment. But the medication, made with semaglutide, isn’t the only weight loss drug out there. In fact, if you are explicitly looking for a weight loss medication, you are likely to be prescribed something other than Ozempic since it is primarily prescribed as a diabetes medication.

What are Ozempic alternatives for weight loss? Do they all use semaglutide? Are they still effective? Are they safe? We’re going to discuss all this and more.

Semaglutide weight loss medications

Two of the best-known weight loss drugs, Ozempic and Wegovy, use semaglutide as their active ingredient. Semaglutide is a GLP-1 agonist, which mimics the hormone GLP-1 in the body to manage blood sugar levels. This helps manage type 2 diabetes and also leads to weight loss. It has also been found to reduce the risk of heart attacks and strokes in overweight or obese people.

Semaglutide weight loss drugs include:

• Ozempic is indicated to treat type 2 diabetes and heart disease in people with type 2 diabetes and preexisting heart conditions like heart attack or stroke. Ozempic is prescribed off-label as a weight loss drug.
• Wegovy is approved for weight loss and to lower heart disease in adults who are obese or overweight with known heart conditions.
• Rybelsus is prescribed to lower blood sugar levels in adults with type 2 diabetes. It is not formally approved for weight loss. It is one of the only semaglutide medications in pill form.

Both Ozempic and Wegovy are administered via weekly injection.

Ozempic users have lowered their A1C levels below 7% in studies (the recommended amount) and, in a clinical trial with people with obesity, nearly half the participants lost 15% of their body weight and a third lost 20%.

Tirzepatide weight loss drugs

Mounjaro and Zepbound, produced by Eli Lilly, contain a different GLP-1 receptor agonist chemical, tirzepatide. Both Mounjaro and Zepbound are once-weekly injections.

Apart from working the GLP-1 pathway like semaglutide, Mounjaro and Zepbound also activate a different pathway called GIP (glucose-dependent insulinotropic polypeptide). This leads to impacts on food intake, appetite, and metabolic function.

• Mounjaro is indicated for adults with type 2 diabetes.
• Zepbound is approved for weight loss for adults with a BMI greater than 30 or people with a BMI 27 or higher who also have co-existing type 2 diabetes or heart conditions like high cholesterol.

By activating both GLP-1 and GIP receptors, tirzepatide has been shown to:

• Stimulate insulin production
• Improve insulin sensitivity
• Regulate blood sugar levels

A 2021 trial showed that 92% of people with type 2 diabetes on tirzepatide lowered their HbA1c levels to less than 7% (compared to 19% for those on placebo).

And in a 72-week 2022 clinical trial, participants lost over 20% of their body weight, a substantial amount. Their heart health also improved, as did their blood pressure.

Tirzepatide has been shown to lead to greater weight loss at the 3, 6, and 12-month markers than semaglutide.

Liraglutide for weight loss

Liraglutide is another GLP-1 agonist medication ingredient. It is the active ingredient in Saxenda and Victoza. It is prescribed explicitly as a weight loss medication, alongside diet and exercise. Liraglutide is administered via injection.

• Saxenda is US FDA-approved for chronic weight loss management in adults as well as children aged 12 and older.
• Victoza has lower amounts of liraglutide compared to Saxenda and is indicated for the treatment of type 2 diabetes in adults and children aged 10 and over.

In a study of over 3,000 people, 85% lost weight on Saxenda. One out of three people lost over 10% of their body weight, and three out of five lost 5% or more. Liraglutide has also been shown to have cardiovascular benefits.

What to expect when taking weight loss medication like Ozempic

GLP-1 and Ozempic alternatives for weight loss may seem like the “magic pill” people wish they could take to lose weight without too much difficulty. And it’s undeniable how rapidly they have changed the world of weight loss, and much of the initial research is truly promising.

However, these weight loss medications aren’t without their drawbacks. First and foremost, every study showing their effectiveness included a change in diet and exercise. You cannot take a medication like Ozempic and expect to lose weight with no other changes.

GLP-1 agonists delay gastric emptying. This means it takes food longer to move through your digestive system, often leading to feeling full sooner and for longer. Drugs like Ozempic also act on the brain, signaling a sense of fullness, thereby reducing appetite and overall intake.

It is this reduced food intake that, alongside exercise and healthy habits, leads to weight loss with Ozempic and other weight loss drugs.

While many people find eating less easier with drugs like Ozempic due to how it influences the brain and reduces the amount of “food noise” in your mind, unhealthy habits don’t disappear once you start taking the medication. You will have to eat well and focus on a healthy lifestyle in order to lose a meaningful amount of weight – as well as keep it off once you stop taking the medication.

The best way to tackle weight loss with medication is to work with a registered dietitian. An RD can design a custom weight loss plan that works with your medication to yield long-lasting results.

Find a qualified weight loss dietitian now with Fay.

Side effects of weight loss medications

Many GLP-1 receptor agonist drugs include gastrointestinal issues like constipation, nausea, diarrhea, abdominal pain, and more. For many people, these issues fade as you adjust to the medication.

Your dose may change over time depending on how you react. You may start on the lowest dose and increase with time if you can tolerate the medication well and your rate of weight loss.

Due to this, some people experience side effects like nausea and vomiting as they increase their doses.

Depending on the person, the side effects can be difficult to manage and, in some cases, quite severe. Not everyone can tolerate GLP-1 agonists well. Discuss any and all side effects with your doctor to determine if the medication is right for you.

Risks of GLP-1 medications

There is some concern around GLP-1 agonist medications and how they might affect pancreatic and thyroid tissue. Current research does not indicate a causal relationship between the two, but more evidence is needed.

It is not yet clear whether it is safe to take medications like Ozempic while pregnant. Talk to your doctor if you plan to become pregnant within the first year of using GLP-1 medication.

If you struggle with binge eating, medication like Ozempic isn’t necessarily the cure. While it may quiet the food noise in your head and help reduce your intake, it is still possible to binge on Ozempic. If you are looking to lose weight but think you may have BED or are already diagnosed, discuss your options with your healthcare provider.

You may hit a weight plateau or even experience weight gain on the drugs. If your weight loss stalls for more than 6-8 weeks, talk to your healthcare provider and dietitian to determine the best path forward.

Finally, when you stop taking the medication, you may experience weight gain.

A trial of nearly 2,000 people published in 2022 by Novo Nordisk indicated that one year after stopping doses of semaglutide, trial subjects had regained two-thirds of the weight they had lost. This is likely because their hunger levels returned to what they were before taking the medication and they returned to their prior eating habits.

Achieve sustainable weight loss with Ozempic alternatives

If you’re looking to make a lasting change with weight loss, whether you use a weight loss medication or not, working with a registered dietitian is one of the best ways to succeed in the long term.

When you work with a board-certified dietitian with Fay, you get top-quality nutrition care for a fraction of the cost. Fay works directly with health insurance and gets your care covered, meaning you could pay as little as $0 per session.

Your dietitian can help not just with a meal plan, but with the psychology behind eating habits too, helping you build healthy habits for life.

Get started with a weight loss dietitian now with Fay.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.