Written by Kyle Ustach | BScEcon
Fact checked by Andrew Lenau ISSA CPT & Sports Nutritionist
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Finding the perfect fat burner can be as challenging as losing the fat. One weight loss medication that has recently become popular is semaglutide, the active compound in Ozempic, Rybelsus, and Wegovy.
Naturally, that means the two most popular weight-loss types, Rybelsus and Ozempic, are often compared to one another. For one, Ozempic is a once-weekly subcutaneous injection, while Rybelsus is a daily oral tablet. While a tablet may sound much more convenient than injections, that doesn't necessarily translate to better results.
Both benefit from semaglutide's ability to manage blood sugar and decrease appetite. But which is better for you? In this article, we will teach you about both weight loss medications and determine which takes the crown.
Table of Contents
- What Is Ozempic?
- What Is Rybelsus?
- Ozempic vs Rybelsus: What's The Difference?
- Is Ozempic Or Rybelsus Better For Weight Loss?
- FAQs
- Rybelsus vs Ozempic: Key Takeaways
What Is Ozempic?
Ozempic, the most well-known and popular form of semaglutide, was developed in 2012 by Danish-based pharmaceutical company Novo Nordisk. It was created to turn semaglutide, a longer-acting version of the commonly used liraglutide, into a once-weekly treatment for diabetes.
Semaglutide belongs to a group of compounds called glucagon-like peptide-1 (GLP-1) receptor agonists, which helps control blood sugar by lowering blood glucose. During development, Novo Nordisk ran clinical trials from January 2016 to May 2017 that discovered not only can it treat diabetes, but it has remarkable weight loss properties. Although this prompted further research, it initially only received FDA approval for type 2 diabetes treatment in December 2017.
After more successful trials, Ozempic was approved in June 2021 for chronic weight management in adults with a BMI of at least 27. The newly approved version featured a higher dose to enhance the weight loss benefits.
What Is Rybelsus?
Rybelsus, another type of medication made of semaglutide, is very similar to Ozempic. It's even manufactured by the same Danish pharmaceutical company Novo Nordisk.
Although Ozempic was an immediate success for Novo Nordisk, the main complaint and deterrent was that it was only available via injection. This led to the creation of Rybelsus, an oral tablet version of Ozempic. Approved by the FDA in September 2019 specifically for type 2 diabetes treatment, Rybelsus became the first GLP-1 receptor agonist available in oral form.
Its sole approval as a diabetes medication is in contrast to Ozempic, which is also approved for weight loss management.¹
Ozempic vs Rybelsus: What's The Difference?
Rybelsus and Ozempic are extremely similar in that they have the same active ingredient, both help manage blood sugar levels by insulin secretion and are used for weight reduction, but there are a few key differences.
1) Mechanism Of Action
Rybelsus and Ozempic are semaglutide products, so their mechanism of action is essentially the same.
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist because they mimic the GLP-1 hormone. GLP-1, a naturally occurring hormone released by the intestines as a response to eating, is vital in blood sugar control. Semaglutide stimulates insulin secretion in the body, reducing the hormone glucagon that increases blood sugar levels, and, in higher doses, triggering the brain to decrease appetite and promote satiety. This combination of better blood sugar regulation and a reduced calorie diet is the perfect recipe for weight loss.
They also slow down the rate at which food leaves the stomach, leading to a more gradual absorption of nutrients, better blood sugar management, and a more prolonged feeling of satiety—the major difference between the two lies in the administration.
2) Dosing And Administration
Ozempic was created first as a once-weekly injectable medication that should be administered simultaneously and on the same day each week, with or without food. Ideally, the subcutaneous injection site rotates between the upper arm, the stomach, or the thigh to limit the damage.
Despite the instant success, Novo Nordisk knew they were limiting their reach by only offering injections. This led to the creation of Rybelsus, an oral Ozempic, which is a much easier alternative for many.
Rybelsus should be taken at the same time every day, first thing in the morning, with water at least 30-60 minutes before the day's first meal. Rybelsus comes in three doses in tablet form: 3 mg, 7 mg, and 14 mg. People typically start with the 3mg tablet for the first month before moving to 7 mg.
In contrast, Ozempic injections come in doses of 0.25 mg, 0.5 mg, 1.0 mg, and 2.0 mg per week, with 2 mg being the maximum dose. The typical starting dose is 0.25 mg for the first four weeks, followed by 0.5 mg for at least four weeks. The 1.0 mg weekly dose of Ozempic produces similar weight loss results as 7-14 mg of Rybelsus, but it should be noted that only Ozempic is actually FDA-approved for weight loss.
3) Effectiveness
To compare the efficacy of semaglutide in oral form to injection (Rybelsus vs. Ozempic), Novo Nordisk did a series of trials testing the different routes of administration.
The PIONEER trials (Peptide Innovation for Early Diabetes Treatment) tested both Ozempic and Rybelsus, while the SUSTAIN (Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes) tested only Ozempic.
In patients with type 2 diabetes being treated with diet and exercise, 1.0 mg of subcutaneous semaglutide (Ozempic) reduced body weight by an average of 4.5 kg (9.9 lbs) compared to 3.7 kg (8.1 lbs) in patients with 14 mg of oral semaglutide (Rybelsus).² While both medicines are very effective at losing weight, the average weight loss with Ozempic is greater than with Rybelsus.
In addition to body weight, the trials also tested the effectiveness of treating type 2 diabetes. Semaglutide causes reductions in the amount of blood sugar attached to hemoglobin, measured in glycated hemoglobin (HbA1c).
The SUSTAIN program reduced HbA1c by an average of 1.5-1.8% after 30-56 weeks of weekly 1.0 mg subcutaneous injection (Ozempic). The PIONEER trials showed HbA1c drop by 1.0-1.4% after 26 weeks of 14 mg of once-daily oral semaglutide (Rybelsus). That is the maximum dosage of Rybelsus, whereas Ozempic was considered a moderate dose.
Regarding hitting their glycemic targets, 1.0 mg of Ozempic had 66-80% success, whereas 14 mg of Rybelsus had 55-77% success. These trials show that subcutaneous injection of semaglutide in Ozempic is slightly more effective at both weight loss maintenance and blood sugar management.
More recent studies suggest that a higher dosage of oral semaglutide can produce results similar to or possibly better than subcutaneous injections. This has led to the development of higher-dosed oral Ozempic, which has shown great success at the 50 mg dose in trials, a breakthrough for the future of medicine.
4) Side Effects
Like nearly any supplement, substance, or drug, the more you take something, the greater the chance of side effects. With semaglutide, users report increased side effects as the dosage increases. Trials compared the side effects of both Rybelsus and Ozempic to placebo after 30 weeks.
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Nausea
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11.4-20% in subcutaneous Ozempic
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5.1-23.2% in oral Rybelsus
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Diarrhea
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4.5-11.3% in Ozempic
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5.1-15% in Rybelsus
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Vomiting
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4-11.5% in Ozempic
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2.9-9.9% in Rybelsus
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Another trial examined the side effects of 20 mg oral (Rybelsus) to 1 mg subcutaneous (Ozempic). The side effects were very similar.
- Gastrointestinal Disturbances: 56% oral to 54% subcutaneous
- Nausea: 34% oral to 32% subcutaneous
- Diarrhea: 20% oral to 14% subcutaneous
- Vomiting: 16% oral to 9% subcutaneous
These statistics show that while side effects are very similar, there are slightly fewer occurrences with subcutaneous Ozempic.³ It is best to start with a low dosage and slowly increase as needed to avoid unwanted side effects or too low blood sugar.
It's important to note that side effects depend on a person's medical history, and you should speak with a healthcare provider before starting any prescription medications to avoid adverse drug interactions. Finally, semaglutide has been shown to cause thyroid tumors or types of thyroid cancer in animal studies, but it's not known if that risk carries over to humans. Regardless, contact a doctor immediately if you experience any severe side effects.
If you are interested in taking a fat-burning supplement but prefer to start with something more natural, check out our article: Are Fat Burners Safe?
5) Cost
The cost of medicine will depend heavily on what country you are in and what kind of insurance plan you have. Without insurance, the medicine is quite pricey.
As of May 2023, the Ozempic list price is $892.06 for a 28-day supply of all dosages, while taking Rybelsus is $851.60 for a 30-day supply. These are significantly more expensive than your average store-bought fat burner, but they are powerful medicines.
If you don't want to spend upwards of $800 a mont on Ozempic or Rybelsus, you can see if you qualify for at-home semaglutide treatment via our partner Fountain GLP which offers patients semaglutide for an avergae cost of $80 a week! For more information about this amazing offer click the "Take Quiz" button below.
You can dig into this more in our article: How Much Is Semaglutide Without Insurance?
For those with insurance, copay savings cards drop the price significantly down to roughly $25 for Ozempic and $10 for Rybelsus. While other GLP-1 receptor agonists are available, none have as much success as semaglutide, and they are similarly priced.
Is Ozempic Or Rybelsus Better For Weight Loss?
Based on the results of the PIONEER and SUSTAIN trials and other studies, Ozempic is better for weight loss and treating type 2 diabetes. The initial trials showed that the average weight loss on Ozempic was 9.9 lbs, while Rybelsus had an average loss of 8.1 lbs. Testimonials across Reddit and other forums tend to agree that Ozempic is the better option.
The r/Pharmacy sub-Reddit, a thread titled "Rybelsus vs. Ozempic? Is Rybelsus less effective or just less hyped?" features real-life testimonials. A consensus in this and other forums is that Ozempic is more effective, primarily due to the route of administration. Rybelsus requires a specific daily routine that several people find tedious and likely causes a worse bioavailability.
To learn more about both forms of semaglutide for weight loss, check out our article: How Much Weight Can You Lose On Semaglutide?
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These types of posts are very common, as most people agree with the trials and data that Ozempic is better than Rybelsus for weight loss.
If you're hesitant to dive into potent prescription medicines or prefer something more readily available, check out our article on the 8 Best Supplements For Weight Loss.
FAQs
These are some of the most common questions about Ozempic vs. Rybelsus weight loss.
Can you take Rybelsus if you are not diabetic?
Technically Rybelsus is not approved by the FDA to be prescribed if you don't have diabetes, but you can certainly take it safely regardless.
Can you take Ozempic and Rybelsus together?
No! Rybelsus and Ozempic both contain the active ingredient semaglutide. They are the same compound, so you should take Rybelsus or Ozempic, not both. active ingredient semaglutide.
Is semaglutide the same as Ozempic?
Yes, Ozempic is a brand-name version of semaglutide. Semaglutide is the active ingredient found in Ozempic.
Is Rybelsus more effective than Ozempic?
No, while the results are similar, Ozempic is slightly more effective.
Can you switch from Ozempic to Rybelsus?
Yes, you can switch from Ozempic to Rybelsus, or vice versa, depending on your preference or which works better.
Is Ozempic cheaper than Rybelsus?
No, Ozempic is more expensive than Rybelsus.
How long can you stay on Ozempic?
Studies have shown that you can stay on Ozempic safely for up to 68 weeks. There is a need for studies beyond 68 weeks.
Do you gain weight back after stopping Ozempic?
Although you will not continue to lose weight at the same rate, you may not necessarily regain the weight that was lost. This is where lifestyle choices, diet, and exercise play a significant role in maintaining the results.
Rybelsus vs Ozempic: Key Takeways
Finding the perfect solution to weight loss may be impossible, but semaglutide has proved remarkable for thousands of patients. As the active ingredient in all three brand-name medications, its insulin stimulation creates a powerful appetite management tool to control blood sugar levels and maximize weight loss efforts.
Based on the trials and human testimonials, it appears that Ozempic is slightly better than Rybelsus for weight loss, type 2 diabetes treatment, and limiting side effects. Several users attribute the differences to the route of administration, as Ozempic is a once-weekly injection while Rybelsus requires a more strict routine.
While a tablet may sound more convenient than an injection, it requires a specific schedule first thing in the morning with a sip of water and no food for at least 30 minutes. Luckily, a higher-dose pill version of Ozempic is in development, as higher doses of semaglutide are required to maximize weight loss.
Regardless of which you choose, you can maximize your weight loss by following a healthy diet, exercising consistently, and living a healthy lifestyle.
Interested in learning about additional weight loss medications? Head to our article that compares Liraglutide vs Semaglutide: Uses, Differences, & Results, or check out our article comparing Ozempic vs Wegovy.
References
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Henderson, Laura. “The History of Rybelsus | Semaglutide Tablets.” MyBMI, 23 Jan. 2023, my-bmi.co.uk/medical-therapy/history-of-rybelsus/.
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Meier, Juris J. “Efficacy of Semaglutide in a Subcutaneous and an Oral Formulation.” Frontiers in Endocrinology, vol. 12, 25 June 2021, https://doi.org/10.3389/fendo.2021.645617.
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Smits, Mark M., and Daniël H. Van Raalte. “Safety of Semaglutide.” Frontiers in Endocrinology, vol. 12, 7 July 2021, https://doi.org/10.3389/fendo.2021.645563.
Kyle Ustach
Author