The Ultimate Guide: Diabetes Drug for Weight Loss

More than 40% of adults in the United States have obesity and it is only expected to increase over the next decade. Obesity puts you at a  higher risk for a host of medical conditions, including  heart disease, high blood pressure, stroke, sleep apnea, and type 2 diabetes.³ Moreover, nearly 80% of people with type 2 diabetes have either overweight or have obesity,³ thus losing weight is recommended to help prevent or delay type 2 diabetes if you are at risk.³

Semaglutide is FDA-approved for both type 2 diabetes and weight loss. Tirzepatide is FDA- approved for type 2 diabetes and is expected to be approved for weight loss by the end of 2023.

FDA-Approved Semaglutide: Marketed for Type 2 Diabetes or Weight Loss

Semaglutide is the active ingredient of Ozempic, Wegovy, and Rybelsus. Sometimes, when a medication is approved  for treating different diseases, comes in different dosing forms, or is produced by more than one drug company, it may be approved under different brand names. This is the case with semaglutide. 

Studies have shown benefit for both type 2 diabetes and weight management with semaglutide, which has led to its FDA-approval as a treatment for both type 2 diabetes and chronic weight management. 

What is Semaglutide?

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. This class of medication works by imitating the GLP-1 hormone.⁵ The GLP-1 hormone is a hormone produced naturally in the digestive tract of our bodies when we eat.⁵ This hormone signals the body to make more insulin to help lower and control blood sugar levels and type 2 diabetes.⁵ It can also help you feel fuller faster and fuller for longer, which often results in decreased appetite, decreased portion sizes, and weight loss.⁵  This is why semaglutide is effective for both type 2 diabetes and weight loss.

Three FDA-approved Semaglutide Drugs

Each of the FDA-approved semaglutide products are manufactured by Novo Nordisk. The approved products all contain the same active ingredient.

Clinical trials have reflected the proven benefit of semaglutide for both blood sugar lowering and weight loss.  At this time, Wegovy is the only brand name formulation of semaglutide that has been FDA-approved for weight loss. This section will outline the three approved formulations of semaglutide.

• Rybelsus Tablets: Rybelsus is FDA-approved to improve blood sugar control in adults with type 2 diabetes mellitus in combination with diet and exercise. It is the first and only oral GLP-1 receptor agonist approved for the treatment of type 2 diabetes and is taken once daily.
• Ozempic Injection: Ozempic is FDA-approved to improve blood sugar control in adults with type 2 diabetes mellitus in combination with diet and exercise. There is also an added benefit for patients with type 2 diabetes and heart disease as it is also indicated for reducing the risk of major cardiovascular events such as heart attack and stroke. It is an injectable medication that you can inject yourself from home once weekly.
• Wegovy Injection: Wegovy is approved for chronic weight management and is therefore different from Rybelsus and Ozempic in that it is not approved for blood sugar control in type 2 diabetes. You can take Wegovy if you have type 2 diabetes, but it is not approved for treatment of the condition. It is a once-weekly self-administered injection like Ozempic, but it has a higher maximum dose of 2.4 mg. Ozempic’s maximum dose is 2 mg.  

Wegovy is FDA-approved for chronic weight management in adult patients who meet specific body mass index (BMI) criteria:

• Initial BMI of ≥ 30 kg/m² (obese) or
• Initial BMI of ≥ 27 kg/m² (overweight) AND at least one other weight-related condition such as high blood pressure, type 2 diabetes mellitus, or high cholesterol

Wegovy vs Ozempic injections for weight loss

Ozempic is not FDA-approved for weight loss, but some healthcare providers may use it off-label for this purpose.

The maximum dose of Ozempic is 2 mg weekly.. The maximum dose of Wegovy is 2.4 mg weekly. Ozempic is not available in a 2.4 mg dose.

In a clinical trial, semaglutide 1 mg was compared to semaglutide 2.4 mg. In the study, the 2.4 mg dose of semaglutide resulted in 3.6% more weight loss than the 1 mg dose.

Side effects among Wegovy and Ozempic are similar. The most common side effects include nausea, vomiting, diarrhea, constipation, stomach pain, and indigestion. Low blood sugar may also occur in patients with type 2 diabetes. Because Wegovy is available at higher doses, side effects may be more prevalent.

Both Wegovy and Ozempic come as a weekly injection and both may cause weight loss. The amount of time it may take for you to lose weight on each medication may vary from person to person and is dependent on multiple factors. Consult with your healthcare provider if you are considering using weight loss medications.

Mounjaro May Be FDA-approved For Weight Loss This Year (2023)

Tirzepatide (Mounjaro) is a glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 dual receptor agonist that is currently FDA-approved for the treatment of type 2 diabetes in combination with diet and exercise. Eli Lilly, the drug’s manufacturer, recently announced that the clinical trials for this drug revealed significant weight loss results. At 72 weeks, the average weight loss was 20.9% on the maximum dose of the medication. The company plans to submit for FDA-approval for weight loss, and it is possible that approval may be granted in 2023. 

Some healthcare providers are already prescribing the medication off-label as a weight loss medication. 

Which is Better For Weight Loss: Ozempic or Mounjaro?

Both Ozempic and Mounjaro are effective at helping with weight loss. Based on clinical trial data, Mounjaro resulted in more weight loss for study participants. It is important that you discuss these medications with your healthcare provider before deciding which option may be best for you.

Common Side Effects: Ozempic vs Mounjaro

Side effects among the two drugs are comparable with the most common side effects of nausea, vomiting, diarrhea, stomach pain, indigestion and constipation.

Both medications have a warning for the risk of thyroid tumors and pancreatitis. Patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 should not take either medication.

Conclusion

Weight loss can be obtained through lifestyle changes and weight loss medications. There are diabetes medications that can help with weight loss when combined with diet and exercise. Researchers continue to evaluate new treatment options for obesity.

The currently available diabetes medications for weight loss are safe and have shown great benefit in patients with obesity. If you are having trouble losing weight or maintaining weight loss on your own, be proactive and speak with your healthcare provider to determine if weight loss medications may be right for you. Click here to learn more and explore medication options.