Ozempic vs Wegovy: Which One Works Better for Weight Loss?

If you are struggling with chronic weight management, you may have heard of two prescription medications that can help you lose weight: Ozempic and Wegovy.

Ozempic and Wegovy belong to the class of medications called glucagon-like peptide-1 receptor agonists, or GLP-1 agonists. GLP-1 medications mimic the structure and function of your GLP-1 hormone. For background, when you eat, your pancreas releases GLP-1, a hormone. GLP-1 binds to your GLP-1 receptors, lowering your blood sugar levels and reducing your appetite. 

Since GLP-1 agonists like Ozempic and Wegovy act like your natural GLP-1, they are effective for managing diabetes and weight reduction. As a side note, GLP-1 agonists have not shown the same benefits in those individuals with type 1 diabetes.

Ozempic and Wegovy share the same active ingredient (or generic name), semaglutide. Yet they are FDA-approved for managing different medical conditions. Ozempic is currently only approved for managing type 2 diabetes. However, healthcare providers may prescribe it off-label to help with weight loss. In contrast, Wegovy is only approved for chronic weight management in combination with lifestyle modifications, but not for treating type 2 diabetes

In this article, we will discuss the similarities and differences between Ozempic and Wegovy and  help you to better understand these medications and which one may be better suited for weight management.

Understanding The Basics of These Weight Loss Drugs

Many healthcare providers are now prescribing both Ozempic and Wegovy to aid in weight loss, but only Wegovy is FDA-approved for that purpose. Let’s take a closer look at these two medications and how they might help you lose weight.

What is Ozempic?

Ozempic mimics the structure and function of your natural GLP-1 hormone, helping to lower blood sugar levels in those with type 2 diabetes by: 

• Increasing insulin secretion. GLP-1 agonists increase your pancreas’ secretion of insulin, a hormone, in response to high blood sugar levels. The higher your blood sugar levels, the more insulin your pancreas secretes.  
• Preventing the liver from releasing sugar. To help prevent your blood sugar levels from becoming too low, your liver releases sugar into your blood. When your blood sugar levels are high, such as after eating, GLP-1 agonists stop your liver from releasing extra sugar into the blood. 
• Delaying gastric emptying. GLP-1 agonists slow down the movement of food from your stomach to your intestines. This helps prevent blood sugar spikes and keeps you feeling full longer. The longer you feel full, the less likely you are to eat extra calories. 

Those taking Ozempic have shown to have better glycemic control, compared to those taking a placebo or most other medications used to manage diabetes. Over half of those taking Ozempic will lower their hemoglobin A1c (HbA1c) to less than 7%. HbA1c is the 3-month average of your blood sugar levels. The lower the number, the better controlled your blood sugar levels are. 

Besides its blood sugar-lowering benefits, Ozempic may also benefit your heart. About 24% of those taking Ozempic had a lower incidence of major heart-related events such as heart attack or stroke than those taking a placebo. 

Because weight loss is a known benefit of taking Ozempic, some healthcare providers may prescribe it “off-label” for weight loss for those without diabetes. Taking a medication “off-label” means the FDA has not reviewed clinical studies showing the medication is safe and effective for treating that particular medical condition.

Like Ozempic, other medications are prescribed off-label as weight loss aids. As an example, Mounjaro (tirzepatide) is approved for managing type 2 diabetes. However, most lose about 15% of their starting weight while taking the lowest dose, 5 mg. Higher doses of Mounjaro lead to an even greater weight loss. Based on this evidence, healthcare providers may decide to prescribe either Ozempic or Mounjaro for weight management.

What is Wegovy?

Like Ozempic, Wegovy mimics the structure and function of your GLP-1 hormone (as both share the same active ingredient, semaglutide). Thus, you can expect this medication to work the same way in your body.

The exact way that Wegovy and other GLP-1 agonists cause weight loss is still the subject of debate. As mentioned, GLP-1 agonists delay gastric emptying. Yet, that effect may only play a small role in their weight loss benefit. 

GLP-1 agonists activate a part of your brain responsible for reward and motivation reactions towards food. Instead of pleasant feelings as you eat, you may experience negative ones, thus reducing food intake and potentially cravings. As an example, if a slice of pie tastes really good, you are likely to eat more of it. But, if your brain tells you it isn’t good, you will likely stop eating it. Because of these actions, GLP-1 agonists effectively regulate your appetite, helping you lose weight. 

Besides Wegovy, there are four other medications FDA-approved for long-term weight loss. One is another GLP-1 agonist, Saxenda (liraglutide), which works the same way as Wegovy. However, Wegovy appears to be more effective at weight reduction than Saxenda.  

Weight loss medications work differently in the body, thus are also taken differently. Wegovy is a weekly injection and Saxenda is a daily injection that decrease your energy (food) intake. Xenical is an oral capsule taken three times a day that prevents your body from absorbing fat.

Regardless of how these weight loss medications work or are taken, their success depends on whether you are also making lifestyle modifications, such as diet and exercise, as well as limiting medication side effects.

What’s the Difference Between Ozempic and Wegovy?

Even though Ozempic and Wegovy share the same active ingredient and work the same way, there are some key differences.

As mentioned, these medications are FDA-approved to treat different medical conditions. Wegovy is approved for chronic weight management in adults and children over 12 who meet the body weight criteria approved by the FDA. In contrast, Ozempic is only approved for treating adults with type 2 diabetes. 

Both medications are available as a prefilled pen for weekly subcutaneous (under the skin) injections. However, there are differences in the dose preparation and injection device. In addition, the dose you take for Ozempic and Wegovy may differ.  

Ozempic dosing starts at 0.25 mg weekly and increases every four weeks based on your glycemic control and how you tolerate the medication. The maximum dose is 2 mg, but that doesn’t mean you have to be on that dose in order to see the benefits of Ozempic. For instance, some may only need a low dose, such as 0.5 mg weekly, to reach their goal glycemic level. Once met, your healthcare provider may decide to stop increasing your dose. 

On the other hand, Wegovy starts at 0.25 mg weekly and is increased every four weeks until you reach 2.4 mg weekly. This is the dose shown to achieve the best weight loss results.

Ozempic vs Wegovy: Which One is Better for Weight Loss?

We know that both medications aid weight loss, however, one medication does lead to more weight loss than the other. It is important to remember that changing your diet or physical activity levels can also affect how much weight you lose on these medications.

On average, adults taking Wegovy lose about 35 pounds or 15% of their starting weight compared to those taking a placebo. This amount of weight reduction is also higher than what is seen in those taking Ozempic.

According to the research, those taking 0.5 mg and 1 mg of semaglutide saw over an 8-pound weight loss compared to those taking a placebo. In comparison, when added to a diabetes regimen containing metformin with or without a sulfonylurea, those taking Ozempic 2 mg saw up to a 14-pound weight reduction. In that same study, those taking Ozempic 1 mg had an average 12.5-pound weight loss. It is important to note that these Ozempic studies were not looking at weight loss as their primary goal. Their primary objective was to determine how these doses affected HbA1c levels, so not all studies incorporate lifestyle changes.

Research shows that as semaglutide doses increased, so did the amount of weight reduction. Those taking semaglutide 2.4 mg saw a greater weight reduction than those taking semaglutide 1.7 mg or a placebo. So it is probably not surprising that a 2.4 mg dose of semaglutide is more effective at reducing weight compared to a 1 mg dose.

Based on this evidence, Wegovy at a dose of 2.4 mg is more effective for weight reduction when combined with lifestyle modification, compared to lower doses of Ozempic. 

Ozempic vs Wegovy: Side Effects

For both medications, gastrointestinal (GI) side effects such as diarrhea or stomach pain are common. However, nausea is by far the most common side effect with nearly half of those taking Wegovy reporting feeling nauseous. Other GI-related side effects shared by Ozempic and Wegovy include:

• Vomiting
• Constipation
• Indigestion or gastroesophageal reflux disease (GERD)
• Burping
• Gas

GI side effects are often experienced in those taking higher doses or in those with a lower body mass index (BMI). Unfortunately, GI side effects are one of the main reasons individuals stop taking either of these medications. In fact, up to 8% of those taking Wegovy stop due to GI side effects. 

Whether GI side effects contribute to weight loss, even indirectly, is debatable. Some suggest GI side effects have little to no impact on weight loss.  But if you always feel nauseous, you may choose not to eat, or to eat smaller portions.

Besides GI side effects, Ozempic and Wegovy can cause the following side effects: 

Ozempic

Wegovy

Bloating

Change in taste

Dizziness

Fatigue

Gallbladder problems (gallstones or inflammation)

Hair loss

Headache

Increased heart rate

Infections such as the flu, common cold, sinusitis, or urinary tract

Injection site reaction*

Ligament sprains 

(children only)

Viral gastroenteritis

* Injection site reaction is characterized by redness or swelling of the injection site. 

When used alone, Ozempic rarely causes hypoglycemia (low blood sugar). In contrast, hypoglycemic episodes in those with type 2 diabetes were reported in those taking Wegovy. However, when either medication is taken with other diabetes medications, such as insulin, the risk of hypoglycemic events increases.

Ozempic vs Wegovy: Cost Analysis

Unfortunately, Ozempic and Wegovy can be costly. Ozempic’s list price (the original price set by the manufacturer) is about $935 for a month's supply. Wegovy is more expensive, costing over $1,300 for a month's supply. 

Most individuals on these medications do not pay the full list price. Factors that can influence the price you pay, include the following:

• Your insurance coverage
• Your deductible and copays
• Manufacturer’s rebates or discount program
• What pharmacy you fill your prescription at

Your healthcare provider may need to complete a prior authorization before your insurance will cover the cost of these medications. If you are using Ozempic “off-label” for weight loss, your insurance company may not cover the cost of the medication at all. It is best to check with your health insurance before filling either prescription to determine your cost and if there are preferred pharmacies.

Ozempic and Wegovy offer patient savings and assistance programs to help lower the cost of your medication. For instance, those that qualify can get a month's supply of Wegovy at no charge. These savings programs may provide better cost savings than your insurance plan, so be sure to check them out even if you do have insurance coverage. 

Even with these savings programs, Wegovy and Ozempic may still cost a lot. There are other effective weight loss medications, such as Contrave that cost less. You can learn more about Contrave, including how it works and potential side effects here. 

Can You Use Ozempic and Wegovy Together?

You should not use Ozempic and Wegovy at the same time. Both medications are the same medication - semaglutide - and as such work the same way in your body. Thus, you probably won’t get any extra benefits from taking both (though high doses of semaglutide have not been studied and could be dangerous). You will, however, experience side effects such as severe nausea, vomiting, and hypoglycemia. 

Precautions: Who Should Be Cautious?

Wegovy and Ozempic carry a warning about increased incidents of diabetic retinopathy or damage to your retina. Because of this, those with diabetes may be at a higher risk of losing their vision while taking either of these medications.   

Severe GI side effects may lead to dehydration, which can impact your kidney function. Be sure to stay hydrated and tell your healthcare provider if you are experiencing severe GI symptoms. 

The medication must be discontinued at least two months before trying to conceive. This helps ensure the medication is out of your body before you become pregnant. Contact your healthcare provider if you become pregnant while taking either Ozempic or Wegovy. 

There is limited data on whether it is safe to breastfeed while taking either medication.The decision to breastfeed should consider the risk of infant exposure to Ozempic/Wegovy versus the benefits of treatment to the breastfeeding mother or lactating parent. I is best to work with your healthcare provider to fully understand the risks and benefits of taking these medications while breastfeeding. 

Those taking a GLP-1 agonist may be at risk for developing pancreatitis or medullary thyroid carcinoma, a type of thyroid cancer. You should avoid taking Ozempic or Wegovy if you have a family history of either of these medical conditions or a condition called multiple endocrine neoplasia syndrome type 2.  

Final Thoughts and Medical Disclaimer

Wegovy and Ozempic can help individuals achieve their weight loss goals, especially when combined with lifestyle modifications such as diet and exercise. These medications contain the same active ingredient, semaglutide, and work the same way in the body. But, at higher doses, Wegovy has been proven to be more effective for weight loss compared to Ozempic. 

Both medications can cause GI-related side effects, with nausea being the most common. Those taking Wegovy may have more GI-related side effects than Ozempic, due to the higher dose. These side effects should improve as you continue to take them.

It is important to remember that taking either Wegovy or Ozempic is not a quick fix for weight loss. The medications can take up to four weeks for you to start seeing the benefits. You will also need to adjust your diet and physical activity to achieve the best results and stay on them for the long term to maintain your weight loss. 

When choosing a weight loss medication, it’s important to work closely with your healthcare provider. There are options, and some may be a better fit for you than others based on their cost or other medical conditions you may have. 

If you want to learn more about these medications and determine whether you could benefit from taking them, set up an appointment with one of our obesity experts today. 

Disclaimer:

Here at Anthology Health, we strive to provide accurate and up-to-date information. But medical knowledge and guidelines are constantly changing. This article is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. 

Everyone responds to medications differently so you might not have the same weight loss results or side effects described above. You mustn’t start, stop, or change any of your medication regimens without consulting with your healthcare provider.