Januvia® and weight loss: What you need to know

Januvia® is a medication that is typically prescribed to help people with type 2 diabetes manage blood sugar. While you may have heard about Januvia® being used for off-label weight loss, like Ozempic® or Mounjaro®, it really isn’t very effective for it. 

While it’s helpful for blood sugar control, people usually don’t lose much weight, if any, while taking it. Research consistently shows that Januvia is considered weight-neutral, meaning it generally helps people maintain their weight rather than lose it.

That distinction matters, especially for people comparing different diabetes or weight-loss medications. To understand why Januvia doesn’t lead to meaningful weight loss, it helps to look at how it works in the body, who it’s designed for, and how its results stack up against more effective options like GLP-1 medications.

What is Januvia®?

Januvia® is a prescription pill used to help people with type 2 diabetes keep their blood sugar under control. It’s a DPP-4 (dipeptidyl peptidase-4) inhibitor, meaning it blocks the enzyme DPP-4, which normally breaks down the body’s GLP-1 and GIP hormones. These hormones are released after a meal to help regulate blood sugar and signal fullness by telling the pancreas to release more insulin and the liver to make less sugar.

By inhibiting the DPP-4 enzyme, Januvia allows GLP-1 and GIP to stay active longer, helping to keep blood sugar steadier throughout the day.

While these are the same hormones targeted by GLP-1 medications like Ozempic®/Wegovy® and Mounjaro®/Zepbound®, the way Januvia works is very different. GLP-1 drugs directly mimic the hormones, creating a much stronger effect that often leads to weight loss. Januvia simply helps your body’s own hormones last longer, improving blood sugar control but typically not causing meaningful weight changes.

How is Januvia® taken?

Januvia is taken once a day by mouth, which makes it convenient. It comes in three strengths: 25 mg, 50 mg, and 100 mg. You can take it with or without food, but it’s best to take it at the same time every day to keep blood sugar stable.

Does Januvia® help with weight loss?

Studies show that Januvia is “weight-neutral.” In a 26-week clinical trial, people taking it lost an average of 1% of their body weight—about 2 pounds for someone weighing 200 pounds. That small drop is most likely from better blood sugar control, not because the drug itself burns fat.

By comparison, medications designed for weight loss tell a very different story. Wegovy® has been shown to help people lose an average of 15% of their body weight. People taking Zepbound® see and average of 21% of body weight lost. It’s easy to see why doctors don’t consider Januvia a weight-loss treatment.

Why would someone consider Januvia® for weight loss?

The main reason is that Januvia® indirectly acts on some of the same hormones as GLP-1 drugs. But the effect is far weaker. The second reason is that it’s a pill, which can feel less intimidating than an injection.

Those factors make it understandable why people might be curious. But the reality is that Januvia isn’t that effective for weight loss. Plus, insurance won’t cover it for that purpose, and paying out-of-pocket can cost over a thousand dollars a month. 

Januvia®: Side effects and safety

Like any prescription medication, Januvia® can cause side effects ranging from mild to serious, though most people tolerate it well.

Common side effects are usually mild and temporary, such as headaches, runny or stuffy nose, sore throat, cough, nausea, or diarrhea.

More serious but less common side effects include pancreatitis, allergic reactions, kidney problems, severe joint pain, and heart failure. Low blood sugar can also occur, especially if Januvia is combined with insulin or sulfonylureas.

Your doctor will go over all the side effects with you in more detail if you are prescribed Januiva®.

Januvia® vs. other medications: Weight loss potential

If you look at Januvia® compared to other medications, you can see that it isn’t the right option if weight loss is the main goal. Here’s what you can expect in terms of weight loss:

Medication	Average weight loss	Study duration
Januvia® (sitagliptin)	1%	26 weeks
Zepbound® (tirzepatide)	21%	72 weeks
Wegovy® (semaglutide)	15%	68 weeks
Qsymia® (phentermine/topiramate ER)	10%	56 weeks
Xenical® (orlistat)	8.5%	52 weeks
Saxenda® (liraglutide)	5%	52 weeks
Metformin	5%	26 weeks

Januvia®: Price, accessibility, and brand

Januvia® isn’t designed for weight loss, and it can also be expensive. Without insurance, the average retail price runs about $994 to $1,664 per month on GoodRx.

Coverage depends on your insurance, and again, coverage is very unlikely for weight loss:

• Private insurance usually covers Januvia®, but only for type 2 diabetes, not weight loss.
  
• Medicare (Part D) and Medicaid also cover it for diabetes, but not for weight management.
  
• Manufacturer savings are available for some people with private insurance (Merck savings card), but don’t apply to Medicare or Medicaid.
  

A true generic version of Januvia® isn’t widely available in U.S. pharmacies yet. However, Zituvio, an authorized generic version of sitagliptin, the active ingredient in Januvia, has received FDA approval and is expected to become more available gradually. This authorized generic contains the same active ingredient and dosage strength as Januvia but is sold under a non-branded label, which could help lower costs once distribution expands.

The bottom line: Januvia® doesn’t typically help people lose weight

When it comes to weight management, Januvia® probably isn’t the right medication. While it’s effective for controlling blood sugar in people with type 2 diabetes, most people won’t lose a meaningful amount of weight while taking it. Januvia® does act on the same hormones as GLP-1 drugs like Wegovy® or Zepbound®, but it does so in a much weaker, indirect way that doesn’t lead to the same weight-loss benefits. 

If you’re thinking about weight loss medication, see if you qualify for Noom Med. You’ll be matched with a clinician who can evaluate your health, discuss your goals, help find a prescription that fits, and prescribe it if needed. Plus, your team will help design a weight loss plan that works for you.

Note: Januvia®, Ozempic®, and Mounjaro® are not FDA-approved to treat obesity or for weight loss.