Semaglutide vs. Ozempic® for weight loss: Which one works best in 2025?

What you’ll learn:

• Semaglutide is the active ingredient in Ozempic^®, Wegovy^®, and Rybelsus^®, the brand names for GLP-1 medications made by Novo Nordisk. 
• Ozempic is FDA-approved to treat type 2 diabetes, but it is often prescribed off-label for weight loss.
• You can also find semaglutide in a compounded form, which can be made by special compounded pharmacies for specific reasons, like shortages or personalized dosing.
• There are no generic forms of semaglutide. 

If you’ve been looking into weight-loss medications, you’ve likely come across semaglutide and Ozempic^®—but what’s the difference? Put simply, semaglutide is the active ingredient, while Ozempic^® is the brand name of a medication that contains it. Ozempic^® is FDA-approved to treat type 2 diabetes, but because semaglutide has been shown to promote significant weight loss, it’s often prescribed off-label for weight management.

To add to the confusion, Wegovy^®, another semaglutide medication, is FDA-approved for weight loss. Despite this, many people still use Ozempic^® for that purpose. Which option is best for weight loss? Should you ask your doctor about Ozempic^®, Wegovy^®, or something else?

The cost will likely be a major factor in your decision. Without insurance, Ozempic^® costs around $1,000 per month, while Wegovy^® is even more expensive. 

To help you navigate your choices, let’s break down how these options compare in 2025, including effectiveness, cost, and accessibility. We’ll also go through alternative medications that might work for you. 

Semaglutide vs. Ozempic^®: How do they work?

Semaglutide is a GLP-1 receptor agonist, meaning it mimics a hormone called glucagon-like peptide-1 (that’s where the GLP-1 comes from). It helps lower appetite, slow digestion, and regulate blood sugar levels.

Once injected (or taken as a pill), semaglutide binds to GLP-1 receptors in your stomach, intestines, pancreas, and brain, signaling your body that you’re not hungry. This lowers your appetite and slows down digestion, leading to food staying in your stomach longer, which helps you feel fuller for longer. It also helps stabilize blood sugar levels, which can prevent energy crashes and hunger spikes. These combined effects make semaglutide an effective tool for weight loss and metabolic health. 

At the end of the day, all semaglutide-based medications work the same way; they just differ in dosage and how you take them. Which one is right for you depends on your health goals and dosage needs.

Semaglutide vs. Ozempic^®: What are the differences?

While Ozempic^®, Wegovy^®, and Rybelsus^® all contain semaglutide, they have key differences in formulation, dosage, and approved uses.

Here’s a breakdown of how they compare:

Medication	How it’s taken	Doses	Approved uses	Cost per month (without insurance)	Insurance coverage
Ozempic®	Once-weekly injection with a pre-loaded injection pen	0.25 mg 0.5 mg 1 mg 2.0 mg	Type 2 diabetes (off-label for weight loss)	$998	Insurance may cover diabetes, but rarely for weight loss. Learn more about the cost of Ozempic.
Wegovy®	Once-weekly injection with a pre-loaded injection pen	0.25 mg 0.5 mg 1 mg 1.7 mg  2.4 mg	Weight loss and to prevent cardiac events	$1,350	Insurance rarely covers Wegovy for weight loss. Learn more about the cost of Wegovy.
Rybelsus®	Daily pill	3 mg 7 mg 14 mg	Type 2 diabetes (off-label for weight loss)	$998	Insurance may cover diabetes, but rarely for weight loss. Learn more about the cost of Rybelsus.

Semaglutide-based medications: What are the similarities?

Semaglutide-based medications share several similarities, from how they work in the body to their effectiveness for weight loss. Here’s what they have in common:

• Active ingredients: Ozempic^®, Wegovy^®, and Rybelsus^® all contain semaglutide as their active ingredient, meaning they work the same way in the body to reduce appetite,  slow digestion, and regulate blood sugar. 
• Who can take them: Ozempic^®, Wegovy^®, and Rybelsus^® can all be prescribed for weight loss to people who meet certain BMI thresholds, though Ozempic^® and Rybelsus^® will be off-label prescriptions. Some people shouldn’t take GLP-1 medications; we’ll go through that below.
• Similar side effects: Nausea, vomiting, diarrhea, constipation, and fatigue are common for all semaglutide drugs, especially in the early weeks of treatment. They also come with similar risks for more serious side effects, which we’ll discuss later.
• Highly effective: One of the biggest advantages of these medications is how effective they can be for weight loss, especially when combined with a balanced diet and regular exercise. Studies have shown that people were able to lose up to 15% of their body weight on 2.4 mg of semaglutide after 68 weeks.

Can you switch between Ozempic^® and other forms of semaglutide?

Switching between Ozempic^® and other forms of semaglutide is possible. While these are very similar medications, a switch should always be done under the guidance of a healthcare provider. Here are some reasons why you may want to switch:

• Cost: Cost is often a major factor when someone is thinking about switching medications. If your insurance covers one or the other, you may want to switch. 
• Your weight loss has stalled: Ozempic can be prescribed up to 2 mg. If your weight loss has stalled on that amount, you may need to switch to Wegovy which has a 2.4 mg pen.
• You can’t get your prescription filled: Due to high demand, semaglutide medications have faced supply shortages. While the FDA declared the shortage of semaglutide to be resolved, these medications may still be hard to find in some locations. A lawsuit has been filed against the FDA for removing semaglutide from the shortage list, claiming that the supply is still unable to reach the demand for these medications. Since the availability of these medications is not guaranteed, it’s always a good idea to plan ahead on refills and contact other pharmacies if needed to see if your medication is in stock.

Semaglutide vs. Ozempic^®: Which is better for weight loss?

All forms of semaglutide should, in theory, lead to similar weight loss on the same dose. Clinical trials show that higher doses of semaglutide can lead to greater weight loss results over time, but your results will vary. Your lifestyle, your body’s biology, and the presence of any preexisting conditions will all come into play. Your ability to tolerate side effects and what you can afford long-term will also impact your overall results. 

Whether you’re considering Ozempic^®, Wegovy^®, or another semaglutide-based option, working with your healthcare provider is the best way to determine which dosage and treatment plan suits your needs.

How much weight can you lose on Ozempic^®  vs semaglutide?

Again Ozempic is available up to a 2 mg dose. Higher doses of semaglutide might lead to more weight loss for certain people. One study of people taking 2.4 mg of semaglutide weekly (the maximum dose of Wegovy^®) lost an average of about 15% of their body weight over 68 weeks. 

Another trial showed that people receiving a 7.2 mg weekly dose of semaglutide lost about 21% of their body weight over 72 weeks. This dose isn’t yet available in any format but shows that higher doses can lead to greater weight loss. 

How long does it take to see results?

Curious about when you might start noticing changes with semaglutide? Here’s a look:

Medication	3 months	Long-term
Ozempic®/Wegovy® (1 mg, 2mg)	Average weight loss was 5% of body weight lost within the first 3 months.	In 40 weeks, people lost slightly more weight with the 2 mg dose of semaglutide (7% of body weight)  compared to the 1 mg dose (6% of body weight).
Wegovy® (2.4 mg)	Studies show 5 to 10% of body weight lost within the first 3 to 4 months.	15% average body weight reduction over 68 weeks.
Rybelsus®	Weight loss is more gradual, with some trials showing up to 4% of body weight lost in 6 months.	Studies show 2 to 5% of body weight lost after one year.

Who is eligible for Ozempic^® or semaglutide for weight loss?

While the FDA has only approved certain medications like Wegovy^® for weight loss, Ozempic^® and Rybelsus^® can also be prescribed off-label for weight loss if a person meets certain conditions. Semaglutide medications can be prescribed for weight loss if you have:

• A BMI of 30 or higher

or

• A BMI of 27 or higher with at least one weight-related health condition, including high blood pressure or other weight-related issues.

Who should avoid semaglutide?

While semaglutide is effective for many, it’s not suitable for everyone. Due to some of the risks, those with certain preexisting conditions should not take semaglutide or any medication that contains it. You shouldn’t take semaglutide if you:

• Have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2)
• Are allergic to semaglutide or any of its ingredients
• Have a history of pancreatitis. (Having a history of pancreatitis can increase your risk of getting it again, so talk to your doctor about the risks.)
• Have severe gastrointestinal issues, such as gastroparesis (delayed stomach emptying)
• Are pregnant, planning to become pregnant, or breastfeeding

If you take semaglutide or Ozempic^® to lose weight, will you need to keep taking the drugs forever?

How long you take these medications depends on your overall results, lifestyle, and health. Semaglutide medications like Ozempic^®, Wegovy^®, and Rybelsus^® are approved for long-term use, but how long you stay on them can vary based on what your doctor recommends and your goals. 

If you stop these medications, especially if you stop them suddenly, it’s possible to regain some weight, especially if you haven’t made sustainable diet and exercise changes. GLP-1 medications help reduce appetite and regulate blood sugar, but they don’t permanently change how your body regulates weight. For that reason, some people stay on a maintenance dose long-term to help maintain the effects of these medications. 

The best way to make sure you can hold on to your results long-term is to eat a balanced diet and get regular exercise while you’re taking your semaglutide medication. A structured plan, like Noom, can help you build lasting behaviors.

When people stop semaglutide, here’s what we’ve seen:

• Some regain weight after stopping, as hunger and appetite control return to pre-medication levels. 
• Gradually tapering off may help to reduce weight regain. One study found that people who tapered off semaglutide slowly were able to maintain a stable weight for 26 weeks.
• Restarting the medication may be possible if you’re unable to maintain the results you’re looking for, but it’s best to do so under medical supervision.
  

A combination of medication, healthy eating, and behavior change can help you get the best long-term results. Semaglutide medications can be tools for weight loss, but lifestyle changes can help you to keep the weight off.

Semaglutide vs. Ozempic^®: Costs

The cost of semaglutide-based medications can vary widely depending on insurance coverage, pharmacy pricing, and available discount programs. If you’re considering one of these medications, it’s important to understand the potential costs and what options might be available to help manage them.

• Ozempic^®: Without insurance, Ozempic^® costs around $998 per month. However, if covered by insurance, some pay as little as $25 per month, depending on their plan. Here’s more information about the cost of Ozempic^®.

Other forms of semaglutide:

• Wegovy^®: Wegovy^® is priced at $1,350 per month without insurance. Here’s more information on the cost of Wegovy^®.
• Rybelsus^®: Rybelsus^® costs around $998 per month without insurance. Here’s more information on the cost of Rybelsus^®.  
• Compounded semaglutide: Compounded semaglutide, which has the same active ingredient as Ozempic and Wegovy, can be a more affordable option for people without insurance coverage. If you qualify for Noom Med, your clinician can prescribe compounded semaglutide, if needed, starting at $149 per month.

Does insurance cover semaglutide for weight loss?

Insurance coverage for semaglutide depends on the specific medication, its intended use, and your insurance plan. Coverage for type 2 diabetes is more common, with plans rarely covering weight loss.  

• Ozempic^® and Rybelsus^® are more likely to be covered by private insurance when prescribed for type 2 diabetes, but coverage is often denied when prescribed off-label for weight loss.
• Though Wegovy^® is FDA-approved for weight loss, many private insurance plans do not cover weight loss medications. Some employer-sponsored plans offer coverage, so checking with your provider or HR department is recommended.
• Compounded semaglutide isn’t covered by insurance.

Does Medicare cover semaglutide for weight loss?

Medicare coverage for semaglutide depends on the specific medication and its intended use.  Let’s take a look:

• Ozempic^® and Rybelsus® may be covered under Medicare Part D when prescribed for type 2 diabetes.
• Wegovy^® is generally not covered because Medicare does not cover weight loss medications, although exceptions may exist if prescribed for heart health.

Starting in 2025, the Inflation Reduction Act will cap annual out-of-pocket drug costs at $2,000 for Medicare Part D enrollees, potentially reducing costs for those who qualify. Since coverage policies change, checking with your Medicare provider is the best way to confirm current eligibility.

Semaglutide vs. Ozempic: Side effects

All forms of semaglutide will theoretically have similar side effects, ranging from mild and temporary to more serious, requiring immediate medical attention. Higher doses can potentially cause stronger reactions. Your prescriber will start you on the lowest dose and then increase it to continue steady weight loss as tolerated. 

Common side effects

Most people experience mild to moderate gastrointestinal side effects when starting the medication or adjusting to a higher dose. These include:

• Nausea
• Vomiting
• Diarrhea or constipation
• Stomach pain
• Fatigue

These side effects can typically be managed with diet and lifestyle changes.

Serious side effects and warnings

While all forms of semaglutide are well-studied and generally safe for most people, they sometimes carry serious risks. It’s important to follow prescription guidelines, monitor your body’s response, and talk to your clinician about any concerns.

Get immediate medical help if you experience any of the following:

• Pancreatitis: Symptoms include severe abdominal pain that may spread to your back, with or without vomiting. Learn more about the risk of pancreatitis with Ozempic.
• Vision changes: Get immediate medical attention if you have sudden vision changes.
• Low blood sugar (hypoglycemia): Symptoms include dizziness, shakiness, blurred vision, fast heartbeat, and jittery feelings. This is more common in people taking diabetes medications. Read about Ozempic and hypoglycemia here.
• Kidney problems: Dehydration from diarrhea, nausea, or vomiting can worsen kidney function. Go to the ER if you have reduced urination, swelling in the ankles or legs, fatigue, or shortness of breath.
• Gallbladder problems: Watch for upper abdominal pain, fever, jaundice, or clay-colored stools, which could indicate gallbladder issues.
• Allergic reaction: Symptoms include swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, and a rapid heartbeat. Seek immediate emergency care if you suspect a reaction.
• Semaglutide carries an FDA-boxed warning for the potential risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). This risk has only been observed in animal studies. If you or a family member has a history of MTC or multiple endocrine neoplasia syndrome type 2 (MEN 2), you shouldn’t take these medications..

For a full breakdown of potential risks, visit our Ozempic^® safety information page.

Lesser-known side effects of semaglutide

While semaglutide has well-documented side effects, some lesser-known effects have been reported by people taking it or observed in clinical practice. These include:

• Muscle loss (sarcopenia) – Rapid weight loss can lead to muscle loss, especially if protein intake is low or strength training isn’t part of a routine. Preserving muscle is key for metabolism and overall health.
• “Ozempic face”– Significant weight loss can reduce facial fat, producing a hollowed or aged appearance. This is common with any rapid weight loss, not just GLP-1 medications.
• GLP-1 hair loss – Some people experience temporary hair thinning or increased shedding (alopecia) while on GLP-1 medications. This is likely due to rapid weight loss. In most cases, hair regrows once weight stabilizes.

Semaglutide vs. Ozempic^®: Dosage and how you take it

When starting a GLP-1 medication, your provider will start you on the lowest dose to help your body adjust and minimize side effects. The dose is then gradually increased as tolerated to ensure steady, sustainable weight loss. Let’s break down how each medication works:

• Ozempic^®: You’ll start with a 0.25 mg dose to help your body adjust. Your dose will be increased to ensure steady weight loss up to 2 mg.
• Wegovy^®: Wegovy starts at the 0.25 mg dose and will be increased as needed and tolerated to the 2.4 mg dose.
• Rybelsus^®: Ryblesus^® comes in 3 mg, 7 mg, and 14 mg tablets. 3 mg is the starting dose. The dose will increase as needed and tolerated.

Choosing between the different forms of semaglutide

When deciding between Ozempic^®, Wegovy^®, and Rybelsus^®, it’s all about finding the right fit for your health goals and lifestyle. Ultimately, the choice boils down to these three key factors:

Insurance and Costs

For some, cost will be the biggest factor when choosing a medication with semaglutide. Ozempic^® and Rybelsus^® both have a list price of $998 per month. They might be covered for diabetes in some cases but will rarely be covered for weight loss. Wegovy^® will cost about $1,350 per month without coverage. Even though Wegovy is approved for weight loss, insurance coverage is rare. 

Compounded semaglutide through Noom GLP-1^Rx offers another alternative. If you qualify for Noom Med, your clinician can discuss whether compounded semaglutide is right for you. It starts at $149 per month and includes medication delivered right to your door. You’ll also get unlimited access to your clinician, a weight loss program designed just for you, and all of Noom’s trackers, tools, and exclusive exercise videos to help you stay on track.

Weight loss goals

All semaglutide medications should work in a similar way to reduce appetite, keep you feeling full longer, and regulate blood sugar. Ozempic will only go up to 2 mg, so if you need to up your dose to continue losing weight, you will need to switch to Wegovy^®. Rybelsus doesn’t seem to work as well for weight loss as the injectable forms of semaglutide.

Medication preference

On the other hand, Rybelsus^® is the only GLP-1 medication that can be taken as a pill if that is a big factor for you. Keep in mind that it must be taken on an empty stomach with just a small sip of water, and you’ll need to wait 30 minutes before eating or drinking anything else.

Ozempic^® and Wegovy^® are once-weekly injections, which some find more convenient (and many report that the needle is so small that it only causes mild discomfort). If you take compounded semaglutide, you will be measuring the medication yourself. Most report this is easy to learn.

Alternatives to semaglutide

Semaglutide isn’t your only option for an effective weight loss medication. There are several other options you can consider. These include other GLP-1 medications and non-GLP-1 medications. Let’s take a look at some of the options:

Tirzepatide

Tirzepatide works similarly to semaglutide but targets a second receptor in addition to the GLP-1 receptors. This action can lead to more weight loss for some people. In clinical trials, people lost an average of 21% of body weight in 16 months with tirzepatide medications. Here are the options:

• Zepbound^® – Zepbound^® is FDA-approved for weight loss under the same BMI guidelines as semaglutide medication. It can also be prescribed to treat obstructive sleep apnea (OSA). The list price is $1,086 per month without insurance.
• Mounjaro^®  – Mounjaro^®, like Ozempic, is FDA-approved for type 2 diabetes but can be prescribed off-label for weight loss. The cost is about $1,080 per month without insurance.

Liraglutide

Liraglutide is another GLP-1 receptor agonist, but it requires a daily injection instead of a weekly one. Weight loss is likely to be less than with semaglutide or tirzepatide. Here are the medications with liraglutide:

• Saxenda^® – Saxenda is FDA-approved for weight loss. Its list price is $1,349 per month without insurance.
• Victoza^® – Victoza is FDA-approved for diabetes management and is sometimes prescribed off-label for weight loss. Without insurance, the cost ranges from $800 to $1,400 per month.
• Generic liraglutide – One of the only generic GLP-1 medications available, this form of liraglutide is typically used to manage type 2 diabetes. It costs around $470 for two pens and $704 for three pens.

Dulaglutide

Dulaglutide is another weekly injectable GLP-1, available under the brand name Trulicity^®. It works similarly to Ozempic^® but targets GLP-1 receptors differently. Trulicity^® is FDA-approved for diabetes management and occasionally prescribed off-label for weight loss. The list price is $987 per month without insurance.

Other weight loss medications

If GLP-1 medications aren’t an option due to availability or insurance coverage, there are other medications that may help you lose weight. 

• Metformin – Metformin is a pill often used to treat diabetes but can be prescribed off-label for weight loss. If you qualify for Noom Med, your clinician can prescribe it if needed. Through the program, it costs $59 for the first month and $89 per month after that, billed in 3-month increments. This price includes medication, plus medical counseling, coaching, and access to Noom’s tools and trackers.
• Orlistat – This oral medication prevents fat absorption and is taken three times daily with meals. Costs range from $50 to $800 per month without insurance.
• Phentermine – Phentermine is a short-term appetite suppressant taken as a pill once daily. Pricing typically falls between $27 and $100 per month without insurance.
• Diethylpropion – This medication is also used as an appetite suppressant and is taken one to three times daily. Costs range from $40 to $85 per month without insurance.
• Naltrexone and bupropion (Contrave) – This combo drug helps reduce appetite and cravings in some people. Through the CurAccess™ Patient Support Program, Contrave®  costs $99 per month with free shipping. Without this program, prices can range from $600 to $800 per month, depending on insurance.

Choosing between semaglutide and Ozempic^®: Key considerations

Choosing between Ozempic^®, Wegovy^®, or other semaglutide-based medications ultimately comes down to your health goals, budget, and accessibility. While all of these medications contain semaglutide and work similarly to regulate blood sugar, curb appetite, and promote weight loss, they differ in approved uses, dosages, and costs. 

While these drugs can be highly effective for weight loss, long-term success depends on maintaining healthy lifestyle habits. A well-rounded approach—combining medication with balanced nutrition, regular exercise, and behavior change—can help ensure lasting results. Noom Med offers guidance on how to build sustainable habits alongside medication, helping you develop a plan that supports both short-term weight loss and long-term health.

*Compounded semaglutide available on the Noom platform is produced in an FDA-registered facility but not reviewed by the FDA for safety, efficacy, or quality.

Note: Ozempic^® is not FDA-approved to treat obesity or for weight loss.