What you’ll learn:
- Wegovy® and Rybelsus® both contain semaglutide, just like Ozempic.
- Wegovy is FDA-approved for weight management and to prevent heart disease, while Rybelsus is approved to treat type 2 diabetes and is sometimes prescribed off-label for weight loss.
- Wegovy is a weekly injection, while Rybelsus is a daily pill.
- While both medications can help people lose weight, Wegovy® typically leads to greater results.
The world of weight loss medications has undergone significant changes in recent years, largely due to the rise of GLP-1 receptor agonists. Originally developed to treat type 2 diabetes, these medications are now widely used to support meaningful weight loss. While Ozempic® is the most recognized name, its counterparts—Wegovy® and Rybelsus®—are also worth considering if you’re exploring your options.
All three contain semaglutide as the active ingredient and are made by the company Novo Nordisk. Semaglutide mimics the GLP-1 hormone to reduce appetite, slow digestion, and improve blood sugar control. But which one is right for you?
Before you start thinking about whether one is right for you, it’s important to know that these medications can be expensive. Without insurance, they can cost nearly $1,000 per month, and most insurance plans cover them for weight loss. They also require a prescription, and your healthcare provider will need to determine if you’re a good candidate based on your medical history and weight loss goals. Cost, access, and your response are all factors to weigh alongside effectiveness.
We’ll walk you through the key similarities and differences between Wegovy® and Rybelsus®, including how they work, what results to expect, their costs, and whether your insurance may help cover them. (And what to do if it doesn’t.)
Wegovy® vs. Rybelsus®: How do they work?
Both Wegovy® and Rybelsus contain semaglutide, so in theory, they work the same way—by lowering appetite, helping you feel full longer, and keeping blood sugar levels steady. The primary difference lies in how they’re taken, which affects how much semaglutide your body absorbs.
With Wegovy®, you take it as a once-weekly injection. Since it goes directly into the body, it gets absorbed more efficiently. Rybelsus®, on the other hand, is taken as a pill by mouth. Because it must pass through your digestive system, only a small amount of the semaglutide reaches your bloodstream. That’s why the doses of Rybelsus® are higher.
Because of this, Rybelsus® usually isn’t as effective for weight loss as Wegovy®. However, higher doses of Rybelsus are currently being studied and could eventually match the effectiveness of the injectables. We’ll go into more detail about how they compare in terms of results below.
Wegovy® vs. Rybelsus®: What are the differences?
Both Rybelsus® and Wegovy® can aid in weight management and blood sugar control, to different degrees, but they work differently and come with unique considerations. Here are the biggest differences between the two semaglutide medications:
They are approved for different uses
- Wegovy® was FDA-approved for weight loss in 2021. It’s also approved to prevent heart disease.
- Rybelsus is approved for the treatment of type 2 diabetes; it can be prescribed off-label for weight loss.
They have very different dose levels
As we talked about above, Rybelsus has higher doses because less of the semaglutide is absorbed in pill form.
Rybelsus® starts at 3 mg once daily for about 30 days, then will increase to 7 mg per day and then 14 mg daily, as needed and tolerated.
Wegovy® starts at 0.25 mg once a week and gradually increases over several months to the maximum dose of 2.4 mg per week, as needed and tolerated. Your doctor will judge whether you need to go up a dose based on how quickly you’re losing weight and how you’re tolerating side effects.
They have different pricing structures
The list price of Wegovy® is about $1,350 per month without insurance, while Rybelsus® is about $998 per month. Neither is likely to be covered for weight loss, but Rybelsus® may be approved if prescribed for the treatment of type 2 diabetes. If you don’t have insurance, Wegovy® is available through Novo Nordisk’s NovoCare Pharmacy for $499 per month.
Wegovy® vs. Rybelsus®: What are the similarities?
While Rybelsus® and Wegovy® have different dosing and administration methods, they share several key similarities that might influence your decision. Understanding these common traits can help you and your healthcare provider determine which option best fits your health and weight-loss goals.
They have similar side effects
Because they contain the same active ingredient, Rybelsus® and Wegovy® have similar potential side effects, including nausea, vomiting, diarrhea, decreased appetite, and stomach discomfort. Studies show that side effects may be more pronounced or frequent with Wegovy®.
They follow a step-up dosing schedule
Both Wegovy® and Rybelsus® use a step-up dosing schedule, which means you start with a lower dose and gradually increase it over time. This helps your body adjust to the medication and may make side effects, like nausea or stomach upset, more manageable.
Can you switch between Wegovy® and Rybelsus®?
Since Rybelsus® and Wegovy® contain the same active ingredient (semaglutide), switching between them is possible. However, the transition isn’t a direct swap, as these medications differ in dosage, absorption, and effectiveness for weight loss.
Here’s what to keep in mind if you’re considering a switch:
- Weight loss results may change – Wegovy® is designed for weight loss and delivers semaglutide more effectively, leading to an average weight reduction of 15% or more over time. Rybelsus®, while still helpful for weight management, isn’t as potent since the body absorbs oral semaglutide differently. If you switch from Wegovy® to Rybelsus®, you may notice slower weight loss or even some weight regain.
- Digestive side effects could shift – Both medications can cause nausea and stomach discomfort, but in different ways. But, since everyone has a different experience with each medication, you might have worse side effects with one than the other.
Switching between these medications depends on your health goals, lifestyle, and how your body responds to them. Discuss with your doctor whether Rybelsus can help maintain your progress or if another approach might be more suitable. Tracking your appetite, energy levels, and weight changes can also help guide the transition and ensure you stay on track.
Wegovy® vs. Rybelsus®: Which is better for weight loss?
Wegovy® is more effective for weight loss, but the best choice depends on your health goals, insurance coverage, and preferences. Your healthcare provider will help you find what works for your long-term goals.
How much weight can you lose with Wegovy® vs Rybelsus®?
Research shows that at the current doses, Wegovy leads to great weight loss. Here’s a look:
- Wegovy® (injectable semaglutide) – People taking Wegovy® experienced an average weight loss of 15% to 17% of their body weight over 68 weeks.
- Rybelsus® (oral semaglutide) – Studies show that people taking 14 mg of Rybelsus® daily lose an average of 4% of their body weight over a year. Some studies show that if oral semaglutide were available in higher doses, it could achieve weight loss closer to the range seen with Wegovy®.
If you’re looking for the most effective option for weight loss, Wegovy® is the clear winner. But if you prefer a daily pill over a weekly injection, Rybelsus® can still help you lose some weight. And, it’s still the only GLP-1 approved in pill form.
How long does it take to see results?
While both medications are effective, the timeline and amount of weight loss depend on dosage, metabolism, and lifestyle choices. Pairing these treatments with a balanced diet and regular exercise can help enhance and speed up results. Here’s a look at the weight loss you can expect with either in terms of average body weight lost in trials:
3-6 months:
1 year and beyond:
- Rybelsus®: 4%
- Wegovy®: 15% or more
Who can take Wegovy® or Rybelsus® for weight loss?
Wegovy® or Rybelsus® are prescribed based on specific criteria, and eligibility will vary depending on your medical and weight loss history. Both medications are generally approved for people with:
- A BMI of 30 or higher
or
- A BMI of 27 or higher with at least one weight-related condition like high blood pressure or high cholesterol (Rybelsus as an off-label prescription).
Who shouldn’t take Rybelsus® or Wegovy®?
Rybelsus® and Wegovy® can be great tools for weight loss—but they’re not the right fit for everyone. Certain health conditions or risk factors might make these medications unsafe, so it’s important to talk with your doctor before getting started. They’ll help you figure out if one of these options makes sense for your body and your goals.
- Personal or family history of medullary thyroid carcinoma (MTC) – Both medications carry a warning for an increased risk of this rare thyroid cancer.
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) – If you have this genetic disorder, these medications are not recommended.
- Serious allergic reactions to semaglutide – If you’ve experienced an allergic reaction to Wegovy®, Rybelsus®, or other semaglutide-based medications, you should not take them.
- Pregnancy or breastfeeding – These medications can’t be taken during pregnancy or while nursing due to unknown effects on fetal and infant health. If you’re trying to conceive, you should stop taking them at least 2 months prior to attempting to conceive.
Talk to your doctor if you have a history of
- Severe gastrointestinal conditions – People with gastroparesis or other digestive disorders may experience worsened symptoms due to delayed stomach emptying.
- History of pancreatitis – Rybelsus® and Wegovy® may increase the risk of pancreatitis, so they should be avoided if you’ve had previous episodes.
If you take Rybelsus® or Wegovy® to lose weight, will you need to keep taking them forever?
The answer depends on your long-term weight management goals and how your body responds after stopping the medication. Some people may need to continue taking a maintenance dose, while others may gradually taper off under their doctor’s guidance.
What happens when you stop taking Rybelsus® or Wegovy®? You might experience
- Increased appetite
- Slower metabolism
- Potential weight regain
Tapering off these medications may help your body adjust and reduce the risk of rapid weight regain. Your doctor may gradually lower your dose while helping you transition to a plan focused on maintaining your results through nutrition, exercise, and behavioral strategies. But long-term success relies on sustainable lifestyle changes.
The best way to keep the weight off is to develop healthy eating habits, stay active, and use behavioral strategies to manage cravings and emotional eating. That’s where programs like Noom can help. Noom’s psychology-based approach teaches you how to build better habits so that you’re not dependent on medication alone to maintain your progress. By combining the right tools, you can achieve lasting results, whether you stay on the medication or transition off it eventually.
Rybelsus® vs. Wegovy®: Costs and insurance
We already mentioned the list prices of Rybelsus® and Wegovy®, but most people don’t pay these amounts. Insurance and other programs can impact what you pay out of pocket. Here’s a look:
Rybelsus®:
Rybelsus, while unlikely to be covered for weight loss alone, might be covered if prescribed for type 2 diabetes. Here’s a look at some different pricing scenarios
- Without insurance: A 30-day supply of Rybelsus® costs about $998 without insurance, but the price will vary depending on your location and pharmacy.
- With insurance: Copays can be as low as $10 per month, depending on your plan.
- Medicare and Medicaid coverage: Copays under Medicare vary, typically ranging from $0 to $15, depending on your plan’s tier and deductible status. Most state Medicaid programs cover Rybelsus® for diabetes, but coverage for weight loss is unlikely. Each state sets its own Medicaid policies, so eligibility and coverage details can vary.
Here’s more info on what Rybelsus® could cost you.
Wegovy®:
Wegovy is also rarely covered for weight loss. Here are some considerations to keep in mind when thinking about the cost:
- Without insurance: The list price for a month’s supply of Wegovy® is about $1,350 without insurance. If you don’t have insurance, you can get your prescription filled through Novo Nordisk’s NovoCare Pharmacy, where you’ll pay $499 per month.
- With insurance: Depending on your coverage, copays can vary. Some people may pay as little as $0 per month, while others might have higher out-of-pocket costs.
- Medicare and Medicaid: Coverage for Wegovy® under Medicare and Medicaid varies by state and plan. Refer to your specific plan to determine coverage and potential out-of-pocket costs.
Here’s more info on what Wegovy® could cost you.
Wegovy® vs. Rybelsus®: Side effects and safety
Wegovy® and Rybelsus® come with potential side effects. While most are mild and temporary, some are more serious and require medical attention. Knowing what to expect, what’s normal, and when to contact your doctor can help you manage these medications more effectively.
Common side effects
Both medications contain semaglutide, so they share similar side effects, especially in the early weeks as your body adjusts or when your dose is increased. Here’s what to expect
- Nausea
- Diarrhea
- Vomiting
- Constipation
- Abdominal pain
- Headache
- Fatigue
- Indigestion
If symptoms persist or become bothersome, talk to your doctor about possible adjustments.
Serious side effects and warnings
While Rybelsus® and Wegovy® are well-studied and generally safe for most people, they carry serious risks in some cases. It’s important to follow prescription guidelines, monitor your body’s response, and talk to your clinician about any concerns.
Boxed warning for Rybelsus® and Wegovy®
Both Rybelsus® and Ozempic® carry an FDA-boxed warning (the strongest safety warning) for the potential risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). This risk has only been observed in animal studies, but it is unknown whether it applies to humans.
Get immediate medical help if you experience any of the following:
- Pancreatitis: Symptoms include severe abdominal pain that radiates to your back, with or without vomiting. Learn more about the risk of pancreatitis with semaglutide.
- Vision changes: If you notice any sudden changes in your vision while taking these, get immediate medical attention.
- Low blood sugar (hypoglycemia): Low blood sugar is most likely in people who are also taking medications for diabetes. Symptoms include dizziness, shakiness, blurred vision, and a fast heartbeat. Read about semaglutide and hypoglycemia here.
- Kidney problems: Diarrhea, nausea, and vomiting can cause dehydration and worsen kidney issues. Go to the ER if you experience decreased urination, swelling in the ankles or legs, fatigue, or shortness of breath.
- Gallbladder problems: Symptoms include upper abdominal pain, fever, jaundice, or clay-colored stools.
- Allergic reaction: Symptoms include swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, or a rapid heartbeat. Get immediate medical attention if you’re having an allergic reaction.
For a detailed breakdown of potential risks and safety considerations, visit the Rybelsus® safety page or the Wegovy® safety page.
Which one is safer?
Rybelsus® and Wegovy® are both considered safe when you take them as directed, though there are some rare but serious side effects associated with them. Studies have shown that the benefits of taking these medications to reduce BMI and treat other health conditions like type 2 diabetes outweigh the possible risks for most people.
Building sustainable habits and working closely with a healthcare provider to monitor side effects and adjust the dosage accordingly is the best way to ensure safe and effective treatment. If you get your prescription through Noom Med, your clinician can also help you work through side effects. You’ll also get a diet and exercise plan to help improve your health while taking the medication. If you get your medication through your private doctor, Noom’s GLP-1 Companion can be added to any Noom subscription if you’re following the GLP-1 track. It can help you make lifestyle changes and maintain long-term success while taking weight loss medication.
Wegovy® vs. Rybelsus®: Dosage and how you take it
Wegovy® and Rybelsus® both use the same active ingredient—semaglutide—but they’re taken in totally different ways. One’s a weekly shot, the other’s a daily pill. They also come in different doses and follow different step-up schedules. Knowing how each one works can help you figure out which option might fit better with your routine and preferences.
- Rybelsus®: Take one tablet every morning, at least 30 minutes before eating, drinking, or taking any other medications. Swallow it with no more than four ounces of water to help your body absorb it properly. After that, wait at least 30 minutes before eating or drinking anything. Rybelsus® can be stored at room temperature in a dry place, but it must be kept away from heat, moisture, and direct light.
- Dosing: Your doctor will start you on the 3 mg dose, increasing to 7 mg and then 14 mg as needed and tolerated.
- Wegovy®: To take Wegovy®, you will inject once a week with a prefilled injection pen. Your timing can be flexible, but it should be on the same day each week. The injection goes under the skin (subcutaneous) in your stomach, thigh, or upper arm. Wegovy® should be kept in the refrigerator (36°F to 46°F) before first use. Once opened, it can be stored at room temperature (below 86°F) for up to 56 days but should still be kept away from heat and light.
- Dosing: The starting dose for Wegovy® is 0.25 mg and is increased gradually to 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg as needed and tolerated.
Choosing between Rybelsus® and Wegovy®
Deciding between Rybelsus® and Wegovy® comes down to your personal preferences, health goals, and lifestyle. Both medications contain semaglutide, but they differ in effectiveness, administration, and cost. Here’s a complete breakdown of their comparison:
| Medication | Rybelsus® | Wegovy® |
|---|---|---|
| Pricing per month (without insurance) | List price of $998 per month | List price of $1,350 per package $499 through NovoCare® Pharmacy |
| What it’s used for | Type 2 diabetes/off-label weight loss | Weight loss/to prevent heart disease |
| How you take it and dosing | Once daily pill Doses: 3 mg, 7 mg, and 14 mg | Once weekly injection Doses: 0.25, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg |
| Insurance coverage | Coverage varies; often covered if prescribed for diabetes, but weight loss coverage is unlikely | Unlikely to be covered for weight loss |
Alternatives to Wegovy® and Rybelsus®
Wegovy® and Rybelsus® are both semaglutide-based medications that help with weight loss and blood sugar control, but they may not be the right fit for everyone. If you’re looking for alternative options, whether due to cost, availability, or personal preference, there are several other medications that offer similar benefits.
| Medication | Brand names and uses | Cost per month (without insurance) | Effectiveness | How it’s taken |
|---|---|---|---|---|
| Semaglutide – GLP-1 receptor agonist – Same active ingredient as Wegovy® | Ozempic®: type 2 diabetes, off-label weight loss | Ozempic®: $998 Learn more | Ozempic®: People lost an average of 15% of body weight in 68 weeks with injectable semaglutide | Ozempic®: Weekly injection |
| Liraglutide – GLP-1 receptor agonist | Victoza®: type 2 diabetes, off-label weight loss Saxenda®: weight loss and heart disease Generic liraglutide: type 2 diabetes, off-label weight loss | Victoza®: $800 to $1,400 Saxenda®: $1,350Learn more. Generic liraglutide: $470 – $700 | People lost an average of 5-6% of body weight in one year. | Daily injection |
| Tirzepatide – GLP-1/GIP receptor agonist | Mounjaro®: type 2 diabetes, off-label weight loss Zepbound®: weight loss and obstructive sleep apnea (OSA) | Mounjaro®: $1,080Learn more Zepbound®: Pens: $1,087 Vials: $349 (2.5 mg) $499 (5 mg, 7.5 mg, 10 mg) Learn more | People lost an average of 21% of body weight at 72 weeks. | Weekly injection |
Other medications
GLP-1s aren’t the only options. These medications work in different ways and can be prescribed to help people lose weight if needed.
| Medication | Brand names | Cost per month (without insurance) | Effectiveness | How it’s taken |
|---|---|---|---|---|
| Metformin (off-label weight loss) | Glucophage®, Fortamet®, Glumetza® | Generic: $4–$15 Brand name: $100–$500+ Learn more. | People lost an average of about 6% of their body weight over six months while taking metformin. | Pill taken up to two times daily |
| Phentermine | Lomaira®, Adipex-P® | $27-$100 | About 80% of people with a BMI of 30 or more lost at least 5% of their body weight in 6 months. | Daily pill |
| Diethylpropion | Tenuate®, Tenuate Dospan® | $40-$85 | People lost an average of 10% of their body weight in 6 months. | Pill taken one to three times daily |
| Naltrexone and bupropion | Contrave® | $600-$800 CurAccess™: $99 | People lost an average of 7 to 8% of their body weight in a year. | Pill taken up to twice daily |
| Orlistat | Xenical®, Alli® | $50-$800 | People in a study lost about 10% of body weight after taking Orlistat for 1 year. | Pill taken three times daily with meals. |
Finding the right medication for your weight loss journey
Choosing between Wegovy® and Rybelsus® depends on your weight loss goals, health profile, lifestyle preferences, and insurance coverage. Wegovy® is the stronger option when it comes to weight loss results, but for those who prefer a daily pill or are already managing type 2 diabetes, Rybelsus® may offer a more convenient and potentially more affordable path. Both medications can be effective when used as directed and under the supervision of a healthcare provider.
Whether you’re leaning toward Rybelsus® or Wegovy®, the most important step is working closely with your healthcare provider to find the right fit and dosage for you. And no matter which route you choose, lasting success comes from pairing medication with sustainable lifestyle changes. With the right support system, you can build healthy habits, navigate side effects, and set yourself up for long-term results
Note: Ozempic®, Rybelsus®, Mounjaro®, and Victoza® are not FDA-approved to treat obesity or for weight loss.
