Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist approved by the FDA for use in adults with type 2 diabetes. Ozempic is injected into the abdomen, the upper arm, or into the thigh, and is prescribed for use along with exercise and diet. It should be taken with or without food on the same day each week.
The prefilled injection pens, prescribed as 0.25mg, 0.5mg, 1 mg, or 2 mg dosages, are initially prescribed in the smallest dosage that effectively lowers blood sugar levels.
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Ozempic is prescribed to
- improve blood sugar levels in adults with type 2 diabetes, along with diet and exercise
- lower the risk of serious cardiovascular problems, such as stroke, heart attack, and, in some cases, death due to heart disease in adults with heart disease and type 2 diabetes
Ozempic is not prescribed for weight loss. However, because Ozempic helps reduce blood sugar levels, it can reduce weight in people with type 2 diabetes who are overweight.
Semaglutide is also available as a daily tablet called Rybelsus for the treatment of type 2 diabetes. Comparatively, the medications are similar in both their efficacy and their costs.
Ozempic for Weight Loss
Though Ozempic is designed and prescribed for the treatment of type 2 diabetes, its popularity has risen due to its effectiveness to gradually decrease weight over time.
Here’s how:
Using Ozempic as an insulin therapy drug that lowers blood sugar works by stimulating the pancreas to release insulin. Ozempic helps the body release the naturally-occurring GLP-1 hormone produced in the digestive system that regulates appetite and insulin secretion.
By releasing GLP-1 hormone after eating, patients feel full longer, which can lead to weight loss.
The medication is also used off-label for weight loss in people who are diagnosed with type 2 diabetes and cardiovascular risk. The off-label reference means there may be unapproved use of an approved drug being used for a medical condition or disease that it’s not approved to treat. Recent social media messaging has been influential, propelling the use of Ozempic as a weight loss medication, a prime off-label example.
Ozempic is available for people with a body mass index (BMI) of at least 27. It’s also approved for use in people with dyslipidemia.
To learn your body mass index, divide your weight in pounds (or kilograms) by the square of your height in feet (or meters). High body fat is indicated by a high BMI. AARP offers a useful BMI calculator on its website that’s handy as long as you can correctly measure your height and weight. AARP’s corresponding gauge is a good BMI determination, though not meant for diagnostic purposes.
How Does Ozempic Help With Weight Loss?
Ozempic reduces the amount of glucagon released by the pancreas. Glucagon raises blood sugar levels, and if the pancreas secretes too much glucagon, blood sugar levels may rise too high. Semaglutide slows the secretion of glucagon to help reduce the risk of heart attack, stroke, and death.
In a 56-week study, Ozempic monotherapy reduced fasting blood sugar levels by 44 mg/dL after 30 weeks. Ozempic also lowered the average A1C level—the measure of blood sugar control over time—from 8% to 7%. Ozempic users may expect to see weight-loss benefits in 1-4 weeks.
Ozempic Side Effects
Depending on your needs, Ozempic may be a good option. People with type 2 diabetes want what’s best—consuming the proper foods, maintaining healthy A1Cs, getting enough exercise—and more.
But there’s uncertainty: which, among the many medications available, may best help manage blood sugar levels with the least side effects?
Ozempic side effects may include nausea, vomiting, stomach (abdominal) pain,
constipation, and diarrhea, experienced by around 30% of patients (Chamberlin, 2019). Less common side effects include abdominal pain, constipation, and redness at the injection site. Ozempic may also increase the risk of hypoglycemia, or low blood sugar (in 23.1% of patients). (Smits and Van Raalte, 2021)
Ozempic isn’t recommended for children (people under 18), people who are pregnant (unless potential benefit justifies potential risk to the fetus), or when breastfeeding (DailyMed, 2022).
Ozempic may increase the risk of kidney damage if you have kidney disease or other conditions. Additionally, Ozempic may worsen diabetic retinopathy, vision loss caused by diabetes, so it’s important to keep your eyes healthy by having eyes checked yearly.
Other, more serious possible side effects include:
- Pancreatitis
- Serious allergic reactions, including swelling of face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting of feeling dizzy; or very rapid heartbeat
- Gallbladder problems
- Thyroid cancer in patients with a personal or family history of thyroid cancer*
- Multiple endocrine neoplasia syndrome type 2*
*See: Ozempic Black Box Warning
“The Food and Drug Administration (FDA) has issued a “black box” warning for Ozempic, the most serious advisory they issue for a medication.
Why Use an Alternative to Ozempic?
Ozempic is marketed by Novo Nordisk, available for use with prescription insurance or for those who have private or commercial insurance. Ozempic is available through most pharmacies and pharmacy chains.
The cost of Ozempic may range from $700 to $1,000/month or more, making out-of-pocket costs prohibitive for many people. It’s expensive.
However, Americans can save up to 90% on medication through a Canadian online pharmacy partner such as BuyCanadianInsulin.com.
According to the Novo Nordisk website, the cost is $1,025. However, costs may vary depending on the medication’s formulation and— importantly— a patient’s insurance and/or discounts.
| Prescription Trade Name & (class) | FDA Approved Use/Route | Average Weight Loss | Common Side Effects | Avg Cost | Current cost through BuyCanadianInsulin.com (*as of Dec 19, 2022) |
| Ozempic (semaglutide) | Weekly to reduce cardiovascular events for people with type 2 diabetes and reduce blood sugar (glucose) levels, thus reducing weight in people with type 2 diabetes and overweight.Injection. | 8-10 lbs and 12-14 lbs (In studies, weight results varied) | Nausea, vomiting, diarrhea, stomach pain, constipation | $1,025 for 1 pen | $339 for 1 pen |
| Victoza (liraglutide) | Once-daily non insulin medication that lowers blood sugar (glucose) and A1C, and reduces risk of major cardiovascular events. Injection. | Some weight lossSome weight gain(In studies, weight results vary) | Nausea, diarrhea, vomiting, decreased appetite, indigestion, and constipation | $1,128 for 3 pens | $382.23 for 3 pens |
| Mounjaro (tirzepatide) | Increases insulin levels in your body which decreases blood sugar (glucose) in adults with type 2 diabetes. Injection. | Between 12-25 pounds with diet and exercise | Nausea, diarrhea, low appetite, vomiting, stomach upset, constipation, stomach pain | $1,174 for 4 pens | Currently unavailable. |
| Byetta (exenatide) | Twice daily in combination with diet and exercise to improve glycemic control in adults with type 2 diabetes.Injection. | 6-6.4 pounds, 2.9-5.7 pounds, 2.4-3.5 pounds(In studies, weight-loss results vary) | Belching, nausea, vomiting, headaches, reduced appetite, diarrhea, feeling jittery, heartburn, hypoglycemic, stomach discomfort or upset | $944 for 1 pen | Currently unavailable. |
| Bydureon BCise (exenatide) Long-acting | Weekly non-insulin medication that tells the body (in adults and children 10 years and older) to release insulin after you eat; blocks your liver from releasing sugar into your blood.Injection. | 3 pounds | Nausea, vomiting, diarrhea, headache, injection-site lump, constipation | $793 for 4 pens | Currently unavailable. |
| Trulicity (dulaglutide) | Weekly non insulin used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. Injection | 2-6 pounds | Nausea, diarrhea, vomiting, abdominal pain, decreased appetite, indigestion, fatigue | $901 for 4 pens | $282 for 4 pens |
| Wegovy (semaglutide) | Once weekly as an adjunct to a reduced calorie diet & increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of 30 kg/m2 or + (obesity) or 27 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (ex. type 2 diabetes)Injection. | 10-16% average weight loss (of starting body weight) after about 1 year when following a lower-calorie diet and exercise plan | Nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distension, eructation, hypoglycemia in patients with type 2 diabetes, flatulence, gastroenteritis, gastroesophageal reflux disease | $1,563 for 4 pens | Currently unavailable. |
| Rybelsus (semaglutide) | Once-daily non-insulin medication for adults with type 2 diabetes to help lower their blood sugar (glucose) when used with exercise and diet changes. Tablet | 1.3 – 6.8 pounds | Nausea, abdominal pain, diarrhea, decreased appetite, weight loss, vomiting, constipation | $1,062 for 30 tablets | $299.79 for 30 tablets |
*prices in the above table are based on averages taken from GoodRX and/or subject to change.
It’s likely that you can sign up for an Ozempic savings card or a patient assistance program. Check the website for costs based on ‘different insurance scenarios’ here.
Ozempic Alternatives
Semaglutide is just one of a number of GLP-1s for treating adults with type 2 diabetes. Your healthcare provider may work with you to find weight-loss alternatives to Ozempic, to prescribe another drug or recommend other forms of medication.
Don’t be surprised, though, if s/he also advises you to start a healthy diet and exercise program to help control your blood sugar levels. Having a healthy diet and plenty of fruits and vegetables generally helps you maintain good health.
Ozempic alternatives may include the GLP-1s Bydureon and Byetta (both exenatides), Victoza (liraglutide), Mounjaro (tirzepatide), Tanzeum (albiglutide), Trulicity (dulaglutide), Wegovy and Rybelsus (both semaglutides).
This chart lists medications by name and class, FDA approved use(s), administration routes, avg. weight loss, side effects, and costs (without discounts, insurance, or other possible reductions).
What’s your best choice? It’s important to talk with your healthcare provider for answers to your questions.
Or, Pursue Other Alternatives
Ozempic alternatives may also include over-the-counter drugs or vitamins to help lower blood sugar. According to the American Diabetes Association (ADA), however, there’s a possibility of drug interactions and/or effects on blood sugar with such alternatives. Furthermore, the ADA warns, “research on many supplements is inconclusive.” Therefore, consult your doctor about adding supplements or vitamins to your regimen.
Modifying diet and lifestyle can help control blood sugar, too. However, dietary and lifestyle changes aren’t meant as a replacement for prescription medication. Your healthcare provider can explain which diet plan is best for you.
Generally, a healthy diet should include a variety of fruits and vegetables, lean protein, whole grains, and low-fat dairy. Exercise can help to control blood sugar, too. Consult your healthcare provider if you need help determining the type of exercise that’s safe and effective for you. Be sure to discuss when you should test blood sugar in relation to exercising – and how you can avoid/ treat hypoglycemia (low blood sugar).
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