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Ozempic vs. wegovy
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Have you struggled to achieve permanent weight loss with diet and exercise alone?? If so, you may be curious about trying medication to see if it can give you an added boost. Several of my clients have been asking me about the prescription weight loss meds Ozempic vs. Wegovy and if they are effective.

Ozempic and Wegovy are two of the most popular medications used for weight loss on the market. They share the same active ingredient, semaglutide, but they are not interchangeable. Read on for all you need to know about Wegovy vs. Ozempic, including eligibility, expected weight loss, doses, cost, side effects, and who shouldn’t take them.

What is Ozempic? 

The Ozempic injection was FDA-approved in 2017 to treat type 2 diabetes. It’s prescribed for:

  • Improving blood sugar in adults with type 2 diabetes along with diet and exercise
  • Reducing the risk of cardiovascular events – such as heart attacks or strokes – in adults with type 2 diabetes and heart disease

Ozempic is therefore not considered a weight loss drug. But because weight loss is a side effect, doctors still prescribe Ozempic for weight loss off-label. Ozempic’s popularity has taken off, especially among celebrities, leading to frequent shortages. 

You also may have heard of Mounjaro, another type 2 diabetes medication that leads to even greater weight loss than Ozempic.

What is Wegovy? 

The Wegovy injection was FDA-approved in 2021 for weight loss. It’s prescribed for adults with either: 

  • A BMI ≥30
  • A BMI ≥27 and at least one weight-related condition, like high cholesterol, high blood pressure, or type 2 diabetes

Wegovy has the same active ingredient as Ozempic, called semaglutide. Wegovy is a higher-dose version, which leads to greater weight loss than the amount seen with Ozempic.

Ozempic vs. Wegovy – Similarities and Differences

Let’s dive into an in-depth comparison of Ozempic vs. Wegovy to learn which is best for you.

Who are they intended for?

Ozempic is meant for adults with type 2 diabetes to help them manage their blood sugar. Wegovy is meant for adults over a certain BMI with or without certain medical risk factors to help them lose weight.

What is their expected weight loss?

When it comes to Wegovy vs. Ozempic for weight loss, Wegovy performs better. 

A large, long-term, randomized study compared weight loss between weekly 2.4 mg (Wegovy’s target dosage) and 1 mg (one of Ozempic’s higher doses) semaglutide injections. 

At 68 weeks, Wegovy led to a 9.64% average weight loss compared to a 6.99% weight loss on Ozempic. And at 104 weeks, Wegovy led to 15.2% weight loss.

The problem is that if you stop taking semaglutide, you’ll likely regain the weight you lost. Because of this, you may need to stay on these medications indefinitely in order to keep the weight off. 

Ozempic vs. wegovy
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What are their doses?

Both drugs are injected once a week on the same day, with or without food. To minimize side effects, gradually increase your monthly dose until you reach the target dose. 

Here is a breakdown of a typical Wegovy vs. Ozempic dosage schedule.

Ozempic comes in 4-dose strengths

  • Month 1: 0.25 mg 
  • Month 2: 0.5 mg
  • If needed, Ozempic also comes in doses of 1 mg and 2 mg.

Wegovy comes in 5-dose strengths:

  • Month 1: 0.25 mg
  • Month 2: 0.5 mg
  • Month 3: 1 mg
  • Month 4: 1.7 mg
  • Month 5: 2.4 mg (target dose)

Each month the dose is increased as tolerated to the goal of 2.4 mg weekly. 

How much do they cost?

The Ozempic vs. Wegovy cost depends on your insurance. Insurance usually covers Ozempic for diabetes, but not always for weight loss. The same applies for Wegovy – it mainly depends on your insurance company.

The list price for Ozempic is $935.77 for a month’s supply. This reflects the cost of the medication regardless of why it’s prescribed, whether off-label for weight loss or for its FDA-approved use for diabetes.  Therefore, the total out-of-pocket cost will ultimately depend on your individual insurance plan’s policy for coverage of FDA-approved medications.

There are a few ways you may be able to save, however. It may cost you as little as $25 for a 1-, 2-, or 3- month prescription if you use an Ozempic Savings Offer. If you have Part D Medicare coverage, you may qualify for its Extra Help program to help with Ozempic’s cost. 

Novo Nordisk, the manufacturer of Ozempic, also offers a Patient Assistance Program (PAP) to provide Ozempic for free to those in need. 

The list price for Wegovy is $1350 for a month’s supply. It can cost you as little as $0 a month if you use a Wegovy Savings Offer. Wegovy is not covered by Medicare, but it is covered by some Medigap and Medicare Advantage plans. 

All in all, not all insurance companies with cover these drugs for weight loss and coverage can be difficult to get.

What are their side effects?

Many of my clients are concerned about the side effects of weight loss medications, and for good reason. All supplements and medications come with some level of risk, so it’s important to know what to look for.

In one large study, over 80% of people taking semaglutide reported gastrointestinal problems. Another very common side effect that is not as widely discussed is muscle loss. This is common with fast weight loss, whether on medications or not, but seems to be more profound with these medications.

The most common side effects of Ozempic and Wegovy include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Stomach pain
  • Constipation 
  • Muscle loss

Because Wegovy delivers a higher dose of semaglutide, side effects may be more likely. Additionally, people on Wegovy also commonly report fatigue, dizziness, heartburn, runny noses, and sore throats.

There is also the risk of more serious side effects which include:

  • Pancreatitis (inflammation of the pancreas)
  • Changes in vision
  • Hypoglycemia (low blood sugar)
  • Kidney problems
  • Serious allergic reactions
  • Gallbladder problems 
  • Thyroid cancer

No studies on Ozempic and Wegovy beyond two years, so we don’t know their long-term effects. If you are experiencing any of these side effects while taking these medications, be sure to speak to your doctor.

Who shouldn’t take them?

Weight loss medications are not for everyone, despite their popularity. Here are some situations where Ozempic and Wegovy are not recommended:

  • You or your family ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC)
  • You have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • You are allergic to their ingredients
  • You are pregnant or breastfeeding
  • You have a current or past eating disorder

It’s also recommended to tell your healthcare provider if:

  • You have a history of problems with your kidneys or pancreas
  • You have a history of diabetic retinopathy (an eye disease from high blood sugar)
  • You have a history of mental health concerns
  • You take other medications and supplements

I always advise my clients to speak to their doctor about the pros and cons of weight loss medications, including a review of their medical status to determine if it’s right for them. 

Ozempic vs. wegovy
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Bottom line – Which is Better for Weight Loss?

Wegovy leads to greater weight loss than Ozempic and is specifically approved for this purpose, but it also has more side effects. Both drugs are expensive, not always covered by insurance, and are designed for long-term use. They’re also meant to supplement, not replace, lifestyle changes.

Whether Ozempic vs. Wegovy is right for you depends on your medical history and overall goals. It’s important to work with a medical team including a dietitian for the best results.

My biggest takeaway? Make sure you’re eating enough protein and performing regular strength training exercises to minimize muscle loss. This will help support health, a faster metabolism, and reduce the side effects of weight regain long-term. As a weight loss dietitian, I guide you on maintaining a healthy lifestyle to prevent weight regain, especially if you decide to stop taking these drugs.

For more helpful resources on using medications for weight loss and sustainable weight loss in general, check out these blogs:

Disclaimer: This article is for informational purposes only and is not intended to replace medical advice.