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

What you’ll learn:   

• Ozempic^® and Wegovy^® are essentially the same medication (semaglutide), but Wegovy^® is FDA-approved for weight loss, while Ozempic® is approved for diabetes and often prescribed off-label for weight management.
• The key difference between the two is dosing—Wegovy^® can be prescribed at a higher dose, which may lead to greater weight loss for some people.
• Insurance coverage varies. Some plans cover Ozempic® for diabetes but not weight loss, while Wegovy^® is rarely covered by insurance.

GLP-1 medications are transforming the way people approach weight loss. Originally developed to help manage blood sugar in people with type 2 diabetes, these medications have also been shown to lead to significant weight loss. They work by reducing appetite, slowing digestion, and regulating blood sugar levels, making it easier for people to lose weight.

Choosing the right medication can be confusing, though, especially since it’s common for two nearly identical drugs to have different FDA approvals—like Ozempic^® and Wegovy^®. Both contain the same ingredient, semaglutide, but Ozempic is FDA-approved for diabetes, and Wegovy is approved for weight management and cardiovascular protection in people with a history of heart disease. Even more confusing is that many people turn to Ozempic over Wegovy for weight loss despite its approval for diabetes. 

How do you choose between them if your primary goal is weight loss? Let’s break down the similarities, key differences, costs, and other factors between Ozempic and Wegovy to help you and your doctor determine which option is right for you.

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

Since Ozempic^® and Wegovy^® are both once-weekly injectable medications containing semaglutide, they work the same way. Semaglutide helps with weight loss by:

• Lowering appetite: Semaglutide reduces hunger, so you’ll eat fewer calories.
• Slowing digestion: Food will stay in your stomach longer, which helps control hunger and reduce blood sugar spikes.
• Regulating blood sugar levels: Semaglutide Improves insulin sensitivity and reduces glucose production, preventing cravings caused by blood sugar fluctuations.

While both medications work the same way, Wegovy^® can be prescribed at a higher maximum dose (2.4 mg per week) than Ozempic^® (2 mg per week). A person taking either medication will start at the lowest dose. It will be increased as tolerated to ensure steady weight loss. Not everyone needs the highest dose to see results—some may reach their weight loss goals on lower doses with fewer side effects. For some people, this higher dose may lead to greater weight loss and improved appetite suppression.

Because both drugs affect appetite and digestion in a similar way, the best choice for an individual depends on factors like insurance coverage, cost, and personal tolerance to side effects.

Ozempic^® vs. Wegovy^®: The similarities

Again, Ozempic^® and Wegovy^® have a lot in common because they are the same medication under two different brand names. Both contain semaglutide, are once-weekly injectables, and are manufactured by Novo Nordisk, the same pharmaceutical company.

Since they work in the same way, both medications can support significant weight loss, particularly when combined with diet and lifestyle changes. They also share similar potential side effects, such as nausea, vomiting, and gastrointestinal discomfort, especially when first starting or increasing the dose.

While dosing, price, and FDA-approved uses set them apart, their overall mechanism of action and benefits remain the same, making both options effective for weight management, depending on individual needs and insurance coverage.

Ozempic^® vs. Wegovy^®: The differences

Ozempic^® and Wegovy^® differ in their approved uses, dosing, and cost. Here’s a look at these aspects and why they are important:

Approved uses

An approved use means the FDA has evaluated a medication for safety and effectiveness for a specific condition. When a drug is FDA-approved for a particular use, it can be marketed and prescribed for that purpose. Insurance coverage is also more likely, though it will depend on your particular plan.

• Ozempic^® is FDA-approved for type 2 diabetes, but it can be prescribed off-label for weight loss. This means that while the medication is officially intended for diabetes management, doctors can still prescribe it for weight loss based on their clinical judgment. The bigger issue is that insurance coverage for off-label use is uncommon. Because it is not FDA-approved for weight loss, most insurers will deny coverage or require documentation of a diabetes diagnosis.
• Wegovy^® is FDA-approved for weight management for people with a BMI over 30 or a BMI over 27 and at least one weight-related condition, like high blood pressure, and cardiovascular protection in people with heart disease. Despite the approval for weight loss, insurance coverage remains inconsistent, as many health plans exclude weight loss medications or impose strict eligibility criteria. Even when coverage is available, patients may face step therapy requirements, meaning they must try other weight loss methods before Wegovy is approved.

Dosing

Both medications follow a step-up dosing schedule, meaning the dose is increased gradually to help your body adjust. Wegovy can be prescribed at a higher maximum dose, which may lead to greater weight loss for some people. Again, the dose will be adjusted for steady weight loss based on how well it’s tolerated. Not everyone on Wegovy reaches the full 2.4 mg. 

• Ozempic^® starts at 0.25 mg once weekly and is increased as needed and tolerated up to 2 mg per week.
• Wegovy^® follows a similar plan but has a higher maximum dose. It starts at 0.25 mg and can be increased to the 2.4 mg dose, as needed.

Price

The cost of both Ozempic® and Wegovy® can be a major factor in choosing between them, as insurance coverage for medication prescribed for weight loss isn’t common. Many health plans do not cover Wegovy, while Ozempic may be covered for diabetes management but not for off-label weight loss use.

• Ozempic®: The list price is about $997 per month, regardless of dose. Here’s a complete breakdown of what Ozempic will cost you based on your insurance coverage.
• Wegovy®: The list price is $1,349 per month, making it more expensive than Ozempic. Since Wegovy is FDA-approved for obesity treatment, some insurers may cover it, but most exclude weight loss drugs from their plans entirely. Here’s a complete breakdown of what Wegovy will cost you based on your insurance coverage.

If you’re considering either medication, check with your insurance provider to see what’s covered and your out-of-pocket costs. Discount programs, manufacturer savings cards, and pharmacy discount services may help lower the cost. Pricing can vary by pharmacy, location, and available savings programs, so checking your specific costs with insurance or manufacturer discounts is key.

Can you switch between Ozempic^® and Wegovy^®?

Since both medications contain semaglutide, switching between them is definitely possible, but the pricing structure will be different. Always consult your healthcare provider before making any changes.

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

Since Ozempic and Wegovy contain the same active ingredient (semaglutide) and work the same way in the body, both medications can effectively support weight loss. The key difference lies in dosing. As we said, Wegovy can be prescribed at a higher maximum dose than Ozempic if needed.

The higher Wegovy dose may lead to greater appetite suppression and weight loss for some people. However, this does not mean everyone needs the highest dose to see results—some people achieve significant weight loss with lower doses and fewer side effects. Additionally, cost and insurance coverage can influence the decision. While Wegovy is FDA-approved for weight management, many insurance plans exclude weight loss medications, making Ozempic (which may be covered for diabetes) a more accessible option for some.

Ultimately, the best option depends on your weight loss goals, medical history, tolerance for side effects, and insurance coverage. A doctor can help determine the most effective and affordable choice based on personal needs. 

Ozempic^® vs. Wegovy^®: How much weight can you lose?

Weight loss with semaglutide, the active ingredient in both Ozempic^® and Wegovy^®, depends on the dose and lifestyle factors rather than the brand name. 

In a 16-month study, participants taking 2.4 mg semaglutide lost an average of 15% of their body weight, compared to 2.4% with placebo. About 86.4% lost at least 5%, and over 50% lost 15% or more. The average weight loss was 33.7 pounds with semaglutide and 5.7 pounds with placebo.

Of course, individual results will vary. While semaglutide can help a person lose weight, healthy eating, exercise, and consistency remain essential for long-term success.

Ozempic^® vs. Wegovy^®: How long does it take to see results?

If you’re taking Ozempic® or Wegovy®, you might notice some weight loss in the first few weeks. Studies, like the STEP 5 trial, show that people on semaglutide continue losing weight gradually, with an average weight loss of 15% of their body weight after two years (104 weeks). That said, weight loss may slow down or level off around 60 weeks for some, which is sometimes called the ‘Ozempic plateau.’ But sticking with treatment—and making healthy lifestyle choices like eating well and staying active—can help you maintain your progress and get the best results.

Ozempic^® vs. Wegovy^®: Who are they approved for?

While both medications contain the same ingredient, they are approved for different purposes. 

Ozempic^® is FDA-approved to treat type 2 diabetes. It can also be prescribed off-label for weight loss if a person has a BMI of 30 or higher or a BMI of 27 or higher with a weight-related health condition, such as high blood pressure.

Wegovy^® is FDA-approved for weight management under the same BMI criteria. It is also FDA-approved to reduce the risk of heart attacks, strokes, and other cardiovascular events in people with a BMI of 27 or higher with cardiovascular disease.

Who shouldn’t take Ozempic^® or Wegovy^®?

These medications aren’t right for everyone and can be harmful to some groups of people. You should not use them 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
• Have severe gastrointestinal issues, such as gastroparesis (delayed stomach emptying)
• Are pregnant, planning to become pregnant, or breastfeeding

For more detailed safety information, visit the Ozempic^® safety page or the Wegovy^® safety page.

If you take Wegovy or Ozempic to lose weight, will you need to keep taking them forever?

It depends. These medications are approved for long-term use, but how long you should stay on them depends on individual health goals and doctor recommendations. Stopping can lead to weight regain, especially if you haven’t made lifestyle changes that you can stick with. GLP-1 medications like Wegovy and Ozempic help control appetite and blood sugar but don’t permanently change how your body regulates weight. Some people stay on a maintenance dose long-term to reduce appetite. 

The best way to maintain your results is to create a balanced diet and move your body regularly while taking them. A structured plan, like Noom, can help you build lasting behaviors.

If you stop taking Wegovy or Ozempic, here’s what you should know:

• Some regain weight after stopping, as hunger and appetite control return to pre-medication levels. 
• Gradually tapering off may reduce this risk. A study found that people who tapered off semaglutide maintained a stable weight for 26 weeks.
• Restarting the medication may be possible, 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. Wegovy or Ozempic can be tools for weight loss, but maintaining progress comes down to sustainable lifestyle changes.

Does insurance cover Wegovy or Ozempic for weight loss?

Insurance coverage for Wegovy^® and Ozempic^® varies widely depending on your plan, but coverage for weight loss is unusual. 

• Wegovy: Private insurance coverage is inconsistent—many plans don’t cover Wegovy^® for weight loss, but it’s worth checking with your provider, as some exceptions exist. Employer-sponsored insurance depends on your company’s specific plan. If Wegovy^® isn’t covered, speaking with HR or your benefits team may help explore options. Get the full details on pricing and insurance coverage for Wegovy.
• Ozempic: Ozempic^® is more likely to be covered for type 2 diabetes but is usually not covered when prescribed off-label for weight loss. Prior authorization is standard, and insurers may require proof that other treatments, like metformin, were ineffective for diabetes management. Get the full details for pricing and insurance coverage for Ozempic.

Since insurance policies change frequently, it’s best to check directly with your provider for the most up-to-date coverage details.

Does Medicare cover Ozempic or Wegovy?

Medicare does not typically cover Wegovy^® or Ozempic^® for weight loss, but Ozempic^® may be covered under Medicare Part D when prescribed for type 2 diabetes. Wegovy^® is generally not covered since Medicare Part D does not include medications used solely for weight loss, though exceptions may exist if prescribed for a heart condition. 

Starting in 2025, the Inflation Reduction Act will cap annual out-of-pocket drug costs at $2,000 for Medicare Part D enrollees, potentially lowering expenses.

Ozempic^® vs. Wegovy^®: Side effects

Ozempic^® and Wegovy^® can cause side effects ranging from mild and temporary to more serious, requiring immediate medical attention. Since both drugs contain semaglutide, they share the same side effect profile.

Common side effects

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

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

Learn how to manage the side effects of Wegovy and Ozempic.

Serious side effects and warnings

While Wegovy^® and Ozempic^® are well-studied and generally safe for most people, they sometimes carry serious risks. It is important to follow prescription guidelines, monitor your body’s response, and talk to your clinician about any concerns.

Boxed warning for  Wegovy^® and Ozempic^®

Both  Wegovy^® and Ozempic^® carry 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. Do not take these medications if you or a family member has a history of MTC or multiple endocrine neoplasia syndrome type 2 (MEN 2).

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. It 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.

Additional warning for Wegovy^®:

• Depression or suicidal thoughts: Be mindful of any changes in mood, behavior, thoughts, or feelings. If you notice new or worsening mental health symptoms, seek immediate medical attention.

For a full breakdown of potential risks, see the Wegovy^® safety information and Ozempic^® safety information.

Lesser-known side effects of Wegovy® and Ozempic®

While Wegovy® and Ozempic® have well-documented side effects, some lesser-known effects have been reported anecdotally by patients or observed in clinical practice. These are not officially listed side effects:

• 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.

Ozempic® vs. Wegovy®: Which one is safer?

Since Ozempic^® and Wegovy^® contain the same active ingredient (semaglutide), their safety profiles are nearly identical. However, higher doses may increase the likelihood of side effects. Clinical studies have shown that gastrointestinal issues—such as nausea, vomiting, diarrhea, and constipation—are more common at higher doses. In one trial, 34% of patients on a 2 mg dose of semaglutide experienced gastrointestinal side effects, compared to 31% on a 1 mg dose.

Doctors start with a low dose to minimize side effects and gradually increase it as tolerated. Contact your doctor immediately if you experience severe side effects or concerning symptoms. While these medications are highly effective, monitoring side effects, staying active, and following a balanced diet can help improve your experience.

Choosing between Wegovy or Ozempic: Which is right for you?

Deciding between Wegovy^® and Ozempic^® depends on weight loss goals, insurance coverage, cost, and availability. Since both contain semaglutide, they work similarly, so these differences will be the most significant factors when you are deciding between them. Let’s break them down:

• Weight loss goals: Both Ozempic^® and Wegovy^® can help you lose weight, but the right choice depends on insurance coverage and your budget. If you’re using Ozempic^® for weight loss and not seeing results at the highest dose (2 mg), you may need Wegovy^® at 2.4 mg for additional support.
• Insurance coverage: Ozempic^® can be covered for type 2 diabetes but typically isn’t for weight loss. Wegovy^® has more restrictive coverage, as many insurers don’t cover weight loss medications. Some private and employer-sponsored plans may offer coverage, but prior authorization is often required. Always check with your insurance for details on your specific plan.
• Price: Without insurance, Ozempic costs around $997 per month, while Wegovy is more expensive at $1,349 monthly. Exploring savings programs and alternatives can help.
• Side effects: Since Ozempic^® and Wegovy^® contain the same active ingredient, they have the same side effect profile. Common side effects include nausea, vomiting, diarrhea, and constipation, especially when starting or increasing the dose. Serious side effects like pancreatitis, kidney problems, and allergic reactions are rare but require immediate medical attention.
• Availability: Both Wegovy^® and Ozempic^® have faced supply shortages, making them difficult to find at some pharmacies. They were both removed from the FDA shortage list, and all doses are listed as “available.” Still, it’s a good idea to check with your pharmacy in advance to confirm stock or explore backup options if needed. Here are some tips on locating Wegovy or Ozempic in stock. 

Alternatives to Ozempic^® and Wegovy^®

If Ozempic^® or Wegovy^® isn’t the right fit due to cost, side effects, availability, or personal preference, you can consider alternatives. These include other GLP-1 receptor agonists and non-GLP-1 options. Let’s take a look:

Other semaglutide medications

Rybelsus^®  is semaglutide in pill form that is FDA-approved for diabetes management and sometimes used off-label for weight loss. The list price without insurance is $998 per month, similar to Ozempic^®.

Compounded semaglutide via Noom GLP-1^Rx

Those who need a more affordable alternative can explore compounded semaglutide via Noom GLP-1^Rx. It contains the same active ingredient as Ozempic and Wegovy at a potentially more affordable price. If you qualify for Noom Med, a clinician can determine whether it is a good option. If prescribed, it will cost $149 for the first month, with medication included. You’ll get access to a clinician to answer your questions and develop a weight loss plan. You can also access all of Noom’s tools, trackers, and fitness programs. Plus, you’ll be part of a community that will motivate you on your weight loss journey.

Tirzepatide medications

Tirzepatide works similarly to semaglutide but targets GLP-1 and GIP receptors, which may lead to more significant 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 Wegovy^®. 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 medications

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 medication

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

Other medications may be an option if GLP-1 medications aren’t available or covered. Their effectiveness varies from person to person.

• Metformin – Metformin is typically prescribed to treat type 2 diabetes but is sometimes used off-label for weight loss. 
• Orlistat – Orlistat blocks fat absorption and is taken three times daily with meals. The cost ranges from $50 to $800 per month without insurance.
• Phentermine – Phentermine is a short-term appetite suppressant taken once daily. Prices typically range from $27 to $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.

Ozempic^® and Wegovy^®: Choosing a weight loss medication

Choosing between Ozempic^® and Wegovy^® depends on more than what might get you to your goal weight. Since both medications are identical, insurance coverage and accessibility can be the biggest factors. 

At the end of the day, the best choice is the one that aligns with your long-term goals and fits into your budget. No matter which medication you take, building sustainable habits—like balanced eating, regular activity, and behavior change—is essential for long-term success. If you’re considering your options, talk to your doctor to find the best fit, or explore Noom Med for additional support in your weight loss journey.

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

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