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

What you’ll learn:

• Rybelsus^® and Ozempic^® both contain semaglutide and can regulate blood sugar and reduce appetite. 
• Rybelsus^® comes as a pill you take once a day, while Ozempic^® is a once-weekly injection.       
• Ozempic^® will likely be more effective for weight loss than Rybelsus^® at its current doses.

If you’ve been thinking about getting a prescription for a weight loss medication, you’ve likely heard of Ozempic^®. This injectable medication, developed to treat type 2 diabetes, has become a popular (off-label) choice for people looking to lose weight. It’s not the only option, though. Its active ingredient, semaglutide, is also available in two other branded medications, Wegovy^® and Rybelsus^®. 

Rybelsus^®, like Ozempic^®, is approved to treat type 2 diabetes and can be prescribed off-label for weight loss. Wegovy^® is approved for weight management and to prevent cardiac events like heart disease and stroke. The biggest difference between Rybelsus^® and Ozempic^® or Wegovy^® is that it comes as a once-daily pill, while the others are taken as once-weekly injections. Can Rybelsus^® be a convenient oral option for Ozempic-level weight loss? Let’s take a look at it side by side with Ozempic^®.

We’ll break down the similarities and differences, go through what the studies say, and discuss potential insurance coverage and costs to help you decide if one is right for you. First, let’s take a look at how each medication works.

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

As we said, Ozempic^® and Rybelsus^® contain semaglutide, a GLP-1 receptor agonist that mimics a hormone called GLP-1. GLP-1 (short for glucagon-like peptide 1) is released by your body after you eat certain things. Semaglutide bonds to GLP-1 receptors in your digestive system, brain, and other organs to:

• Reduce appetite
• Slow digestion
• Regulate blood sugar 

These actions can help you eat less and lose weight. When combined with healthy lifestyle changes, they work even better. 

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

While Ozempic^® and Rybelsus^® work in a similar way, they have important differences. Let’s go through those: 

How they are taken

The biggest is how they are taken. Ozempic^® is a once-weekly injection that you give yourself with a prefilled pen. Rybelsus^® comes as a pill that you take once per day. 

Dosing

Rybelsus^® and Ozempic^® have very different dosage amounts because even though they contain the same active ingredient, they are absorbed differently. 

• Rybelsus^® is prescribed in higher doses since it’s absorbed through the digestive system and is partially broken down by stomach acid. Its doses range from 3 mg to 14 mg.
• Ozempic^® is injected directly into the upper arm, stomach, or thigh. It requires lower doses and only needs to be taken once a week. Its doses range from 0.25 mg to 2 mg.

Effectiveness

According to studies, Ozempic^® is significantly more effective than Rybelsus^®. While both contain semaglutide, their differences in formulation and absorption impact their overall weight loss results. Let’s take a look at what the studies show.

• Ozempic^®: In one study, people lost 10 to 15% of their body weight over two years, depending on the dose of injected semaglutide.
• Rybelsus^®: After one year, people taking Rybelsus^® were able to lose about 4% of their body weight. This difference is likely due to the amount of semaglutide absorbed with a pill. 

Could Rybelsus^® be an effective option for weight loss in the future? Possibly. A study found that people taking a 50 mg dose of oral semaglutide (much higher than the current highest dose of 14 mg) lost an average of 15% of their body weight over 68 weeks. This weight loss was comparable to the results seen with injectable semaglutide. 

Ozempic^® vs. Rybelsus^®: What are the similarities?

As we’ve touched on, Rybelsus^® and Ozempic^® have a lot in common. This isn’t surprising, considering they are essentially the same medicine, semaglutide, in different forms. Here are some more of the things they share:

They share a manufacturer

Both Rybelsus^® and Ozempic^® are made by Novo Nordisk, a global healthcare company that focuses on treatments for diabetes and other chronic diseases. Ozempic^® was approved by the FDA for diabetes management in 2017. Rybelsus^® followed in 2019. Wegovy^® was approved to manage weight in 2021. In March 2024, the FDA also approved Wegovy^® to reduce the risk of heart-related events, such as heart attacks and strokes.

They have the same approved use

Both medications are FDA-approved for managing type 2 diabetes, and they can be prescribed off-label for weight management. 

They have the same list price

Both Ozempic^® and Rybelsus^® have a list price of about $998 per month. Your insurance coverage (or lack of it) will affect the price you pay. Savings programs and manufacturer discounts can help reduce costs, 

Insurance coverage for weight loss is rare

Coverage for both medications varies depending on individual insurance plans and the reason you are taking them. Some plans cover Rybelsus^® and Ozempic^® for diabetes treatment. But, it is rare for insurance to cover these medications for weight loss treatment. 

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

It’s possible to switch between Ozempic^® and Rybelsus^®, but you should only do so under the supervision of a medical professional. These medications have different rates of absorption and stay in the body for different amounts of time, so it’s important to get the timing right when switching from one to the other.

Your doctor will look at your current dose, how your body has responded to the medication, and your side effects to determine the best strategy for changing medications. Because Ozempic^® and Rybelsus^® are administered differently and may affect your body in different ways, your doctor will typically start you at an equivalent or slightly lower dose to minimize side effects.

Your reasons for switching may also impact the best approach for you. Here are a few reasons why you might want to switch between Rybelsus^® and Ozempic^®.

• You need more weight loss support: If you find you’re not getting the weight loss results you want with Rybelsus^®, you might consider switching to Ozempic^®. 
• You may be having uncomfortable side effects: If you’re experiencing more side effects, you may want to try a different medication to see if there is any improvement.
• Your insurance may cover one and not the other: Though both are rarely covered by insurance for weight loss, if yours covers one and not the other, you may want to switch.

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

Ozempic^® will likely be more effective for weight loss due to differences in absorption and dosing. Since Rybelsus^® is absorbed through the digestive system, higher doses than are currently approved are required to achieve effects similar to those of Ozempic^®. Studies are being done to see if higher doses of Rybelsus^® will result in the same weight loss potential as injectable semaglutide. 

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

Clinical trials show that injectable semaglutide leads to more weight loss than oral semaglutide at current doses. Let’s take a look at the numbers: 

• In one study, people taking 14 mg of Rybelsus^® (the highest dose currently available) lost about 4% of their body weight over a year. 
• In comparison, a two-year study showed an average loss of 10 to 15% of body weight for those taking injectable semaglutide.

How long does it take to see results?

Many people begin noticing weight loss within the first three months of taking Rybelsus^® or Ozempic^®, especially when paired with healthy lifestyle changes.

Short-term results (3 to 6 months)

• Rybelsus^®: Clinical studies show that people lost about 4% of their body weight in the first six months.
• Ozempic^®: Studies show that weight loss tends to be slightly higher, with people losing an average of 6% of their body weight at three months and 11% at six months.

Long-term results (12+ months)

Over one year, the weight loss effects of Ozempic^® become more pronounced, but those with Rybelsus^® remain the same:

• Rybelsus^®: People lost an average of 4% of their body weight over a year with Rybelsus—not much more than at the six-month mark. 
• Ozempic^®: People taking Ozempic^® typically lose an average of 16% of their body weight in a year.

Your results will, of course, vary. The key to achieving long-term success with these medications is to also make sustainable lifestyle choices like eating a healthy diet and exercising regularly. Some people may experience plateaus or fluctuations in weight loss, but sticking with the medication and maintaining healthy habits like balanced nutrition and regular activity can help maximize results.

Who can take Ozempic^® or Rybelsus^® for weight loss?

If you’re considering Ozempic^® vs Rybelsus^® for weight loss, your BMI and overall health will play a key role in determining your eligibility. While these medications are FDA-approved for type 2 diabetes, they are often prescribed off-label for weight loss to people who meet the following conditions:

• BMI of 30 or higher 

or

• BMI of 27 or higher with a weight-related health condition like high blood pressure, sleep apnea, or insulin resistance.

Having a prescription doesn’t mean your insurance will cover them. Insurance coverage for Ozempic^® and Rybelsus^® as weight loss treatments is very limited. 

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

Ozempic^® or Rybelsus^® are considered safe, but if you have certain conditions or family history, you shouldn’t take them, including:

• A personal or family history of medullary thyroid carcinoma (MTC) – MTC is a rare type of thyroid cancer.
• Multiple endocrine neoplasia syndrome type 2 (MEN 2) – MEN 2 is a genetic condition that increases the risk of thyroid tumors.

Talk to your doctor if you have a history of:

• Pancreatitis
• Severe kidney disease 
• Severe gastrointestinal issues 

You also can’t take Ozempic^® or Rybelsus^® if you are pregnant, plan to become pregnant, or are breastfeeding. Read more about what you need to know about Ozempic^® and pregnancy.

If you take Rybelsus^® 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 Rybelsus^® 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 Rybelsus^® 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. Read more about how to prevent weight gain after stopping Ozempic^®.
• 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. Rybelsus^® and Ozempic^® can be tools for weight loss, but maintaining progress comes down to sustainable lifestyle changes.

Rybelsus^® vs. Ozempic^® costs

While the list price for Rybelsus^® and Ozempic^® is the same, the exact price you’ll pay will depend on your insurance coverage, pharmacy pricing, and your eligibility for manufacturer discounts and savings programs. We’re also including the comparison of Wegovy^® because it can be more affordable than both of these medications in certain cases. Here’s a look:

Brand name	Available doses	Cost (monthly)
Ozempic®	0.25 mg, 0.5 mg, 1 mg, 2 mg	$998 Learn more about the cost of Ozempic®.
Rybelsus®	3 mg, 7 mg, 14 mg	$998 Learn more about the cost of Rybelsus®.
Wegovy®	0.25 mg, 0.5 mg, 1 mg, 1.7 mg, 2.4 mg	$1,350 NovoCare® Pharmacy: $499 (if you don’t have insurance) Learn more about the cost of Wegovy®.

Ozempic^® vs. Rybelsus^®: Side effects

Semaglutide can cause side effects ranging from mild discomfort to more serious complications. Since these medications work in similar ways, they share many of the same potential side effects, though the frequency and intensity can vary from person to person.

Your body also needs time to adjust. Many people experience mild gastrointestinal issues when they first start or increase their dose, with nausea being the most common complaint. These symptoms often improve over time as your body adapts.

There are also serious risks associated with GLP-1 medications that you should be aware of before starting treatment. We’ll go through those below.

Common side effects

Most people report experiencing the following, but most continue taking it and adjust well: 

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

Serious side effects and warnings

While Rybelsus^® and Ozempic^® 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 Ozempic^®

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 Ozempic^®.
• Vision changes: If you notice any sudden changes in your vision while taking any, 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 Ozempic^® 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 full breakdown of potential risks, check out Ozempic^® safety information and learn more about Rybelsus^®. 

Which is safer: Ozempic^® or Rybelsus^®?

Rybelsus^® and Ozempic^® 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 to help you make lifestyle changes and maintain long-term success while taking weight loss medication.

Rybelsus^® vs. Ozempic^® : Dosage and administration

While both medications contain semaglutide, they are taken very differently and have different doses. Ozempic^® is a once-weekly injection, while Rybelsus^® is taken as a morning pill. Here’s what to expect with each:

• 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 for the first month, increasing to 7 mg and then 14 mg as needed and tolerated. 
• Ozempic^®: To take Ozempic^®, you will inject once a week with a prefilled injection pen. Your timing can be flexible, but it should be on the same day of the week. The injection goes under the skin (subcutaneous) in your stomach, thigh, or upper arm. Ozempic^® 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 Ozempic^® is 0.25 and is increased gradually to 0.5 mg, 1 mg, and 2 mg as needed and tolerated. If you need to go beyond the 2 mg dose to continue losing weight, you’ll need to switch to the 2.4 mg dose of Wegovy^®.

Choosing between Rybelsus^® or Ozempic^®: Which is right for me?

Choosing between Rybelsus^® and Ozempic^® is all about finding what fits best with your lifestyle, preferences, and health goals. Both medications contain semaglutide and work in similar ways, but differences in administration, costs, insurance coverage, and availability may make one a better choice for you.

Medication	Ozempic®	Rybelsus®
Pricing per month (without insurance)	About $998 per month Learn more about what affects the cost of Ozempic®.	About $998 per month Learn more about what affects the cost of Rybelsus®.
Effectiveness	People taking injections of semaglutide lost 10 to 15% of their body weight over two years.	People taking Rybelsus® lost about 4% of their body weight after one year.
How to take it	Once-weekly injection	Once daily pill
Doses	0.25 mg, 0.5 mg, 1 mg, and 2 mg	3 mg, 7 mg, and 14 mg
Insurance coverage	More likely covered for diabetes, rarely for weight loss.	Same.

Alternatives to Ozempic^® and Rybelsus^®

Ozempic^® and Rybelsus^® can be effective for weight loss, but they might not be the right for everyone. Cost, individual preferences, or specific health needs might lead you to explore other options. There are several alternative medications that can effectively support your weight loss journey. These include other GLP-1s and other oral medications. Let’s take a look at them:

Semaglutide medications

As we’ve mentioned, there’s another medication that has semaglutide and is FDA-approved for weight loss. Wegovy^® has a list price of $1,350 per month and is taken as a weekly injection like Ozempic^®. If you don’t have insurance and get your prescription filled through the NovoCare^® Pharmacy, you will pay $499 per month for all doses of Wegovy^®.

Tirzepatide medications

Tirzepatide is a dual receptor agonist; what does that mean? While semaglutide mimics only the GLP-1 hormone, tirzepatide medications mimic both GLP-1 and GIP to improve blood sugar control and promote weight loss. A couple of different medications contain tirzepatide:

• Zepbound^® – Zepbound^® is FDA-approved for weight management and treatment of obstructive sleep apnea (OSA). It costs roughly $1,086 per month without insurance.
• Mounjaro^®  – Approved for type 2 diabetes, like Ozempic^®, Mounjaro^® is often prescribed off-label for weight loss. The current list price for Mounjaro^® is $1,080 per month without insurance.

Compounded semaglutide 

If you qualify for Noom Med, you can ask your clinician about compounded semaglutide* through Noom GLP-1^Rx. It contains the same active ingredient as Ozempic^® and Wegovy^® but can be more affordable for some people. Your clinician can determine if it is the right medication for you and then prescribe it if needed. It starts at $149 for the first month and then costs $279 per month, billed in three-month increments. This price includes medication delivered to your door, unlimited access to a clinician, and a weight loss plan designed specifically for you. You’ll also get access to all of Noom’s trackers, tools, and community support. Here’s how you can find out if a prescription for compounded semaglutide is right for you.

Liraglutide medications

Liraglutide is another medication that mimics the GLP-1 hormone, like semaglutide, but requires daily injections rather than weekly. There are a few different medications that contain this active ingredient:

• Saxenda^®: This version of liraglutide is FDA-approved for weight loss and has a list price of $1,349 per month without insurance. Learn more about what Saxenda costs.
• Victoza^®: FDA-approved to manage type 2 diabetes, Victoza^® is sometimes prescribed off-label to help with weight loss. Without insurance, it typically costs between $800 and $1,400 per month.
• Generic liraglutide: Generic liraglutide can be a budget-friendly choice, with prices around $470 for a two-pen pack and $704 for a three-pen pack.

Dulaglutide medications

Dulaglutide is a weekly injectable GLP-1, available under the brand name Trulicity^®. It works similarly to Ozempic^®  but targets GLP-1 receptors differently and might be less effective. 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

While GLP-1 medications are a very popular choice, other weight loss medications can also be effective or more affordable for some people. Here are some of the alternatives. (Always double-check the prices at your pharmacy for the most accurate numbers.)

• Metformin – Metformin is FDA-approved for diabetes, but it can be prescribed off-label for weight loss. It can help people lose modest amounts of weight. If you qualify for Noom Med, your clinician can decide if a prescription for metformin is right for you. It will cost $59 for the first month and $89 for recurring 3-month supplies if prescribed. You’ll also get access to medical counseling, a coach, and Noom’s trackers and tools.
• Orlistat – This medication helps block fat absorption and is taken three times daily with meals. The cost can vary widely, ranging from $50 to $800 per month without insurance.
• Phentermine – Phentermine is an appetite suppressant designed for short-term use. It’s taken once daily to help reduce hunger. Prices typically range from $27 to $100 per month without insurance.
• Diethylpropion – Diethylpropion is taken one to three times daily and is used for short-term appetite suppression. Its price ranges from $40 to $85 per month without insurance.
• Naltrexone and bupropion (Contrave) – This combination drug is FDA-approved for weight management and helps reduce appetite and cravings. For people using the CurAccess™ Patient Support Program, Contrave is $99 per month with free shipping. If your insurance covers Contrave, it may cost less. Without these benefits, prices can range from $600 to $800 per month.

Making the right choice for your weight loss journey

Choosing between Rybelsus^® and Ozempic^® for weight loss comes down to what works best for your lifestyle and health goals. The list price for these two medications is the same, but your personal insurance coverage could be a factor. Ozempic^® will likely have greater weight loss results, but if you prefer to take an oral medication rather than an injection, Rybelsus^® might be the right choice for you. Ultimately, your personal health goals, budget, and tolerance of side effects can help you and your healthcare provider decide which is the right option for you.

And, again, medication is just one piece of the puzzle. In order to be successful with any weight loss medication, it’s important to develop sustainable diet and exercise habits. Noom can help you build lasting healthy habits and give you the extra support you need to succeed. By combining the right medication with meaningful lifestyle changes, you’re setting yourself up for long-term success. Ready to take the next step? Explore Noom’s resources and start building a plan that supports both your weight loss goals and overall well-being.

*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.