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Ozempic Alternatives: Three Options For Weight Loss, According To Experts

— By Rena Goldman | Forbes

Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board. Getty Creative

Ozempic is exclusively approved by the Food and Drug Administration (FDA) as a medication to treat type 2 diabetes, but semaglutide (its active ingredient) has become increasingly popular for its ability to boost weight loss. Even though Ozempic shows promise as a weight loss medication, it might not be for everyone; the medication isn’t safe for people with certain conditions, it can be pricey and there are side effects and supply concerns to consider.

Depending on your health history, preferences, the medication’s cost and availability and your treatment needs, you might want to consider different options. In this article, we explore some alternatives to Ozempic for weight loss.

What Is Ozempic?

Ozempic is an FDA-approved medication for treating type 2 diabetes. Its active ingredient is semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist that acts like the GLP-1 hormone released in the digestive tract when eating. This weight-regulating hormone “signals fullness to the brain, delays stomach emptying and lowers blood sugar,” says Rekha Kumar, chief medical officer at the medically-assisted weight loss program, Found, and practicing endocrinologist in New York City.

The medication is available by prescription only and is used as a weekly injection to help with blood sugar management and help reduce the risk of a heart attack or stroke in people with type 2 diabetes. Since semaglutide has shown effectiveness in reducing body weight for those with overweight or obesity, Ozempic may also aid in weight loss. However, Ozempic itself is not FDA approved to treat weight loss alone in patients without a diagnosis of type 2 diabetes.

Ozempic Alternatives For Weight Loss: Similar Medications

Many people with obesity have a difficult time losing a significant amount of weight and keeping it off with lifestyle changes alone, notes Katherine H. Saunders, M.D., co-founder of Intellihealth, an obesity treatment company, and clinical assistant professor of Medicine at Weill Cornell Medicine in New York. This is where medication can come into play.

“Some [weight loss] medications are better for hunger, some are better for cravings, and some are great for both,” says Dr. Saunders. She stresses the importance of selecting an anti-obesity medication based on a personalized treatment plan. “Obesity is not a simple disease, and there’s no one medication that’s right for everyone.”

While Ozempic isn’t FDA-approved for weight loss, Wegovy and Saxenda—two weight loss medications that are also GLP-1 agonists—are.

“Just like Ozempic, Wegovy and other GLP-1 agonists are the most effective weight loss medications that currently exist,” says Raoul Manalac, M.D., the senior director of clinical experience at Ro, a company offering at-home medical treatment.

The list price (according to Novo Nordisk, the manufacturer of Ozempic and Wegovy) of Ozempic is $935.77. However, the manufacturer notes that most people don’t pay list price when the drug is covered by insurance.

By comparison, Novo Nordisk lists Wegovy at $1,349.02 per package. The company also notes that when health insurance covers weight-management medications, people don’t pay list price. Saxenda, which is also made by Novo Nordisk, is listed at $349.02.

What an individual ends up paying will depend on their insurance coverage for anti-obesity medications.

Wegovy

Wegovy is another injectable medication made with semaglutide (the active ingredient in Ozempic). It’s approved by the FDA for weight management in people with a body mass index or BMI of 27 who have another weight-related condition, such as type 2 diabetes, or those with a BMI of 30 or higher. In recent research, semaglutide showed a higher effectiveness for weight loss than older medications, with the potential for a 15% weight loss after 68 weeks in adults with a BMI of 30 or greater[1].

Like Ozempic, it’s also prescription only and taken once a week. The main difference between the two, notes Dr. Saunders, is in the instructions for increasing the dose and the highest dose given.

Saxenda

Saxenda, like Ozempic and Wegovy, is a GLP-1 receptor agonist, but it’s made with liraglutide (instead of semaglutide). The medication is also prescription-only and FDA-approved for the treatment of obesity in people aged 12 and older who weigh more than 132 pounds or adults with BMI of 30 or higher. While liraglutide may be slightly less effective than semaglutide, it’s still a potent weight loss medication that could lead to up to an 8% weight loss, says Dr. Manalac.

Liraglutide works by helping to decrease appetite and slow the emptying of the stomach, which causes feelings of fullness and leads to lower calorie intake.

Saxenda is a daily injection, while Ozempic and Wegovy are weekly injections.

Ozempic Alternatives For Weight Loss: Natural Solutions

Weight loss medications can be effective, but many people gain the weight back after stopping them. They may also not be covered under insurance or Medicaid in many states. Those who are not able to access or use weight loss medications may choose to focus on natural solutions, such as dietary changes and exercise.

Even if you do use weight loss medications, they’ll still need to be paired with dietary changes and regular physical activity for the best results. In fact, the FDA notes in its approval of Saxenda for weight management in individuals ages 12 and older that the medication is an additive to a reduced calorie diet and increased physical activity.

If you’re not sure how to start changing your diet or making physical activity part of your weekly routine, healthcare providers can help. Dietitians and nutritionists can provide personalized counseling to help you plan meals and make lasting changes to your eating habits. A healthcare provider can also help you get started on an exercise routine that’s safe for you.

Dietary Changes

In order to achieve and maintain weight loss in the long term, the changes you make should be habits you can keep, rather than following the latest diet fad. In fact, recent research concludes there’s no one best weight loss strategy. and that healthcare providers should consider a person’s personal preferences when helping them come up with a plan[3].

However, there are general recommendations for dietary changes that can help with weight loss.

Dr. Kumar recommends increasing protein intake because eating protein reduces hunger. “To maximize muscle preservation during active weight loss, people should focus on consuming 25 to 30 grams of protein per meal,” she says. Some easy ways to get extra protein in your diet include using low-fat Greek yogurt or cottage cheese as part of a snack or in place of sour cream, adding beans to salads and using quinoa instead of rice or pasta, adds Dr. Kumar.

People should consider making dietary changes by avoiding ultra-processed foods, added sugars, fast food and sugar-sweetened drinks, advises Dr. Saunders. Ultra-processed foods include potato chips, lunch meats, white bread and anything that must be heavily processed to make. These foods have ingredients like high-fructose corn syrup, artificial flavors and hydrogenated oils. Research suggests that ultra-processed foods are linked to weight gain.

Another behavior change Dr. Saunders encourages people to make is to consume most of their calories during the day and try to make dinner a smaller, earlier meal. “Research shows that eating late decreases calories burned, increases calories stored as fat and leads to more hunger in general,” she explains.

Physical Activity

Physical activity has a number of physical and mental health benefits, including reducing the risk of type 2 diabetes, high blood pressure and osteoporosis, and improving the quality of sleep. It’s also an important part of losing weight and maintaining a healthy weight. The Centers for Disease Control and Prevention (CDC) recommends at least 150-300 minutes of moderate-intensity aerobic activity each week.

Examples of moderate activity include walking and biking, while high-intensity activities may include running, swimming laps or jumping rope.

In order to lose weight or maintain weight loss, you’ll need to pair regular physical activity with dietary changes.

Over-The-Counter Ozempic Alternatives: Why You Should Avoid Them

The semaglutide weight loss medications Ozempic and Wegovy are available by prescription only, and there are no FDA-approved generic versions. This means only the pharmaceutical company that makes them can produce the FDA-approved drugs.

“Unauthorized semaglutide (Ozempic) alternatives that pharmacies are offering are called compounded semaglutide,” explains Dr. Kumar. “Compounded medications are not FDA-approved or vetted, and are custom-made by combining, mixing or altering ingredients to create a medication tailored for a specific patient, including the combining of two or more drugs.”

The FDA warns consumers about drug compounding and recommends that people avoid them because they aren’t regulated.

“We have no idea what the products contain, what the actual dose of the active ingredient is or whether the product has contaminants,” notes Dr. Saunders.

Whether Ozempic or an alternative medication is right for you will come down to your personal health history. Speaking with your doctor is the best way to figure out which weight loss method will work best.