Ozempic vs Rybelsus vs Saxenda vs Victoza for Weight Loss

Listen to this article on Spotify, watch it on YouTube, 或者用中文读。

Ozempic vs Rybelsus vs Saxenda vs Victoza

Ozempic, Rybelsus, and Victoza are medications used for diabetes. They also happen to have a noticeable weight loss effect.

Currently, these three are approved in Canada only for treating diabetes. Nevertheless, they can also help patients who are taking them to lose weight.

But how do they work? And how do their weight loss effects compare to the weight loss drug known as Saxenda?

Let’s compare the four closely related drugs Ozempic vs Rybelsus vs Saxenda vs Victoza and also touch on Wegovy briefly for all their effects on weight loss. I’ve also done a separate more comprehensive comparison of all GLP-1 agonists.

Victoza and Saxenda are essentially the same drug, known as liraglutide, just officially used for different purposes. Whereas Victoza is used for diabetes, Saxenda is used for weight loss.

Ozempic and Rybelsus are also essentially the same drug, known as semaglutide. Both are used to treat diabetes, however Ozempic is injected, whereas Rybelsus is a pill.

A newcomer to the market, Wegovy, is also semaglutide, and is essentially a higher dose of Ozempic. Wegovy is marketed specifically for weight loss, while Ozempic is marketed specifically for diabetes.

They all work in similar ways, by stimulating the effects of a hormone called Glucagon-like peptide-1 or GLP-1. We call these types of drugs GLP-1 agonists.

This hormone stimulates the release of insulin, and therefore helps diabetics with poor insulin control.

GLP-1 also makes us feel full, so all four drugs also have the effect of suppressing appetite, often resulting in weight loss when used by patients.

There’s a lot of similarities here, so if you’ve used Saxenda before, they will all work in a very similar capacity to suppress your appetite. So in this article, I’ll do my best to focus on the differences between all four drugs.

Dosing

Probably one of the biggest differences between all four drugs is how they’re dosed. The following doses are in milligrams (mg):

Semaglutide drugs

• Ozempic (1x/wk): 0.25 → 0.5 → 1.0 (max of 2.0)
• Rybelsus (1x/day): 3.0 → 7.0 → 14.0
• Wegovy (1x/wk): 0.25 → 0.5 → 1.0 → 1.7 → 2.4

Liraglutide drugs

• Saxenda (1x/day): 0.6 → 1.2 → 1.8 → 2.4 → 3.0
• Victoza (1x/day): 0.6 → 1.2 → 1.8

Victoza and Saxenda, which is liraglutide, are given by injection, once per day.

However, Saxenda is often dosed higher than Victoza, to achieve a greater appetite suppression, at the expense of increased side effects.

Ozempic and Wegovy, which are semaglutide, are given by injection as well, but only once per week, since it’s a longer-acting drug.

Rybelsus, which is also semaglutide, is a pill taken once per day.

Approved uses and availability

All the medications are available in Canada with a prescription.

Of all the GLP-1 agonists, only Saxenda and Wegovy is approved for weight loss alone.

The other three are approved only for type 2 diabetes control, albeit not a first choice for treating diabetics.

However, this doesn’t stop clever patients and physicians from using them off-label for weight loss.

Rybelsus is a newer medication, so it might be harder to find than the other three.

Costs

Saxenda and Wegovy will be the most expensive. They can cost up to a few thousand dollars a month.

Between Victoza, Ozempic, and Rybelsus, costs can vary, but I’ve seen a few hundred dollars per month. So they’re still pretty expensive.

Also, Victoza and Ozempic are often covered by insurance to help treat diabetics, while Saxenda, which is used to just treat obesity, is not covered as often.

Side effects

• Saxenda will likely have more side effects than Victoza
• Ozempic may have slightly more side effects than Rybelsus
• Wegovy is expected to have the most side effects

They all carry similar side effect profiles, with the most common being nausea, followed by gastrointestinal disturbances, like diarrhea, abdominal pain, cramping, vomiting, heartburn, and so on.

Also, the same rare, but more severe side effects show up on all their packaging, like damage to the liver or pancreas, gallstones, kidney failure, an increase in thyroid cancers, and so on.

Saxenda is given at a higher dose than Victoza, and will likely result in more side effects.

Wegovy is given at a higher dose than Ozempic, and will also likely result in more side effects.

Rybelsus is the only GLP-1 agonist which is a pill taken orally. The others are all injected, and although they use an auto-injector that makes the process a little easier, you’ll still have to learn how to inject yourself properly.

So additional bruising, bleeding, and other possible side effects related to injections are applicable to Ozempic, Wegovy, Saxenda, and Victoza.

Effectiveness for weight loss

They all work by suppressing your appetite and controlling insulin levels.

However, studies seem to suggest that semaglutide may cause more people to lose weight than liraglutide. The total amount of weight loss appears to be similar, just that more people are losing weight on semaglutide.

This would suggest that Ozempic and Rybelsus probably works just as well, if not slightly better than Victoza and Saxenda in causing weight loss in patients. This may be especially true with Wegovy, which is semaglutide with a larger dose than Ozempic, marketed specifically for weight loss.

Comparison studies suggest that Wegovy is likely the strongest GLP-1 agonist at the moment.

Between Victoza and Saxenda, the higher dose used in Saxenda makes it more effective for weight loss than Victoza.

In practice, I haven’t really noticed any significant difference between them all, and they can all be quite effective at helping patient’s lose weight when used with a proper weight loss protocol.

In addition to their similar effectiveness, I’ve also noticed their similar ineffectiveness. If one doesn’t work for someone, or stops working for them, switching to another rarely seems to work.

For example, I’ve had patients put onto Ozempic, and experience no weight loss.

They then switch to Saxenda, and experience the same thing, nothing.

I’ve also had many patients switch from Saxenda to Ozempic, when Saxenda stopped working for them, and many of them had no additional weight loss effects.

Summary

They all may be useful if you have a hard time with controlling hunger and tend to overeat and snack too often.

At the moment, only Saxenda and Wegovy are approved for weight loss alone, so if you’re not diabetic or have blood sugar issues, you’re probably getting Saxenda.

While I cannot officially condone off-label use, if you had the choice to try any one of them to help with weight loss, Ozempic may be easier on your wallet, and might be easier to get yourself used to injecting your own medication, since it’s only done once per week.

Rybelsus is a lot newer than the others and may be more difficult to get, but if you can get it, it may have the additional benefit of not having to inject yourself.

However, if you’ve tried any one of them before, and it hasn’t affected your weight, switching to another will not likely have any effect on your weight either.

Regardless, you’ll need to check with your doctor to see if any of them are appropriate for you to use. And remember that the drugs should never replace the implementation of good dietary and lifestyle habits for losing weight.

Learn more about

• What to Expect With Wegovy
• What Forms of Semaglutide are Available?
• Comparing GLP-1 Agonists for Weight Loss
• 5 Things To Know Before Starting Weight Loss Medication
• Other weight loss medications

See also

• 
  Comparing Weight Loss Drugs in 2024
  Ozempic and Mounjaro are highly effective at treating obesity, however there are many other approved and off-label options that also work.
• 
  Bupropion vs Contrave vs Naltrexone
  Contrave is a synergistic combination of buproprion and naltrexone, which can be replicated to some degree using the generics individually.
• 
  New Obesity Drugs in 2024
  New obesity drugs target more than just GLP-1 and do much more than suppress appetite for a more nuanced approach to weight loss.
• 
  Mounjaro: Who Loses the Most Weight?
  White or Asian younger women who use metformin and have lower sugar and lipid levels tend to experience more weight loss with Mounjaro.
• 
  How does Oforglipron compare?
  Orforglipron, Semaglutide, and Danuglipron are oral GLP-1 agonists that are all similar enough that cost may end up being the winning factor.