Ozempic Alternatives for Weight Loss: What Are Your Options?

Craig Primack, MD, FACP, FAAP, FOMA

Reviewed by Craig Primack, MD, FACP, FAAP, FOMA

Written by Vanessa Gibbs

Published 04/17/2024

Ozempic® is an FDA-approved medication for people who have type 2 diabetes. It’s often prescribed “off-label” for weight loss — when a drug is prescribed for something it’s not approved for.

It can be effective, but it’s not for everyone. And even if it’s suitable for you, it’s not your only option if you’re looking to lose weight.

Ozempic alternatives for weight loss include:

  • Compounded semaglutide injections

  • Other weight loss injections like Wegovy® and Zepbound®

  • Oral weight loss medications like metformin and Topamax®

  • Drug-free weight loss options like eating nutritious foods and doing more movement

Keep reading to learn more about the different Ozempic alternatives out there.

If you’re looking for weight loss medications similar to Ozempic, there are other weight loss injections and oral weight loss medications to consider. Some drugs are FDA-approved for weight loss and others are prescribed off-label.

Here are your options.

Compounded Semaglutide

Wegovy

Looking for a weight loss medication similar to Ozempic? You can’t get much closer than Wegovy.

Like Ozempic, Wegovy is a glucagon-like peptide-1 (GLP-1) receptor agonist and it has the same active ingredient: semaglutide. It’s also manufactured by Novo Nordisk, it’s a once-a-week injection and it works for weight loss in the same way, by reducing your appetite to promote weight loss.

The difference? It contains a higher dose of semaglutide and it’s FDA-approved for weight loss.

Wegovy is approved for people with a body mass index (BMI) of 30 or more, or 27 or more with at least one weight-related condition, like high blood pressure, high cholesterol or type 2 diabetes.

A doctor will probably get you started on a 0.25 milligram (mg) dose that will slowly increase to 2.4mg.

We’ve compared Ozempic vs Wegovy here.

Mounjaro®

Mounjaro is another diabetes medication that’s like Ozempic. It’s FDA-approved to help people with type 2 diabetes manage their blood glucose levels, but it’s prescribed off-label for weight loss.

It’s a once-a-week injectable medication, but the active ingredient in Mounjaro is tirzepatide.

Unlike semaglutide, tirzepatide is a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist and a GLP-1 receptor agonist.

It works in a similar way to semaglutide, but research shows that it may be more effective for weight loss.

We put Mounjaro and Ozempic head to head here.

Zepbound

For another Ozempic-like drug for weight loss, consider Zepbound, Mounjaro’s weight loss counterpart.

Zepbound is another brand name for tirzepatide. It comes in the same doses as Mounjaro and works in the same way.

The only difference here is that Zepbound is FDA-approved for weight loss. It’s approved for those with a BMI of 30 or more, or 27 or more with a weight-related condition.

Victoza®

There are more semaglutide alternatives for weight loss. Victoza is also a GLP-1 receptor agonist, but the active ingredient is liraglutide.

Liraglutide works in a similar way to semaglutide when it comes to weight loss. It suppresses your appetite, helping you eat fewer calories and promoting weight loss.

Just like Ozempic and Mounjaro, Victoza is FDA-approved to help people who have type 2 diabetes manage their blood sugar levels, but it’s also prescribed off-label for weight loss.

But, instead of once a week, you’ll need to inject Victoza once a day. This might be a deal-breaker for the needle-phobes out there.

Your dose will probably start at 0.6mg and increase to 1.2mg after a week. If needed, your doctor may increase your dose to 1.8mg daily.

How does it compare to Ozempic alternatives? Research shows semaglutide may reduce food cravings and be more effective than liraglutide for weight loss, but liraglutide may be more effective than orlistat and lorcaserin.

Saxenda®

Saxenda is Victoza’s FDA-approved weight loss cousin. It’s approved for weight management in people with a BMI of 30 or more, or 27 or more with at least one weight-related health condition.

It’s a once-a-day injection that contains a higher dose of liraglutide than Victoza.

A doctor would probably get you started on a 0.6mg dose of Saxenda. This could slowly increase each week until a maximum dose of 3mg a day.

Research shows that participants taking a 3mg daily dose of liraglutide for a year experienced weight loss, but liraglutide led to even more weight loss when combined with increased physical activity.

Rybelsus®

Rybelsus has the same active ingredient as Ozempic, but it comes in tablet form. This can make it a great alternative to Ozempic for weight loss if you’re not a fan of needles.

As with many drugs on this list, it’s FDA-approved for people who have type 2 diabetes, but it’s often prescribed off-label for weight loss.

You’d take one Rybelsus tablet a day 30 minutes before any food, drink or other medication. Your starting dose will probably be 3mg a day and this will increase to 7mg after 30 days. After another 14 days, your doctor might increase your dose to 14mg a day if needed.

Metformin

Metformin is another oral medication. It’s used as a diabetes drug, but again, it can be prescribed off-label for weight loss.

For type 2 diabetes, you may take a metformin tablet with meals two or three times a day. Dosages may differ when taking it for weight loss.

It’s thought that metformin can help you lose weight as it can suppress your appetite and change your gut microbiome to promote weight loss.

Studies back it up. A 2020 meta-analysis of 21 trials found that metformin treatment could reduce BMI by one unit.

Beyond weight loss, there are more metformin benefits, including anti-tumor effects, and reducing the risk of heart disease.

Check out our guide to Ozempic vs metformin to see how they compare.

Contrave®

Contrave is yet another oral weight loss medication. It contains both naltrexone and bupropion and it’s FDA-approved for weight management in people with a BMI of 30 or more, or 27 or more with a weight-related condition.

Your dosage of Contrave would slowly increase from:

  • Week 1. One tablet in the morning.

  • Week 2. One tablet in the morning and one in the evening.

  • Week 3. Two tablets in the morning and one in the evening.

  • Week 4 onward. Two tablets in the morning and two in the evening.

It’s not entirely understood how Contrave works — spooky, we know — but it’s thought that it helps you lose weight as it can promote satiety (the feeling of fullness), reduce food intake and increase how much energy your body uses.

Topiramate

Topiramate, sometimes sold under the brand name Topamax, is an antiseizure drug. It’s also used to prevent migraines and prescribed off-label for weight loss.

You take topiramate tablets daily. The dose for weight loss can vary, but for epilepsy, the recommended dose is 400mg a day divided into two doses.

It’s not entirely clear how topiramate works, but it may help lower your calorie intake, decrease fat gain, and lower triglyceride and cholesterol levels.

Check out our guide to topiramate for weight loss for the full nitty-gritty.

Qsymia®

Qsymia is a combo of topiramate and phentermine, which is an appetite suppressant.

You take one tablet each morning. Timing is key, as Qsumia can cause insomnia if you take it in the evening.

Your dose might start at 3.75mg of phentermine and 23mg of topiramate and increase after two weeks to 7.5mg of phentermine and 46mg of topiramate daily.

Like many Ozempic alternatives, Qsymia is FDA-approved for weight management in people with a BMI of 30 or more, or 27 or more with a weight-related condition.

Research shows that treatment with topiramate and phentermine led to:

  • Weight loss

  • A reduction in waist circumference

  • A reduction in fasting triglycerides and fasting glucose levels

Xenical®

The active ingredient in Xenical is orlistat. Orlistat is a lipase inhibitor, which means it stops your body from absorbing fats from food. This results in a calorie deficit, which can promote weight loss.

You’d take a 120mg dose of Xenical three times a day.

In clinical trials, participants taking Xenical experienced weight loss after two weeks of treatment. This continued for six to 12 months.

Pooled data across five clinical trials showed that the average weight loss after six months on Xenical was 12.4 pounds and after a year of treatment it was 13.4 pounds.

This is compared to 6.2 pounds after six months of taking a placebo and 5.8 pounds after a year of taking a placebo.

Prescribed online

Weight loss treatment that puts you first

Weight loss medications aren’t the only way to lose weight. If you’re searching for alternatives to Ozempic for weight loss, consider natural options.

Drug-free weight loss methods are cheaper than medications, they don’t come with risks and side effects, and they can help you manage your weight long-term — weight gain can happen when you stop taking weight loss drugs.

Here are a few strategies.

Eat Nutritious Foods

In general, you’ll want to reach for nutritious, whole foods to aid weight loss.

This includes:

  • Fruits

  • Veggies

  • Lean proteins, like chicken, turkey, and tofu

  • Whole grains, like brown rice, and whole-wheat bread

  • Nuts and seeds

  • Healthy snacks like oatmeal and hard-boiled eggs

There’s no one best eating plan when it comes to weight loss, but the Mediterranean diet — which includes fruits, veggies, lean proteins, and healthy fats — has been shown to help with weight loss and weight management.

Following a program or joining a support group can help you build healthy eating habits and stick to new routines.

Our comprehensive weight loss programs offer support with behavioral change strategies and personalized treatment plans — plus medication if suitable.

Move More

Adding more movement into your day doesn’t mean becoming a regular at your local gym — although, if that’s your thing, be our guest.

You can promote weight loss by playing your favorite sport, hiking with friends, or even just getting out for a daily walk.

Gradually work your way up to at least 150 minutes of moderate-intensity aerobic activity each week — like brisk walking — or 75 minutes of vigorous-intensity activity — like swimming or jogging.

Research suggests that aerobic exercise is best for reducing body weight and BMI, but high-intensity interval training (think: sprints) is best for improving body composition in people with overweight and obesity.

Learn how many steps a day you need to lose weight.

Drink Plenty of Water

That’s right, drinking more water can help you lose weight.

Water can:

  • Help you feel fuller

  • Increase fat oxidation

  • Stimulate your metabolism

  • Keep you well hydrated for exercise

And drinking water comes with plenty of other health benefits, like boosting energy levels and reducing your chances of high blood pressure and kidney stones.

Try drinking a glass of water before meals and having a water bottle with you all day to remind you to stay hydrated.

Check out our guide to drinking water for weight loss for more tips.

Get Enough Sleep

Aim for seven hours of sleep or more a night. This will not only give you the energy and motivation to stick to healthy lifestyle changes, it can help you manage your weight.

If you struggle to hit that number, here are some tips:

  • Keep a regular sleep schedule — yes, even on weekends

  • Make sure your bedroom is dark, quiet, and not too warm

  • Avoid caffeine, large meals, and alcohol before bed

  • Make your bedroom a device-free zone

  • Get some movement each day to help you drift off at night

Word of warning: In your hunt for the best Ozempic alternatives, avoid over-the-counter weight loss supplements, or so-called fat-burning supplements. They may not be safe or effective.

Ozempic may be an effective — and let’s face it, popular — weight loss medication, but there are many reasons you might want to consider alternatives.

Those reasons include:

  • Potential side effects. Common side effects of Ozempic include nausea, vomiting, diarrhea, constipation, and abdominal pain.

  • Contraindications. You can’t take Ozempic if you have or are at high-risk for certain rare conditions, including medullary thyroid cancer and multiple endocrine neoplasia syndrome type 2 (MEN 2).

  • Needles. Eek. This one’s self-explanatory. Ozempic is a once-a-week injection, but there are oral weight loss medications available — no injections necessary.

  • Cost. Ozempic, and weight loss drugs like Ozempic, are often not covered by insurance and the price tag for brand name Ozempic can be around $900 to $1,000 a month.

  • Shortages. The rise in popularity of Ozempic means there are often shortages of the drug. A healthcare provider may recommend a different prescription medication simply because it’s more readily available.

If you’re looking for medication like Ozempic for weight loss, you have plenty of options.

There are other weight loss medications out there, including injections, like Wegovy and Zepbound, and tablets, like metformin and Topamax. A healthcare professional can walk you through which ones are best for you.

There are also drug-free alternatives to consider, either instead of Ozempic or as part of your weight loss journey. Those include eating nutritious foods, doing more movement, drinking more water and getting enough sleep.

And you don’t need to choose one or the other.

Our comprehensive weight loss programs combine medication (if appropriate) with realistic eating plans and expert advice and support on building healthy habits.

27 Sources

  1. Ozempic Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/209637s020s021lbl.pdf
  2. Wegovy Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/215256s007lbl.pdf
  3. Mounjaro Highlights of Prescribing Information. (n.d.) https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/215866s000lbl.pdf
  4. Jung, H. N., & Jung, C. H. (2022). The Upcoming Weekly Tides (Semaglutide vs. Tirzepatide) against Obesity: STEP or SURPASS?. Journal of obesity & metabolic syndrome, 31(1), 28–36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8987449/
  5. Zepbound Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/217806s000lbl.pdf
  6. Victoza Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/022341s039lbl.pdf
  7. Rubino, D. M., Greenway, F. L., Khalid, U., O'Neil, P. M., Rosenstock, J., Sørrig, R., Wadden, T. A., Wizert, A., Garvey, W. T., & STEP 8 Investigators (2022). Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA, 327(2), 138–150. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753508/
  8. Mehta, A., Marso, S. P., & Neeland, I. J. (2017). Liraglutide for weight management: a critical review of the evidence. Obesity science & practice, 3(1), 3–14. https://onlinelibrary.wiley.com/doi/full/10.1002/osp4.84
  9. Saxenda Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/206321s016lbl.pdf
  10. Lundgren, J. R., Janus, C., Jensen, S. B. K., Juhl, C. R., Olsen, L. M., Christensen, R. M., Svane, M. S., Bandholm, T., Bojsen-Møller, K. N., Blond, M. B., Jensen, J. B., Stallknecht, B. M., Holst, J. J., Madsbad, S., & Torekov, S. S. (2021). Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined. The New England journal of medicine, 384(18), 1719–1730. https://www.nejm.org/doi/full/10.1056/nejmoa2028198
  11. Rybelsus Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/213182s000,213051s001lbl.pdf
  12. Metformin. (2024). https://medlineplus.gov/druginfo/meds/a696005.html
  13. Yerevanian, A., & Soukas, A. A. (2019). Metformin: Mechanisms in Human Obesity and Weight Loss. Current obesity reports, 8(2), 156–164. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520185/
  14. Pu, R., Shi, D., Gan, T., Ren, X., Ba, Y., Huo, Y., Bai, Y., Zheng, T., & Cheng, N. (2020). Effects of metformin in obesity treatment in different populations: a meta-analysis. Therapeutic advances in endocrinology and metabolism, 11, 2042018820926000. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243386/
  15. Contrave Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/200063s000lbl.pdf
  16. Sherman, M. M., Ungureanu, S., & Rey, J. A. (2016). Naltrexone/Bupropion ER (Contrave): Newly Approved Treatment Option for Chronic Weight Management in Obese Adults. P & T : a peer-reviewed journal for formulary management, 41(3), 164–172. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771085/
  17. Topamax Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020844s041lbl.pdf
  18. Wajid, I., Vega, A., Thornhill, K., Jenkins, J., Merriman, C., Chandler, D., Shekoohi, S., Cornett, E. M., & Kaye, A. D. (2023). Topiramate (Topamax): Evolving Role in Weight Reduction Management: A Narrative Review. Life (Basel, Switzerland), 13(9), 1845. https://www.mdpi.com/2075-1729/13/9/1845
  19. Qsymia Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/022580s021lbl.pdf
  20. Smith, S. M., Meyer, M., & Trinkley, K. E. (2013). Phentermine/topiramate for the treatment of obesity. The Annals of pharmacotherapy, 47(3), 340–349. https://www.researchgate.net/publication/236039060_PhentermineTopiramate_for_the_Treatment_of_Obesity_March
  21. Xenical Highlights of Prescribing Information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2005/020766s021lbl.pdf
  22. Kim J. Y. (2021). Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance. Journal of obesity & metabolic syndrome, 30(1), 20–31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8017325/
  23. Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., Loria, C. M., Millen, B. E., Nonas, C. A., Pi-Sunyer, F. X., Stevens, J., Stevens, V. J., Wadden, T. A., Wolfe, B. M., Yanovski, S. Z., Jordan, H. S., … Obesity Society (2014). 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation, 129(25 Suppl 2), S102–S138. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819889/
  24. Physical Activity for a Healthy Weight. (2023). https://www.cdc.gov/healthyweight/physical_activity/index.html
  25. Wang, H., Cheng, R., Xie, L., & Hu, F. (2024). Comparative efficacy of exercise training modes on systemic metabolic health in adults with overweight and obesity: a network meta-analysis of randomized controlled trials. Frontiers in endocrinology, 14, 1294362. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10823366/
  26. Tips for Better Sleep. (2022). https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html
  27. Ozempic Prices, Coupons & Savings Tips. (n.d.). https://www.goodrx.com/ozempic
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.