Top 12 Ozempic Alternatives for Weight Loss

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

Ozempic can be effective, but it’s not for everyone. And even if it’s suitable for you, you might be looking for cheaper or more available alternatives.

Luckily, plenty of Ozempic alternatives are out there.

Ozempic alternatives for weight loss include:

• Compounded semaglutide injections

• Weight loss injections like Wegovy® and Zepbound®

• Oral medications like metformin and Topamax®

Keep reading to learn more about the alternatives to Ozempic.

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

Here’s an overview of your options before we dive into the details.

*These drug prices are current as of the publishing of this article, but they’re subject to change.

1. Wegovy

Looking for weight loss drugs like 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. The once-a-week injection works for weight loss in the same way, by reducing your appetite and helping you feel fuller.

The difference? This version of the GLP-1 agonist drug 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. It’s also approved for those with a BMI of 27 or higher with at least one weight-related condition, like high blood pressure, high cholesterol, or type 2 diabetes.

This medication comes with other health benefits, too. In March 2024, the FDA approved Wegovy to reduce the risk of heart attack and stroke in people with excess body weight or obesity and cardiovascular disease.

A healthcare provider will probably get you started on a 0.25-milligram (mg) dose that’ll slowly increase to 2.4 milligrams.

For more similarities and differences, see our guide to Wegovy versus Ozempic.

2. Compounded Semaglutide

What is a cheaper alternative to Ozempic? Compounded semaglutide is one option.

For example, Hers compounded semaglutide starts at $165 a month (for a 12-month plan, paid in full). While Ozempic’s list price is almost $1,000 a month.

Compounded semaglutide contains the same active ingredient as Ozempic and works in the same way to promote weight loss.

The difference is that it’s not FDA-approved. This means it’s important to get compounded semaglutide from a reputable company that works with licensed compounding pharmacies to ensure it’s safe and effective.

Another bonus is that compounded semaglutide may also be more available than Ozempic, so you don’t need to worry about drug shortages.

3. Mounjaro

Mounjaro is FDA-approved to help people with type 2 diabetes manage their blood glucose levels (aka blood sugar levels). But, just like Ozempic, it’s often prescribed off-label for weight loss.

It’s also 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 medication.

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

For instance, a 2022 review — funded by Mounjaro manufacturer Eli Lilly — found that 10-milligram and 15-milligram doses of tirzepatide were more effective for weight loss than 2-milligram doses of semaglutide. But 2-milligram doses of semaglutide were similar to 5 milligrams of tirzepatide — so it all depends on which dose you can tolerate.

You’ll probably start on a 2.5-milligram dose and gradually increase up to a maximum dose of 15 milligrams.

We’ve compared Mounjaro versus Ozempic if you want to learn more.

4. Zepbound

Zepbound is Mounjaro’s weight loss counterpart.

It’s another brand name for tirzepatide. It comes in the same dose as Mounjaro and works in the same way.

The only difference 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.

And, since it’s the same as Mounjaro, it may be more effective than semaglutide at higher doses.

Learn more about Zepbound versus Mounjaro in our blog.

5. Victoza

Another semaglutide alternative for weight loss is Victoza. This drug is also a GLP-1 receptor agonist, but the active ingredient is liraglutide.

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

Like Ozempic and Mounjaro, Victoza is FDA-approved to help with blood sugar control for folks with type 2 diabetes, but it’s also prescribed off-label for weight loss.

But there’s a big difference. 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 0.6 milligrams and increase to 1.2 milligrams after a week. If needed, your provider might increase your dose to 1.8 milligrams daily.

How does Victoza compare to the other alternatives? Some research sponsored by Novo Nordisk (the manufacturer of Ozempic) shows that semaglutide may be more effective than liraglutide for weight loss.

Though semaglutide might reduce food cravings more than liraglutide, liraglutide may be more effective than orlistat, another weight loss drug on this list.

6. Saxenda

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

This once-a-day injection contains a higher dose of liraglutide than Victoza.

A medical provider would probably get you started on a 0.6-milligram dose of Saxenda. This would slowly increase each week until you reach a maximum dose of 3 milligrams a day.

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

7. Rybelsus

Rybelsus has the same active ingredient as Ozempic, but it comes in pill 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, Rybelsus is FDA-approved as a diabetes medication, 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 3 milligrams a day, and this will increase to 7 milligrams after 30 days. After another 30 days, your healthcare provider might increase your dose to 14 milligrams a day if needed.

8. 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 might 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 helps with weight loss by suppressing appetite and changing the gut microbiome to promote weight loss.

Studies back it up. A 2020 meta-analysis of 21 trials found that metformin treatment could reduce your BMI by one unit (like going from a BMI of 27.5 to 26.5).

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

Check out our guide to Ozempic versus metformin to see how the two compare.

9. 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 dose escalation schedule for Contrave might look like this:

• 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 and 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 to help with weight loss by promoting satiety (the feeling of fullness), reducing food intake, and increasing how much energy your body uses.

10. Topamax

Topamax is the brand name for topiramate. It’s FDA-approved as an antiseizure drug but is sometimes also used to prevent migraines and prescribed off-label for weight loss.

Topiramate tablets are taken daily. The dose for weight loss can vary, but for epilepsy, the recommended dose is 400 milligrams 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 reduce triglyceride and cholesterol levels.

11. Qsymia

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

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, on average, a combination of topiramate and phentermine can lead to a 10 percent reduction in weight sustained for up to two years.

You take one tablet each morning. Timing is key, as Qsymia can cause insomnia if it’s taken in the evening.

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

12. Xenical

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

You’d take a 120-milligram 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.

If you’re already taking Ozempic and want to switch to an alternative weight loss medication, speak with a healthcare provider to see what your options are.

If suitable, they can write you a new prescription, recommend the best way to come off Ozempic, and tell you when to start your new medication.

Your provider might get you started on a low dose of your new medication and gradually increase it, even if you were on a higher dose of Ozempic.

Our guide to switching from Ozempic to Mounjaro goes into more detail as an example.

There are no over-the-counter Ozempic alternatives. Ozempic — and similar weight loss drugs like compounded semaglutide, Zepbound, and metformin — are only available on prescription.

If you’re looking for weight loss methods that don’t require a prescription, there are some dietary supplements that may help boost your efforts, like:

• Magnesium

• Protein

• Fiber

• Vitamin B12

But your best bet is to adopt healthy lifestyle changes with much more science behind them.

Those include:

• Eating nutritious foods, including fruits, vegetables, lean proteins, and whole grains

• Drinking plenty of water

• Doing more movement

• Getting enough sleep

For extra support and guidance, get medical advice from a healthcare professional or join a weight loss program like those offered by Hers.

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

There are other weight loss medications available, including injections like Wegovy and Zepbound and pills like metformin and Topamax.

There are many differences — like cost, side effects, and how you take them — but they can all help with healthy weight loss. A healthcare professional can walk you through which ones are best for you.

As well as Ozempic, Wegovy, and compounded semaglutide, Hers offers custom oral weight loss kits. These kits are tailored to you and can combine medications like metformin, bupropion, naltrexone, and topiramate.

Take our free weight loss assessment to discover your options beyond Ozempic.

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.