Prescription weight loss that puts you first

Get started

Rybelsus for Weight Loss: Everything You Need to Know

Craig Primack MD

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

Written by Hadley Mendelsohn

Published 01/21/2025

Updated 01/20/2025

Rybelsus® (semaglutide) is an oral medication approved by the U.S. Food and Drug Administration (FDA) to treat type 2 diabetes. Curious about Rybelsus for weight loss? Rybelsus is sometimes prescribed off-label to help people with overweight and obesity lose weight — though it’s not officially FDA-approved for this purpose.

While Rybelsus may help support your weight loss goals, there are some pros and cons to consider. If you’re wondering if Rybselsus is the right fit for you, you’re in the right place.

We’ll break down all the details, including how Rybelsus works to support weight loss, how it compares to weight loss injections, how much Rybelsus costs, and common side effects.

Rybelsus gained FDA approval in 2019 for the treatment of type 2 diabetes. It’s an oral version of semaglutide, the active ingredient in Ozempic and Wegovy. Unlike weight loss injections, which are taken once weekly, you take Rybelsus once per day. 

Semaglutide belongs to a class of drugs called glucagon-like peptide 1 receptor agonists (GLP-1s). GLP-1 agonists mimic the GLP-1 hormone, which is naturally produced in the digestive tract after you eat. 

Rybelsus works by keeping blood sugar levels healthy. Novo Nordisk, the company that makes Rybelsus, announced that the drug can also boost weight loss.

Rybelsus is not FDA-approved for weight loss. However, some healthcare providers might prescribe it off -label for this purpose. Off-label use means a medication is prescribed to treat a medical condition it’s not FDA-approved for — in this case, overweight or obesity.

In stock now

Rx weight loss your way

A study sponsored by Novo Nordisk shows that semaglutide helps people lose weight by promoting feelings of fullness, thus helping control caloric intake.

So, how does Rybelsus work for weight loss? Semaglutide helps support weight loss by:

  • Impacting the appetite center of the brain. This reduces hunger and leads you to eat fewer calories per day.

  • Delaying gastric emptying. This means food moves more slowly through the digestive tract. So the drug makes you feel fuller for longer, which leads to reduced caloric intake.

  • Regulating blood sugar levels. Semaglutide helps increase insulin secretion and decrease glucagon secretion, keeping blood sugar levels steady. 

You may lose weight on Rybelsus, especially if you eat a reduced-calorie diet and exercise. But oral semaglutide may not lead to the significant weight loss seen in people taking weight loss injections. 

In clinical trials sponsored by Novo Nordisk comparing Rybelsus to placebo, participants with overweight or obesity lost up to 17.4 percent of their initial body weight in 68 weeks. Sounds promising, right? 

Unfortunately, participants in this study took a 50-milligram (mg) dose of oral semaglutide and participated in lifestyle interventions. But this is a very high dose that’s not currently available in U.S. pharmacies. It’s currently available in 3 mg, 7mg, and 14 mg doses.

Rybelsus is an oral tablet you take once a day. It needs to be taken in the morning at least a half hour before your first meal, beverage, or other oral medication. Take it with four ounces of regular water — not with your morning coffee or orange juice.

Those instructions sound strict because they need to be. If you don’t take Rybelsus as prescribed — like not waiting to eat or taking it with something other than water — you risk decreasing the drug’s absorption, which may make it less effective.

Colloquially, people refer to Rybelsus as “the pill form of Ozempic.” That’s because it’s taken orally, and it has the same active ingredient (semaglutide).

Besides being FDA-approved for the treatment of type 2 diabetes, Ozempic is approved to lower the likelihood of heart attack, stroke, or death in people with type 2 diabetes and those who already have heart disease. But, like Rybelsus, it’s also not specifically approved for weight loss treatment.

Wegovy is approved to treat obesity and overweight in adults and adolescents 12 and over (who also have weight-related comorbidities).

It’s currently the only version of semaglutide approved by the FDA to treat obesity and overweight.

There isn’t an official preferred dose of Rybelsus for weight loss because it hasn’t been FDA-approved specifically for weight loss.

That said, the recommended dose for diabetes treatment is as follows:

  • Start Rybelsus with 3 milligrams once daily for 30 days.

  • After 30 days of taking the 3-milligram dose, you can increase the dose to 7 milligrams once daily.

  • After another 30 days, some healthcare providers may recommend increasing to a 14-milligram dose if necessary to manage blood sugar levels.

Early clinical trials sponsored by Novo Nordisk suggest that the ideal dose for weight loss could be much higher.

For example, in one 26-week trial, participants lost an average of 4.6 to 15.2 pounds when they took 10 milligrams of oral semaglutide daily — but they tested as high as 20 to 40 milligrams a day.

And in an early trial from Novo Nordisk, participants took a daily dose of 50 milligrams of oral semaglutide for weight management.

Like all prescription medications, Rybelsus comes with a risk of side effects. Most Rybelsus side effects are mild and temporary, but they’re still worth knowing about.

If you experience any of them or have any questions, talk to your healthcare provider.

Common Side Effects of Rybelsus

Some of the most common Rybelsus side effects include:

  • Nausea

  • Vomiting

  • Diarrhea

  • Constipation

  • Stomach and abdominal pain

  • Loss of appetite

Nausea is the most common side effect, affecting 11 to 20 percent of people on Rybelsus (depending on prescription strength). The gastrointestinal side effects should start to dissipate after a few weeks as your body adjusts.

Also, keep in mind that some Rybelsus side effects, like nausea, vomiting, and diarrhea, are most common when you first start taking Rybelsus and right after you increase your dose. 

Rx Available

Weight loss treatment that puts you first

Less Common Side Effects of Rybelsus

Less commonly, taking Rebelsus for weight loss might cause:

  • Bloating

  • Gas

  • Heartburn

  • Burping

  • Gastroesophageal reflux disease (GERD)

Serious Side Effects

More serious adverse effects of taking Rybelsus for weight loss may include:

  • Hypoglycemia (low blood sugar)

  • Kidney problems, including kidney failure

  • Pancreas issues, like pancreatitis (inflammation of the pancreas)

  • Allergic reactions (call your healthcare provider right away if you notice skin rash, itchiness, flushing, warmth, swelling, or redness)

These are rare, though.

Who Shouldn’t Take Rybelsus for Weight Loss?

Rybelsus has a black box warning from the FDA about an increased rate of thyroid C-cell tumors in rodents — a specific type of thyroid cancer called medullary thyroid carcinoma (MTC). MTC is the rarest of four types of thyroid cancer, making up three to four percent of all thyroid cancers.

Specifically, semaglutide has been shown to cause an increase in thyroid C-cell tumors in mice, but this observation hasn’t been made in human studies. Still, because of this, semaglutide isn’t recommended for people who have:

  • Had (MTC) in the past

  • Multiple endocrine neoplasia syndrome type 2 (MEN 2) 

  • Family members with MTC or a history of MTC

Those who’ve had a severe allergic reaction to Rybelsus (like anaphylaxis and angioedema) also shouldn’t take it.

There isn’t enough information to know whether semaglutide is safe for anyone pregnant or breastfeeding. If you’re pregnant and breastfeeding and want to try Rybelsus, talk to your healthcare provider about your options.

If you have a family history of pancreatitis, a history of chronic pancreatitis, or have had acute pancreatitis within 180 days, your provider may not think you’re a good fit for Rybelsus.

Rybelsus is a prescription medication, meaning you can’t get it over the counter. You’ll need to work with a healthcare professional to see if you’re a good fit for the drug. From there, they can write you a prescription.

In general, most healthcare providers who prescribe Rybselsus off-label for weight loss will usually look for these criteria:

  • A body mass index (BMI) of 30 or greater; or

  • A BMI of 27 or higher with one or more treated or untreated weight-related coexisting conditions — i.e., prediabetes, hypertension (high blood pressure), dyslipidemia (abnormal blood lipid levels), obstructive sleep apnea, or cardiovascular disease

If you’re interested in taking Rybelsus for weight loss, ask a medical provider to see if it might work for your needs and health profile.

There are many variables that make it hard to gauge the cost of Rybelsus. This includes everything from your provider to your insurance company and what pharmacy you go to.

The best course of action is to call your insurance company and ask if your plan covers it. You can also call your pharmacist to get more info on costs in your area.

The Rybelsus manufacturer’s website might also be able to share some pricing information (or walk you through how to get more info).

Insurance companies will usually only cover some of the cost if it’s prescribed for diabetes. So, if you’re getting Rybelsus for weight loss, insurance might not cover it.

Other weight loss medication options exist, including our oral weight loss kits, which start at $79 per month.

Whether you’re interested in a medication you can take less often or you’re worried about the side effects of Rybelsus, there are definitely other options out there.

Weight Loss Pills

Many prescription pills and oral treatments may help support weight management. These include:

  • Metformin

  • Topamax® (topiramate)

  • Contrave® (naltrexone-bupropion)

  • Rybelsus® (semaglutide)

  • Xenical® (orlistat)

  • Qsymia® (phentermine-topiramate)

Weight Loss Injections

A few different injectables are sometimes prescribed for weight loss. They include:

  • Mounjaro® and Zepbound® (tirzepatide)

  • Ozempic and Wegovy (semaglutide)

  • Saxenda® and Victoza® (liraglutide)

Hers offers holistic weight loss programs, combining weight loss medication (if appropriate) with realistic eating plans, behavioral change tools, and expert guidance.

A healthcare provider can walk you through the pros and cons of various weight loss treatments and help you decide which is right for you.

Weight Loss Supplements

Though there’s little research behind them, some supplements may help support weight loss efforts like healthy eating and exercise. Here are a few options:

  • Caffeine and coffee

  • B-12

  • Green tea

  • Magnesium

These are available over the counter (without a prescription) — from grocery stores, online retailers, and pharmacies.

Weight Loss Treatments

Weight loss, unlocked

Here’s the key information to keep in mind about Rybelsus for weight loss:

  • Rybelsus is an oral version of semaglutide, the active ingredient in Ozempic and Wegovy.

  • It’s not FDA-approved for weight loss (only diabetes). Healthcare professionals can prescribe it off-label for weight loss, though.

  • For those averse to injections and needing more than just healthy eating and exercise, Rybelsus could be a viable option.

  • There are potential side effects associated with Rybelsus, and further research is necessary to determine safety measures.

Starting a new medication can be a big step, and there are lots of things to consider. If you’re considering Rybelsus for weight loss, consult a healthcare provider who can provide personalized guidance.

If you’re on the fence or are still interested in doing more research, there are plenty of other safe and effective treatments for weight loss to explore.

13 Sources

  1. Anderson AN, et al. (2021). A pharmacological and clinical overview of oral semaglutide for the treatment of type 2 diabetes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217049/
  2. Blundell JO, et al. (2017). Effects of once‐weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573908/
  3. Bruno BE, et al. (2013). Basics and recent advances in peptide and protein drug delivery. https://pubmed.ncbi.nlm.nih.gov/24228993/
  4. Centers for Disease Control and Prevention (CDC). (2022). About adult BMI. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
  5. Collins LO, et al. (2024). Glucagon-like peptide-1 receptor agonists. https://www.ncbi.nlm.nih.gov/books/NBK551568/
  6. Davies ME, et al. (2017). Effect of oral semaglutide compared with placebo and subcutaneous semaglutide on glycemic control in patients with type 2 diabetes: A randomized clinical trial. https://pubmed.ncbi.nlm.nih.gov/29049653/
  7. Hjerpsted, JU, et al. (2017). Semaglutide improves postprandial glucose and lipid metabolism, and delays first‐hour gastric emptying in subjects with obesity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836914/
  8. Mahapatra MA, et al. (2022). Semaglutide, a glucagon-like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8736331/
  9. Novo Nordisk. (2023). Oral semaglutide 50 mg achieved 15.1% weight loss (17.4% if all people adhered to treatment) in adults with obesity or overweight in the OASIS 1 trial. https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=166110
  10. RYBELSUS (semaglutide) tablets, for oral use. (2017). https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/213051s006lbl.pdf
  11. Smits MA, et al. (2021). Safety of semaglutide. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294388/
  12. U.S. Food and Drug Administration (FDA). (2019). FDA approves first oral GLP-1 treatment for type 2 diabetes. https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-glp-1-treatment-type-2-diabetes
  13. U.S. Food and Drug Administration (FDA). (2024). Medications containing semaglutide marketed for type 2 diabetes or weight loss. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss
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.

Related Articles

Get personalized treatment

Doctor-trusted treatment plans tailored to your unique needs