Victoza vs Ozempic For Weight Loss

Craig Primack, MD, FACP, FAAP, FOMA

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

Written by Lauren Panoff

Published 04/07/2024

Okay, we know that one pair of jeans may be staring at you from the closet, but we also know that weight loss is about so much more than that. If you’re looking to make a change, you probably already know that achieving a healthy weight is important for supporting overall wellbeing. But if diet and exercise aren’t enough, and they may not be, you may consider adding weight loss medications like Victoza® and Ozempic® to your toolkit.

These glucagon-like peptide-1 (GLP-1) receptor agonists are popular choices to help people lose weight. But how do the two stack up?

We’re breaking down the key differences between Victoza and Ozempic, including their mechanisms of action, Ozempic vs Victoza side effects to consider and weight loss efficacy.

Victoza and Ozempic are both in the GLP-1 receptor agonist drug class. They are approved by the Food and Drug Administration (FDA) to help people with type 2 diabetes improve blood sugar control and reduce cardiovascular disease risk. 

However, these two medications are also used “off-label” for weight loss. This means some healthcare providers may prescribe them for weight loss even though they aren’t FDA-approved for this purpose. 

One thing to note is that the active ingredients in Victoza and Ozempic — liraglutide and semaglutide, respectively — are both used in medications that are FDA-approved specifically for weight loss. These include Saxenda® (liraglutide) and Wegovy® (semaglutide).

Still, some people prefer Victoza or Ozempic off-label for many reasons, from insurance coverage to the need to lower blood sugar.

Both Victoza and Ozempic are GLP-1s, but they do have differences. One of these key differences is dosing frequency. Ozempic is typically administered once a week, whereas Victoza is usually taken once daily. 

There’s strong evidence that both diabetes medications can result in reduced body weight for people who are overweight or have obesity.

However, semaglutide appears to lead to more significant weight loss and greater reductions in HbA1c (a measurement of long-term glucose control) versus liraglutide. 

Mechanism of Action

As GLP-1 agonists, these prescription drugs mimic the action of GLP-1, a hormone naturally made by your body to help regulate blood sugar levels. 

GLP-1 stimulates the release of insulin from your pancreas and helps reduce the production of glucagon, another hormone that increases blood sugar.

As a result, Victoza and Ozempic both help lower blood sugar, improve insulin sensitivity and support healthy weight loss. 

Furthermore, like other GLP-1s, Victoza and Ozempic have also been shown to reduce the risk of cardiovascular events (heart attacks and strokes) among people with type 2 diabetes who have an increased risk of heart disease. 

Whether prescribed for blood sugar control or off-label for weight loss, both medications should be used with diet and exercise for optimal benefits. 

Approved Uses

Victoza and Ozempic are FDA-approved for the following uses: 

  • Treating type 2 diabetes in adults, specifically reducing glucose levels and improving blood sugar control 

  • Reducing the risk of major adverse cardiovascular events in adults with type 2 diabetes and cardiovascular disease

Again, while neither drug is FDA-approved for obesity treatment, they are often prescribed off-label for weight loss due to their effectiveness for this purpose.

In addition, neither should be used by people with type 1 diabetes.

Ozempic vs. Victoza Dosage

Both Victoza and Ozempic are weight loss injectable medications. They’re subcutaneous injections, which are administered between skin and muscle (typically in your stomach, thigh, or upper arm) for slower absorption. Victoza typically requires a once-daily injection, whereas Ozempic only needs to be injected once per week. 

The specific dosage of each medication you’ll be prescribed can vary depending on individual factors, like the severity of your diabetes (if taking it for blood glucose control) and response to treatment. 

Generally, you’ll start Victoza at a dose of 0.6mg per day for at least one week, then increase the dose to 1.2mg per day for at least another week before titrating up to a goal therapeutic dosage of 1.8mg per day for better glycemic control.

The beginning dose for Ozempic is 0.25mg once weekly for four weeks, then 0.5mg once weekly for at least another four weeks. If you need further blood sugar control, your healthcare provider may prescribe a dosage of 1-2mg weekly.

Always follow your provider’s medical advice about the best dosing regimen for you and your needs. And no need to memorize these numbers - both medications come in pre-filled pens you can use for your injections.

Prescribed online

Weight loss treatment that puts you first

When it comes to Ozempic vs Victoza for weight loss, which is better ultimately depends on your individual goals and needs. 

Both GLP-1 drugs have been shown to promote weight loss as a secondary benefit to managing glycemic control in type 2 diabetes. 

For example:

  • In one study, 846 participants were given either a 1.8 mg dose of liraglutide, a 3mg dose of liraglutide, or a placebo for 56 weeks, all with a 500-calorie per day deficit and increased exercise. Those who took the higher liraglutide dose experienced the most weight loss.

  • In a 68-week randomized controlled trial with 338 participants, the mean change in weight loss was 15.8 percent with once-weekly semaglutide compared to only 6.4 percent with once-daily liraglutide, both given with diet and exercise.

Still, some clinical trials suggest that Ozempic may offer a slight advantage over Victoza for weight loss benefits. 

One reason for this may be because people take higher doses of Ozempic. Another reason may be that Ozempic only needs to be administered once a week, which may make it easier for people to stay compliant with it and lead to more weight loss. 

Nevertheless, individual responses can vary. Factors like diet, exercise and family history also play a role in weight management.

Ozempic vs Victoza Cost 

The cost of both Ozempic and Victoza can depend on the dose, discounts available when purchased and whether your insurance covers them

Generally, Ozempic tends to be more expensive than Victoza due to its extended dosing interval of once weekly compared to Victoza's daily administration. However, the total cost over time may differ based on insurance coverage and copayments. 

Both medications may offer patient assistance programs or savings cards to help reduce out-of-pocket expenses. Additionally, alternatives may be available at varying costs. 

Because of these factors, there is huge variability in the potential cost of these drugs. Depending on the previously mentioned factors, they could range from $25 to $1400 a month.

Whenever you're getting a prescription, it's a good idea to talk with your healthcare and insurance providers to ensure you end up with the most cost-effective option.

As with all drugs, Ozempic and Victoza both come with side effects to consider. Some of the common side effects of Ozempic and Victoza include: 

  • Nausea

  • Diarrhea

  • Vomiting

  • Constipation

  • Abdominal pain or discomfort

  • Headache

  • Fatigue

  • Dizziness

  • Hypoglycemia (low blood sugar)

  • Injection site reactions (such as redness, itching, or pain)

  • Decreased appetite

  • Indigestion

  • Heartburn

  • Upper respiratory tract infections

  • Urinary tract infections

  • Gallbladder disorders

  • Pancreatitis

  • Hypersensitivity reactions (including rash, itching or swelling)

  • Kidney problems

Research shows that the most common side effects of semaglutide and other GLP-1s are digestive-related. However, they also have the risk of more serious side effects.

For example, Ozempic as well as Victoza, carries a boxed warning of the potential to cause tumors and thyroid cancer (medullary thyroid carcinoma). There is also some evidence that existing diabetic retinopathy may get worse when using Ozempic.

Still, not everyone responds to medications in the same way. It’s important to know whether you’re experiencing something new after starting one of them. Always get in touch with your provider with questions or concerns. 

Drug Interactions

In addition to the potential side effects above, certain drugs may interact with Ozempic and Victoza:

  • Oral medications: Ozempic and Victoza may delay or reduce the absorption of some medications taken by mouth. This is why you'll generally be directed to take any other medications at least an hour before or four hours after taking these weight loss medications.

  • Insulin: Using them with insulin may increase the risk of hypoglycemia (low blood sugar), and your dosage may need to be adjusted.

  • Warfarin: Ozempic and Victoza may affect the blood-thinning activity of warfarin. Your doctor will closely monitor INR, a blood marker that measures the effectiveness of warfarin, when you use these drugs at the same time.

  • Digoxin: These weight loss drugs may delay the absorption of digoxin, a drug used to treat heart failure and heart rhythm problems. Your provider may recommend monitoring digoxin levels and adjusting the dosage.

  • Oral contraceptives: Taking GLP-1s for weight loss may reduce the effectiveness of birth control pills. If you take the pill, it may be a good idea to use additional contraceptive methods while using these.

  • Thyroid medications: Ozempic and Victoza may affect the absorption of thyroid medications, so your provider might order routine thyroid function tests.

If you don’t respond well to Ozempic or Victoza or are just interested in other options, there are plenty to explore, including non-injectable alternatives. 

Some Ozempic and Victoza alternatives for weight loss include: 

  • Naltrexone and bupropion: This combination helps curb cravings and decrease binge eating by acting on your brain's craving and appetite centers.

  • Metformin: This drug helps lower blood sugar levels and reduce appetite. It affects how your body handles insulin and impacts appetite receptors in your brain.

  • Topiramate: This medication has been shown to reduce body fat mass and help suppress appetite. 

  • Behavioral therapy: Counseling or behavioral therapy can help you make sustainable lifestyle changes by addressing factors such as emotional eating, stress management and goal setting that may be getting in the way of achieving successful weight loss.

  • Weight loss programs: Social support is key for successful weight loss, especially when you’re surrounded by peers on a similar journey. Joining a structured weight loss program or support group can provide accountability, education and motivation for long-term success.

  • Weight loss surgery: For individuals with severe obesity or obesity-related health problems, weight loss surgery may be an option. Your healthcare provider may recommend bariatric surgeries like gastric bypass, sleeve gastrectomy or gastric banding.

Remember that all of these options should be paired with a nutrient-rich diet and regular movement to promote sustainable weight loss.

When your weight loss game needs a little boost, you might consider adding a GLP-1 agonist like Victoza or Ozempic to a diet and exercise routine. Here are some things to keep in mind when comparing these two options:

  • The best choice is personal. While there’s some evidence that Ozempic may have a higher likelihood of successful weight loss, both GLP-1s have been shown to be effective in promoting weight loss.

  • There are alternatives. If neither is right for you, you might consider other options like naltrexone and bupropion, metformin or topiramate. Your healthcare provider can help you determine the best choice for you. 

  • They should be used with diet and exercise. Even weight loss drugs aren’t meant to be solely relied upon for achieving weight loss. These should be used in conjunction with diet, exercise and other healthy lifestyle habits that support both weight loss goals and long-term wellness. 

Ready to look further into your weight loss medication options? Start by taking our free weight loss assessment

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