Ozempic (semaglutide) is an injectable prescription medication approved by the Food and Drug Administration (FDA) in 2017 to lower blood sugar levels in adults with type 2 diabetes. (1, 2)
Although not currently approved for weight loss, it is sometimes prescribed off-label for weight management due to its appetite-suppressing effects. (2)
While Ozempic may be effective for weight loss and blood sugar control, that doesn’t mean it’s the best option for everyone. Additionally, due to intermittent shortages, some people who are prescribed it for type 2 diabetes management may have no choice but to consider Ozempic alternatives. (3)
To find the best Ozempic alternatives for 2024, our team of registered dietitians and industry experts researched dozens of options. We evaluated and scored them based on ingredients, scientific research, cost, safety, and company reputation to bring you our top picks. Here’s what we found.
What is Ozempic?
Ozempic is a once-weekly injectable medication used to treat type 2 diabetes and lower the risk of heart attack, stroke, and death in adults with type 2 diabetes and heart disease. (1) It is available by prescription only in the United States.
The active ingredient in Ozempic is semaglutide, which belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. These medications mimic the hormone GLP-1, signaling the pancreas to release more insulin and lowering blood sugar. In higher doses, GLP-1 hormones interact with areas of the brain that reduce appetite and increase feelings of fullness or satiety. (1)
In a recent study on people with type 2 diabetes, researchers found that participants taking 1 milligram of semaglutide weekly lost an average of 13 pounds. In contrast, those taking 2 milligrams—the maximum dose of Ozempic—lost around 15 pounds after 40 weeks. (4, 5)
Participants receiving the higher dose also showed greater improvements in hemoglobin A1C, a blood test that measures your blood sugar levels over the past three months.
Compare Ozempic alternatives
Wegovy | Mounjaro | Saxenda | Zepbound | |
Rating | ||||
Cost per month | $1,999 | $69 membership, plus medication cost | $49 for the first month’s membership and $139 per month after, plus medication cost | $129 membership fee, plus medication cost |
Key ingredients | Semaglutide | Tirzepatide | Liraglutide | Tirzepatide |
Dosage | Up to 2.4 mg | Up to 15 mg | Up to 3 mg | Up to 15 mg |
Insurance coverage | N/A | Prescriptions only | Prescriptions only | Prescriptions only |
Semaglutide vs Liraglutide vs Tirzepatide
When looking at drugs like Ozempic, it’s important to understand active ingredients and what they do or do not accomplish. Semaglutide, liraglutide, and tirzepatide are the main three ingredients these drugs rely on.
Semaglutide (Ozempic and Wegovy) and liraglutide (Victoza and Saxenda) are GLP-1 agonists that can help improve blood sugar control and reduce appetite. (1, 6) Ozempic was first FDA-approved in 2017 to treat type 2 diabetes, while Wegovy was approved by the FDA in 2021 for people with obesity or overweight with weight-related health problems. (7, 2)
Victoza was FDA-approved in 2010 for managing diabetes, while Saxenda–with a higher dose of liraglutide–was FDA-approved for weight loss in 2014. Semaglutide is a weekly injection that lasts longer in your body, whereas liraglutide has a shorter half-life and must be given daily. (6, 8)
Tirzepatide is a dual agonist that mimics GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) hormones. Both hormones help the pancreas release insulin when you eat and create feelings of satiety. Tirzepatide is given once weekly and marketed under the brand name Mounjaro, which was approved by the FDA in 2022 to treat diabetes. In 2023, it received FDA approval for weight loss under the brand name Zepbound. (9, 2)
How to talk to your doctor about weight loss drugs
If you’re considering a weight loss medication, it’s important to first have an open and honest conversation with a trusted healthcare provider. If they believe Ozempic–or an Ozempic alternative–may be a good fit, they may prescribe it or recommend other treatments suitable for your health needs.
In general, health care providers may consider prescribing Ozempic or other GLP-1 medications if your body mass index (BMI) is 30 or higher or 27 or higher with a weight-related health condition, like diabetes or high blood pressure. (7)
Wegovy: Hims | Hers
Key product features
What you should know
Hims & Hers is a telehealth platform that offers a monthly subscription for Wegovy, an FDA-approved weight loss medication. If prescribed, you’ll have unlimited messaging with your provider for dose adjustments and follow-ups free of charge.
- Hims & Hers takes a comprehensive approach to weight loss, offering branded Wegovy, tracking tools, and nutrition education.
- Wegovy, through the Hims & Hers platform, starts at $1,999 per month. This is higher than the market price of $1,349.02 for a month’s supply (four injections). However, with pharmacy mark-ups, the price may be about the same as what you’d pay out of pocket elsewhere. (10)
- Hims & Hers does not offer weight loss treatment to residents in Alabama, Arkansas, Louisiana, Mississippi, New Jersey, North Carolina, North Dakota, Rhode Island, South Carolina, Virginia, and West Virginia.
- If you have insurance, we recommend checking with your provider to see if Wegovy is covered before committing to any out-of-pocket expenses through Hims.
What to consider before you take Wegovy
Wegovy is a once-weekly injectable prescription medication that was approved by the FDA in 2021 to treat weight loss in people with obesity or overweight with at least one weight-related condition like high blood pressure, high cholesterol, or type 2 diabetes. (7)
Like Ozempic, Wegovy’s active ingredient is semaglutide, but it contains a higher maximum dose of 2.4 milligrams weekly, which may be more effective for weight loss. (7) A healthcare provider will be able to walk you through what Wegovy dosage looks like, as well as how it may change as you continue to take the medication.
One large observational study of people with overweight or obesity found an average weight loss of 23 pounds after six months of taking 2.4 milligrams of semaglutide weekly. Nearly 67% of people with prediabetes or type 2 diabetes saw blood sugar levels return to normal, and significant improvements in cholesterol and triglycerides—two markers of heart health—were observed. (11)
To get started with Wegovy on the Hims & Hers platform, you’ll answer questions about your weight loss goals and location. If treatment is available in your state, you’ll be asked for your date of birth and additional information about your past weight loss efforts, stress levels, sleep habits, and eating patterns.
One drawback we encountered during the sign-up process for Hims & Hers was that no questions about height, weight, or existing health conditions were asked upfront. There was also no mention of specific eligibility requirements for receiving prescription medication until after creating an account.
Additionally, Hims & Hers does not accept insurance, health savings accounts (HSA), health reimbursement accounts (HRA), or flexible spending accounts (FSA). This means the $1,999 monthly cost for Wegovy must be paid out of pocket, making it a significant financial barrier for many people.
On a positive note, the Hims & Hers app provides free initial consultations and unlimited ongoing support from your provider. We also like that the app includes personalized educational content centered around nutrition and behavior change and offers tools to track progress, hydration, movement, and sleep—features that are all important for weight loss. (12) Evidence shows that combining weight loss medication with diet, exercise, and behavior change can help people achieve their weight loss goals more effectively. (13)
All medications prescribed by Hims are shipped free and come in discreet packaging, typically mailed in a brown postal box without branding or hints as to what is inside.
During testing, we noticed that Hims was out of Wegovy and other branded GLP-1 drugs. There was a strong push for their compounded semaglutide, priced at $199 per month. Despite being more affordable and having the same active ingredient as the branded medication, the FDA does not approve or evaluate compounded versions of semaglutide for safety, effectiveness, or quality. As a result, the FDA recommends using a compounded drug only if an FDA-approved version is unavailable. (1)
What our experts say
We asked Angela Tran, DO, for her insights on different GLP-1 drugs, particularly Wegovy.
“While Ozempic was the first to create buzz in the news regarding weight loss, Wegovy is actually the first to the market as FDA approved for the treatment of obesity and weight loss as a GLP1 injectable,” explained Tran. “Ozempic is FDA approved only for the treatment of type 2 diabetes even though it contains the same active ingredient—semaglutide. Wegovy just happens to have higher dosing options which is often where the more significant weight loss is achieved.”
Dr. Tran noted that Wegovy entered the spotlight when it was announced as the first treatment approved by the FDA to reduce the risk of cardiovascular disease in obese and overweight individuals. That opened up more opportunity for additional criteria for insurance coverage based on one’s medical history.
However, the criteria for prior authorizations are widely varied and can be strict depending on the insurance, and patients are left to pay out of pocket which is the major financial barrier considering that Wegovy requires long-term treatment both for weight loss and ongoing maintenance.
”I typically remind patients that the higher doses are where effective weight loss occurs, so it could take several months of titrating before one sees real weight loss,” Tran adds.
Specs
Cost | $1,999 per month |
Insurances accepted | N/A |
Form | Weekly injection |
Active ingredients | Semaglutide |
FDA-approved | Yes; for weight loss |
Prescription required | Yes |
Mounjaro: Noom Med
Key product features
What you should know
Noom Med combines Noom Weight–which focuses on behavioral change and psychology–with personalized weight loss medications like Mounjaro to improve the chance of long-term weight loss.
- Noom Med offers several weight loss treatments, including Mounjaro, which is FDA-approved to treat type 2 diabetes but has also been prescribed off-label for weight loss. (14)
- An initial consultation with Noom Med costs $69. From there, you’ll pay $297 for a three-month subscription with unlimited provider access and Noom Weight. This price does not include the cost of medications, which are filled through your local pharmacy and billed through insurance if applicable.
- Noom Med Mounjaro may be a good choice for people with type 2 diabetes who are also interested in weight loss.
- To qualify for Noom Med, you must be at least 18 years old and have a BMI of 30 or greater (or 27 or higher with a weight-related health condition).
What to consider before you take Mounjaro
Noom Med offers prescriptions for several weight loss medications, including Mounjaro (tirzepatide), a once-weekly GLP-1 injectable approved by the FDA to lower blood sugar in people with type 2 diabetes. (14)
However, like Ozempic, Mounjaro has been historically prescribed off-label for obesity, with some studies showing that it may help people with diabetes lose up to 15% of their body weight. (14, 15)
Mounjaro is unique because it activates both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) hormone receptors, which may increase its effectiveness.
GLP-1 receptor agonists help with weight loss by reducing appetite and slowing digestion, making you feel fuller for longer and reducing calorie intake. Similarly, GIP regulates calorie balance by signaling fat cells and the brain, improving the body’s ability to manage energy and potentially making dual-acting drugs more effective for weight loss. (16)
To get started with Mounjaro from Noom, you’ll take a short quiz that asks about your height, weight, goal weight, and health history. We appreciate that if you indicate a history of an eating disorder, Noom ends the process and directs you to a therapist or health care provider for support.
If your eligibility is confirmed, you must pay a $69 initial consultation fee, which covers a 30-day paid trial for Noom Med and Noom Weight.
Then, you’ll schedule a video visit with the clinician, who will review your health history and personalize a weight loss plan. If needed, they might order new labs, which are not included in the initial consultation fee.
After your first visit, you’ll have access to ongoing support from Noom’s Care Team–comprised of clinicians and a Care Coordinator–who will monitor your progress, adjust your care plan, and answer any questions—billed $297 every three months. Noom does not accept insurance to cover subscription fees, though you can use your insurance at a local pharmacy to help cover the costs of any prescribed medications. On average, Mounjaro can cost over $1,000 per month without insurance. (17)
Unfortunately, we were disappointed with the lack of guidance offered by Noom’s live chat agent when we asked questions about the program’s features.
What our experts say
“Mounjaro was introduced to the market as the direct competitor to Ozempic,” Dr. Tran notes. “While both are only FDA approved for the treatment of type 2 diabetes, they also have weight loss effects.”
“Mounjaro does have the edge,” she explains. “In my clinical experience, I have found that individuals who need to lose more weight are often more successful reaching those high-level weight loss goals with Mounjaro.”
“Another added benefit to Mounjaro is that there are more dosing options,” Tran adds. “However, Mounjaro is only FDA approved for type 2 diabetes which means insurance will only cover based on that criteria.”
Specs
Cost | Starts at $69 per month, plus the cost of the medication at your preferred pharmacy, depending on your insurance coverage |
Insurances accepted | N/A |
Form | Weekly injection |
Active ingredients | Tirzepatide |
FDA-approved | Yes; for type 2 diabetes |
Prescription required | Yes |
Saxenda: Everlywell
Key product features
What you should know
Everlywell offers a virtual weight loss program called Weight Care+ that includes ongoing clinical care, lab testing, and prescriptions for GLP-1 medications, including Saxenda for weight loss.
- We love that Everlywell Weight Care+ clearly outlines the indications for initiating GLP-1 prescriptions and offers help navigating insurance for prescription coverage. Everlywell clinicians can also prescribe medications, provide ongoing care, and order lab testing for people with high cholesterol and prediabetes.
- After the initial cost of $49, Everly Weight Care+ costs $99 a month with a 12-month commitment or $139 a month with a 3-month commitment.
- While they do not have to be at the same time every day, Saxenda requires daily injections, which may not be ideal for people who feel uncomfortable with injections or have a busy schedule. (8)
- Currently, telehealth visits for Weight Care+ are not covered by insurance, but you can use your HSA or FSA. Additionally, some insurance plans may cover medications, lab testing, and other costs related to weight loss treatment.
What to consider before you take Saxenda
Saxenda (liraglutide) is an injectable GLP-1 medication approved for weight loss in adults with a BMI of 30 or greater (or 27 or higher with a weight-related health condition). Unlike Mounjaro or Ozempic, which are injected weekly, Saxenda must be injected daily. (8)
Research shows that Saxenda can aid in weight loss, but it may not be as effective as other GLP-1 medications at controlling food cravings and reducing total calorie intake. In a 68-week study involving 338 adults, participants taking Wegovy lost an average of 15.8% of their initial body weight, compared to 6.4% in the Saxenda group. (18)
We found Everlywell incredibly easy to sign up for, and we appreciate that they are upfront about the eligibility criteria, saving time on unnecessary questions.
During your first appointment, a health care provider will review your medical history and, if needed, order lab tests to determine whether Saxenda (or another medication) may be a good fit. At the second visit, they’ll evaluate your results, discuss your goals, and create a personalized care plan, which may include a prescription medication and lifestyle changes. After starting the medication, you’ll have regular check-ins to monitor progress, adjust the dosage, and manage prescriptions.
Additionally, as part of your subscription, you can choose from one of Everlywell’s at-home lab tests or supplements every three months. Options include:
- Heart health test
- HbA1c test
- Cholesterol and lipids test
- Daily multivitamin gummies (3-month supply)
What our experts say
“Saxenda was FDA approved for weight loss back in 2014, while its counterpart, more commonly known as Victoza, is FDA approved for the treatment of type 2 diabetes,” Dr. Tran explains. “Because Saxenda has been around for several years, there may be more options for insurance coverage. However, when compared to weight loss results achieved by newer GLP1 injectables, individuals on Saxenda may not see the same significant or “overnight” success.”
Specs
Cost | $49/first month, $139/month after the first month; $99/month with a 120-month commitment |
Insurances accepted | N/A |
Form | Daily injection |
Active ingredients | Liraglutide |
FDA-approved | Yes; for weight loss |
Prescription required | Yes |
Zepbound: Life MD
Key product features
What you should know
Life MD offers a weight management program that gives customers access to GLP-1 medications like Zepbound and clinical support, education, and at-home metabolic testing.
- To get Zepbound through Life MD, you’ll pay around $129, which includes ongoing support, prescriptions, and lab tests, such as a cholesterol panel, hemoglobin A1C, and complete metabolic panel to check hormone levels that may affect metabolism. It does not include the cost of the medication.
- Life MD may be a good option for anyone looking for an FDA-approved weight loss treatment that includes ongoing support and personalized care.
- People with government health care coverage, such as Medicaid, Medicare, or TRICARE, are not eligible for Life MD’s GLP-1 weight loss programs since the medications prescribed are not generally covered.
What to consider before you take Zepbound
Zepbound, like Mounjaro, contains the active ingredient tirzepatide and is administered as a once-weekly injection. The main difference is that, while Mounjaro is approved for treating type 2 diabetes, Zepbound is exclusively FDA-approved for weight loss. (19)
Zepbound comes as a single-dose injection pen. The recommended starting dose is 2.5 milligrams, which is typically increased each month as tolerated until the desired effect is achieved.
In a 72-week clinical trial of adults with obesity, Zepbound led to significant weight loss. On average, people who took 10 milligrams weekly lost 19.5% of their body weight, while those who took 15 milligrams lost 20.9%. (20)
With Life MD, getting a prescription for Zepbound is simple. To pre-qualify, you enter your height, weight, goals, and location. Eligible customers can then schedule a face-to-face consultation with a health care provider specializing in weight loss. While mystery shopping, we were able to book a next-day consultation, which we appreciated.
If a prescription weight loss medication is recommended, the Life MD Care Team will help you navigate your coverage options and your co-pay. The Care Team can help you find coupons to lower the out-of-pocket cost if not covered by insurance.
To receive refills, you’ll have to fill out a quick questionnaire. This allows your provider to renew your prescription or increase your dosage without a video call.
According to Life MD, if you participate in their Weight Management Program and don’t lose at least 10% of your body weight within a year–a safe, modest rate of weight loss–you’ll be eligible for a refund. (21)
Keep in mind, though, that this only applies to the membership fee and does not cover your out-of-pocket prescription costs.
What our experts say
“Zepbound, to date, has clinically been shown to be the best weight loss injectable in the market,” Dr. Tran comments. “Zepbound is ideal for those who have a BMI of over 30 or BMI of 28 and additional heart risk factors such as high blood pressure and high cholesterol. Currently Zepbound is FDA approved for the treatment of obesity, but I anticipate Zepbound will soon have FDA approval for additional metabolic conditions associated with obesity.”
Tran notes that she believes Zepbound has the potential to “make waves” for individuals who have already tried everything else to lose weight. “Zepbound may give legitimate hope to those who feel like they have failed everything else,” she says.
Specs
Cost | Starts at $129/month |
Insurances accepted | N/A |
Form | Weekly injection |
Active ingredients | Tirzepatide |
FDA-approved | Yes; for weight loss |
Prescription required | Yes |
How to choose a weight loss drug
Weight loss medications aren’t for everyone. If you are overweight or obese, you may be able to lose weight using a weight loss program that focuses on improving your relationship with food, adopting a balanced diet, and increasing physical activity. However, if you have tried lifestyle changes in the past without success, your health care provider may recommend a weight loss drug. (22)
Many factors, including your medical history and health status, can influence the best weight loss medication for you. We recommend talking with a health care provider familiar with your unique health history before choosing a weight loss drug.
That said, here are a few things you’ll want to discuss with your provider during your first visit.
Personal and family health history
When looking for Ozempic alternatives, consider your personal and family health history. Do not take GLP-1 medications, including Ozempic, Wegovy, Saxenda, Mounjaro, and Zepbound, if you are pregnant, planning to become pregnant, or breastfeeding.
Some animal studies have linked these medications to a potentially increased risk of thyroid cancer. However, other studies have shown no connection. Therefore, GLP-1 medications are not recommended in people with a personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia (MEN) syndrome type 2 (a rare syndrome that causes tumors in endocrine glands). (23)
Additionally, although rare, GLP-1 medications may increase the risk of gastroparesis (delayed gastric emptying) and pancreatitis, especially if you have a history of these conditions. (24)
Potential side effects
Ozempic and other GLP-1 drugs may have potential side effects. In most cases, these side effects are mild and improve over time. Reviewing the benefits and risks with a healthcare provider before starting treatment is important to minimize side effects.
Common side effects include: (25, 26)
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Heartburn
- Fatigue
- Abdominal pain
Other rare but potentially severe side effects include: (5, 27)
- Hypoglycemia (low blood sugar) when used in combination with other diabetes medications or insulin
- Pancreatitis
- Acute kidney injury
- Progression of diabetic retinopathy (an eye disease caused by high blood sugar levels due to diabetes)
- Anaphylaxis
- Suicidal thoughts or actions
Lastly, the FDA has received reports of serious side effects, including hospitalizations, due to dosing errors with compounded semaglutide injectables. These errors involve incorrect self-administered doses and miscalculations by healthcare providers. As a result, the FDA only recommends compounded GLP-1 drugs–obtained from state-licensed pharmacies–when FDA-approved medications aren’t available. (28)
Swathi Varanasi, PharmD, notes that one big factor to consider while evaluating potential side effects of drugs like Ozempic and Wegovy is that there is no long-term data on the impact these medications have on the body. “Only time will tell about the long-term impact of these types of medications,” she says.
Desired outcomes
Ozempic and its alternatives can be safe, effective ways to treat obesity. However, they are most effective when combined with lifestyle interventions like diet and exercise. Working closely with a licensed healthcare provider and a registered dietitian can help you develop a personalized plan for sustainable weight loss.
Cost
With insurance, FDA-approved weight loss medications like Wegovy and Zepbound may cost as low as $25 per month. Without insurance coverage, they can cost well over $1,000 per month.
If you’re having trouble paying for your medication, many drug manufacturers, including Novo Nordisk (Saxenda, Wegovy) and Lilly (Zepbound), offer patient assistance programs that can help reduce your out-of-pocket expenses. Most telehealth platforms in this review that offer branded weight loss medications have a dedicated team that helps you navigate insurance coverage and look for the most savings.
Availability
Accessibility is important to consider when choosing a medication like Ozempic, Wegovy, Zepbound, Saxenda, or Mounjaro. These medications have been on and off the FDA’s Drug Shortages List for several years. However, the supply seems to be improving. As of this writing, only the starting dose of Wegovy (0.25 milligrams) is listed as in shortage, which may delay starting treatment for new patients prescribed this medication. (3)
FAQs
What are the best Ozempic alternatives for weight loss?
Wegovy, Saxenda, and Zepbound are the ozempic alternatives that are approved by the FDA to treat obesity and have strong scientific evidence supporting their effectiveness.
What are the best Ozempic alternatives for diabetes?
Mounjaro, Trulicity, Rybelsus (oral semaglutide), Byetta, Adlyxin, and Victoza are the best Ozempic alternatives for those looking to use it as a part of their comprehensive diabetes treatment regimen. These non-insulin medications are approved by the FDA to lower blood sugar levels in people with type 2 diabetes. (29)
Can you get alternatives to Ozempic over the counter?
No, there are no natural alternatives as effective as Ozempic and other GLP-1 drugs. Over-the-counter supplements that claim to produce similar results have limited evidence to support their effectiveness and may even carry potential health risks.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any diseases.
Our experts
Dr. Angela Tran, DO
Dr. Angela Tran, D.O. is Board-Certified in Internal Medicine and Obesity Medicine and is an active member of the American Board of Obesity Medicine Association. She has practiced in primary care since 2007, and recognized that obesity was often the root cause of many chronic medical conditions that she saw in her office including diabetes and high blood pressure.
Swathi Varanasi, PharmD
Dr. Swathi is a pharmacist with a passion about the intersection of personalized medicine and innovation. She received her Doctory of Pharmacy at the Medical University of South Carolina and a Bachelor of Arts at Carleton College. She also completed a postdoctoral fellowship in Medical Affairs in biotech and has training in nutrition from Cornell University.
Lily Moe
Lily is a Brooklyn-based writer and editor with over seven years of experience in health media. As a former Fitness Coach, Lily’s editorial prowess has largely focused on fitness, nutrition, and weight management. She has also spent a fair share of time in testing labs, analyzing everything from protein powders to yoga mats. Her work has appeared in Verywell Fit, Verywell Mind, Health, and more.
Kelly Uhler
Kelly has a multifaceted background in elder care, health care, and copywriting. She has worked for organizations such as A Place For Mom and Homecare.com, which gave her the opportunity to work closely with families, providing reliable information to help them make informed decisions about their loved one’s health, safety, and quality of life.
Lindsey DeSoto, RDN, LD
Fortune Recommends Nutrition Writer
About Author
Lindsey DeSoto is an experienced registered dietitian who enjoys staying up to date on the latest research and sharing her knowledge through writing. Her writing and expertise have been featured in various publications, including Verywell Health, Medical News Today, Health, and CNBC.
She specializes in healthy aging, weight loss, chronic kidney disease management, and general health and wellness. DeSoto holds a Bachelor of Science degree in Food and Nutrition from the University of Alabama, as well as a Bachelor of Science degree in Business Management from the University of Southern Mississippi. Outside of healthcare, Lindsey enjoys spending time with her husband and two children, working out, and attending sporting events.
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