You might know semaglutide as the active ingredient in Ozempic and Wegovy, both weekly injections that can help with weight loss. But did you know that semaglutide comes in pill form, too?
Yep—oral semaglutide is sold under the brand name Rybelsus. Sometimes, people refer to Rybelsus as “oral Ozempic”, but Ozempic and Rybelsus are separate products.
So, how does Rybelsus work and what makes it different from other weight loss medicines? Here’s everything you need to know.
What is oral semaglutide and how does it work?
As the name suggests, oral semaglutide is semaglutide that’s taken as a pill. It’s a type of medicine called a GLP-1 receptor agonist, which means that it acts like the natural hunger hormone GLP-1—and therefore, brings on its effects.
Rybelsus supports weight loss by making you feel full. It suppresses your appetite and slows down your digestion, which keeps you feeling fuller for longer.
Other medicines made with semaglutide (like Wegovy) work in the same way. Studies have shown that there may be other health benefits to taking semaglutide, like lowering blood pressure. But we need more research to understand the potential benefits of Rybelsus specifically.
Rybelsus is the first GLP-1 receptor agonist to be developed as a tablet. It was created by Novo Nordisk, who also make Ozempic and Wegovy weight loss injections.
Is there an oral version of Ozempic?
Here’s where things can get a little confusing. Ozempic, Wegovy and Rybelsus are all brand names for the same medicine (semaglutide). But they’re separate products.
Ozempic is currently only available as an injector pen, meaning that there’s no “Ozempic pill”. Oral semaglutide is sold under the name Rybelsus. Here’s how these medicines differ:
- Ozempic and Wegovy are taken as weekly injections, while Rybelsus is a daily pill
- Ozempic and Rybelsus are approved as treatments for type 2 diabetes, though they’re sometimes used off-label for weight. Whereas Wegovy is specifically licensed for weight loss
- Each medicine has its own dosing schedule
Can you lose weight with oral Ozempic?
Now for the million-dollar question: does oral semaglutide work for weight loss? Studies suggest that yes, it does.
In a clinical trial called PIONEER 4, people with type 2 diabetes taking the highest standard dose of Rybelsus (14mg) daily for 26 weeks lost an average of 4.4kg (compared to 0.5kg for those taking a sugar pill).
In a clinical trial called OASIS-1, people taking Rybelsus once per day for 68 weeks lost 15.1% of their starting weight on average. Here, the semaglutide oral dose for weight loss was 50mg/day, which is much higher than what’s currently available for type 2 diabetes.
Because Rybelsus is still being studied as a treatment for weight loss, we don’t yet know the recommended doses for this use.
Is oral semaglutide as good as injections?
But how does an oral GLP-1 medicine compare to injections? We don’t have much research comparing the two in terms of weight loss, we’re afraid.
In the study we mentioned above, people taking Rybelsus lost slightly more weight than those taking a weight loss injection containing liraglutide (which often goes by the brand name Saxenda).
In another study that looked at people with type 2 diabetes, people taking oral semaglutide for 6 months lost less weight on average (3.6kg) than those using semaglutide injections (5.3kg). However, those in the tablet group had a greater reduction in blood sugar.
But the authors note that these differences weren’t statistically significant, which means that it’s possible they could be explained by chance. The study also showed that side effects were more common in the oral semaglutide group.
Other research suggests that injectable semaglutide works better for weight loss than oral semaglutide. But oral semaglutide might drive more weight loss than sitagliptin (a type 2 diabetes tablet).
Oral GLP-1 medications: Are there alternatives?
Rybelsus is the only oral GLP-1 medicine you can get in the UK right now. It’s a possible alternative to Ozempic, but do check in with your provider before switching medicines. They’ll advise on what’s best for you personally.
Currently, the only tablets approved specifically for weight loss in the UK are orlistat weight loss pills. But orlistat isn’t a GLP-1 receptor agonist—rather, it works by reducing the amount of fat you absorb from your food, so you take in less calories.
There may be more weight loss pills on the market within the next few years. For example, Eli Lilly (who make Mounjaro weight loss injections) are developing a GLP-1 pill called orforglipron.
Is oral semaglutide available in the UK?
You can get Rybelsus on the NHS as a treatment for type 2 diabetes but not for weight loss, because it’s not approved for that use.
Though you may be able to get it via private prescription, from a private clinic or online provider. Here, costs and availability may vary.
But there are plenty of weight loss medications that are available right now that can help you reach your health goals.
We’ve already mentioned orlistat, Mounjaro and Wegovy, but there’s also Saxenda weight loss injections. Saxenda is another GLP-1 receptor agonist that’s taken as a weekly injection.
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