Introduction
You’ve probably heard of two medicines that help people lose weight, and effectively at that: Ozempic and Wegovy. The two, which share the same active ingredient, semaglutide, have achieved household recognition as more people shed pounds with them. From British personality Sharon Osbourne to SpaceX/Tesla’s Elon Musk, more individuals have been turning to them to drop weight.
Both Ozempic and Wegovy come in an injectable pen format. But there’s actually another semaglutide brand that comes in tablet form: Rybelsus. You may wonder if semaglutide injections work better than tablets.
It’s important to note that despite their popularity for weight loss, Ozempic and Wegovy aren’t both intended for weight loss. In fact, only Wegovy has FDA approval to help manage weight. Still, many people turn to Ozempic to drop weight, even if it treats type 2 diabetes. Similarly, Rybelsus is an anti-diabetic drug.
With two options for administering semaglutide, which format is more effective in helping you lose weight? Injections or tablets? Is one more effective than the other? This article investigates this matter.
Semaglutide injections: An overview
Among semaglutide’s brands, two products come in injectable format: Ozempic and Wegovy. Although only Wegovy has FDA approval as a weight loss drug, Ozempic has been equally popular for weight management. Why are doctors prescribing Ozempic over Wegovy for weight loss?
It could be because their common active ingredient, semaglutide, is approved for weight loss. Essentially, the two work the same way. It could also be because the people feel that Ozempic’s higher starting dose could help them lose weight faster. Or because they lose weight as a side effect.
Before we dive into whether semaglutide injections are better than tablets, let’s better understand how each format works.
How semaglutide works
Both Ozempic and Wegovy belong to a class of medications, GLP-1 receptor agonists. Basically, they mimic how the hormone GLP-1 triggers the release of insulin whenever blood sugar levels are too high. Or when other medicines aren’t properly controlling it.
Another effect is they delay gastric emptying, causing you to feel fuller for longer and with less cravings. The result? Weight loss.
Dosages
Ozempic is in an injectable pen format and you should administer it once a week. It comes in 0.5 mg, 1 mg, and 2 mg doses and is only available for purchase with a prescription.
Wegovy, meanwhile, comes in injectable pen format, but in dose strengths of 0.25 mg to 2.4 mg. The different doses come in pens of different colors.
Similar to Ozempic, your doctor will start you on small doses, gradually increasing this until you reach a maintenance dose. Wegovy is also a once-weekly injection.
Administration
You administer Ozempic and Wegovy subcutaneously or under the skin (under the skin). You can inject in three different areas: your 1) abdomen, 2) thigh, or 3) upper arm. Make sure that you are not injecting into a muscle or vein. It is best to use a different injection site with every injection. However, if you want to use the same injection site, pick a different spot in that area.
You can take semaglutide injections with or without meals at any time of the day. For best results, semaglutide manufacturer Novo Nordisk notes that it is best to take semaglutide along with a balanced diet and exercise.
Common and serious side effects
Whether taking Ozempic or Wegovy for weight management, you still face the potential risk of developing side effects. Here are the common and serious side effects of subcutaneous semaglutide.
The most common adverse effects of subcutaneous semaglutide include nausea, vomiting, diarrhea, constipation, heartburn, or abdominal pain. To help manage symptoms, healthcare providers may work your way up from a low starting dose to a higher dosage.
Serious side effects
The more serious side effects of semaglutide injections include allergic reactions, hypoglycemia, pancreatitis, kidney problems, and thryroid c-cell tumors. Note that these are rare.
Efficacy
A growing number of studies illustrate the benefits of taking semaglutide injections for obesity. Moreover, studies show that it potentially has a positive impact on other health conditions.
On obesity
A study in the journal Cureus looked at the efficacy of semaglutide in treating people who were overweight. 40 percent of the people on semaglutide once weekly lost at least 15 percent of their body weight over 68 weeks. Those in the placebo group, meanwhile, lost significantly less weight.
On cardiovascular problems
Clinical studies have proven that apart from type 2 diabetes, Ozempic also helps reduce the risk of developing cardiovascular problems.
Wegovy, meanwhile, helped reduce markers of heart disease, from high cholesterol, high blood sugar levels, and hypertension.
Semaglutide tablets: An overview
Rybelsus is semaglutide’s type 2 diabetes medication that comes in tablet format.
Although not a weight loss drug, weight loss is one of its effects, as with semaglutide brands Ozempic and Wegovy. Some doctors may prescribe it to patients not comfortable or squeamish to inject themselves with semaglutide. They may also prescribe it for those who prefer to take a medication daily rather than once weekly.
How Rybelsus works
Just like Ozempic and Wegovy, Rybelsus is a GLP-1 agonist, meaning it copies GLP-1 in managing high blood sugar levels. Similarly, it triggers slower gastric emptying, leading to a weaker appetite and weight loss.
Dosages
You typically take Rybelsus at 3mg once per day during the first 30 days of use. After this initial month, your doctor will increase your dose to 7 mg per day. This dose is typically what it takes for your body to regulate its blood sugar levels. After another 30 days on 7 mg, he/she might increase the dosage to 14 mg per day.
Administration
- You must take Rybelsus on an empty stomach when you first wake up. Take it with no more than four ounces or 120 ml of plain water. Do not split, chew, or crush the tablet. You must swallow it whole.
- Wait at least 30 minutes before eating, drinking, or taking other oral medications by mouth.
- To maximize results, it is best to eat 30 to 60 minutes after taking Rybelsus. You must take it the same way every time.
Side effects (common and serious)
Similar to Ozempic and Wegovy, Rybelsus’ most common side effects include nausea, vomiting, abdominal pain, constipation, diarrhea, or weak appetite. Nausea is one of the more typical side effects, which should get fewer with gradual dosing.
Its serious side effects, meanwhile, include allergic reactions, hyperglycemia, kidney problems, vision changes, and signs of pancreatic disease. Note that these are rare.
Efficacy
A 26-week study found that Rybelsus effectively lowered blood sugar levels in adults suffering from type 2 diabetes. The participants experienced a 1.2 to 1.4% reduction in HbA1c levels whereas those on placebo lost 0.3%.
Semaglutide injections vs. tablets: Which one works better?
A 2021 review concluded oral semaglutide (Rybelsus) is as effective, if not more effective, for weight loss than injectable semaglutide. In addition, it was also more effective in reducing A1C than injectable semaglutide in people with diabetes. A1C is the blood test that shows your blood sugar level over the past two to three months.
Despite the study’s outcome, note that research comparing oral and subcutaneous semaglutide is still relatively new. More studies will need to be done to conclude that one form is more effective than the other. There have also been no clinical studies directly comparing the two forms.
Pros and cons of oral and injectable semaglutide
It is clear that both injectable and oral forms of semaglutide are effective in helping promote weight loss. Nevertheless, there are advantages to taking one over another. Patients will have their own idea of what is inconvenient or cumbersome. Here is a list of their usage requirements:
Oral semaglutide:
- Does not require needles
- Daily administration
- Can result in side effects like nausea, vomiting, and abdominal pain
- Must be taken on an empty stomach first thing in the morning
Injectable semaglutide:
- Requires the use of needles
- Typically injected just once weekly
- Can result in side effects such as reactions in the injection site
- Does not matter whether food or liquid has been consumed before or after the injection
Conclusion
Ozempic and Wegovy are currently popular weight loss drugs, despite only Wegovy being having FDA approval for weight management. Ozempic treats type 2 diabetes, while Wegovy treats obesity.
The two medicines come in an injectable format and share a common active ingredient: semaglutide. Semaglutide also has another anti-diabetic drug: Rybelsus, which comes in tablet form.
To ensure optimal results, you must administer the three medicines properly each time, whether subcutaneously or orally.
Regardless if you take semaglutide according to its approved use or not, patients can still suffer from side effects. Nausea and vomiting are some of the most common adverse effects, while more serious ones are rare.
A review found that oral semaglutide could be just as effective, if not more effective, than injectable semaglutide. However, more research is needed to conclude whether one form is more effective than the other. On their own, Rybelsus, Ozempic, and Wegovy have been evidenced by studies to be effective in lowering blood sugar levels.
Some patients may prefer taking medicine orally to subcutaneously due to a fear of needles or discomfort with injections. Others may want to switch from injectable to oral semaglutide, or the other way around.
Should you wish to lose weight with semaglutide, seek your healthcare provider’s recommendation on the best medication for you. Make sure you discuss any past or current health issues in its entirety to avoid the risk of complications.
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