Jump to: Is there an OTC Ozempic? | What’s the difference between orlistat and Ozempic? | How orlistat works | Warning: fake weight-loss pens | Do ‘natural Ozempic’ alternatives work? | Prescription alternatives compared | How much do they cost? | Frequently asked questions | Take home message
No, there is no over-the-counter (OTC) Ozempic in the UK. Ozempic (semaglutide) requires a prescription and is only approved for type 2 diabetes. The only OTC weight-loss medication available is orlistat (60 mg, Alli). Prescription weight-loss injections similar to Ozempic, Wegovy and Mounjaro are available.
You can buy orlistat (brand name: Xenical/Alli) as an over-the-counter alternative to Ozempic in the UK. However, orlistat is a very different type of weight-loss medication and is less effective than Ozempic at supporting weight loss.
Research has shown that Ozempic can lead to weight loss of around 15%, whilst orlistat may lead to weight loss of 4-8%.1
Additionally, Ozempic isn’t approved for weight loss in the UK. It’s only available as a medication for people living with type 2 diabetes.
So, if you’re looking for an over-the-counter weight-loss medication in the UK, orlistat is the only reasonable choice.
It’s worth noting that Wegovy, the brand name for semaglutide that has been approved for weight loss, has now launched in the UK. Mounjaro (tirzepatide) was also approved by NICE in 2024 for weight management.
Important safety information: Weight-loss medications require careful consideration of your individual health circumstances. This article is for informational purposes only. Always consult with a healthcare provider before starting any weight-loss medication, and never purchase prescription medications from unregulated sources.
Is there an over-the-counter Ozempic?
No. Ozempic is a prescription-only medication, and there’s no over-the-counter version available in the UK or anywhere else.
Ozempic contains semaglutide, a GLP-1 receptor agonist that requires medical supervision due to its effects on blood sugar levels and potential side effects.
The only weight-loss medication available over the counter in the UK is orlistat 60 mg (sold as Alli). This is an entirely different type of medication that works differently.
What’s the difference between orlistat and Ozempic?
Orlistat is a weight-loss medication approved for use in the UK. Ozempic is a medication for people living with type 2 diabetes and is only available with a prescription.
They are different medications with distinct dosing schedules, costs, and mechanisms of action.
Orlistat is a lipase inhibitor. Lipases are digestive enzymes that break down dietary fat, enabling the gut to transport it into the body for energy or storage in fat cells for later use.
Orlistat blocks lipases, preventing some dietary fat from being digested. This leads to fewer calories being absorbed, which can support weight loss.
Two pharmaceutical companies in the UK produce Orlistat:
- GlaxoSmithKline: Brand name Alli, 60 mg and available over the counter (no prescription)
- Roche: Brand name Xenical, 120 mg and available with a prescription
Ozempic is a weight-loss jab manufactured by Novo Nordisk. It’s a weekly weight-loss injection with semaglutide as the active ingredient.
Semaglutide is a GLP-1 receptor agonist that helps reduce hunger and appetite, allowing you to eat fewer calories, lose weight, and manage your blood sugar levels.
How orlistat works (and what to expect)
Orlistat blocks around 25-30% of the fat you eat from being absorbed. Instead of being digested, this fat passes through your body in your stool.
This means orlistat only works when you eat fat. If you skip a meal or eat something fat-free, there’s no need to take it.
What results can you expect?
Research suggests orlistat can support weight loss of around 4-8% after one year when combined with a reduced-calorie diet.2
For someone weighing 90 kg, that’s roughly 3.5-7 kg over 12 months. It’s more modest than GLP-1 medications, but it can be a helpful starting point.
Side effects to be aware of
Orlistat’s side effects are directly related to how it works. Because it prevents fat absorption, any fat you eat has to go somewhere.
Common side effects include:
- Oily or fatty stools
- Oily spotting on underwear
- Urgent bowel movements
- More frequent bowel movements
- Stomach pain or discomfort
These side effects are more likely if you eat high-fat meals. Many people find that following a lower-fat diet while taking orlistat helps reduce these issues.
Tips for taking orlistat
- Take it with or up to one hour after meals containing fat
- Follow a diet based on whole foods that’s a bit lower in fat (to avoid digestive discomfort)
- Ensure you’re eating meals rich in protein and fibre to provide feelings of fullness. Fat helps us feel fuller for longer after meals, so if you’re taking orlistat and need to reduce fat, you need to compensate for this by increasing protein and fibre.
- Take a multivitamin at bedtime (orlistat can reduce absorption of vitamins A, D, E, and K)
Who orlistat suits best
Orlistat could be a reasonable option if you:
- Want an affordable, non-injection option
- Have modest weight-loss goals (5-8%)
- Are willing to follow a lower-fat diet
- Prefer something you can buy without a prescription
Warning: fake weight-loss pens in the UK
Before looking at alternatives to orlistat, there’s something important to know about buying weight-loss injections online.
The MHRA has issued warnings about counterfeit Ozempic, Wegovy, and Saxenda pens being sold in the UK.3
Some of these fake pens have contained insulin instead of semaglutide, causing people to be hospitalised with dangerously low blood sugar levels (hypoglycaemia). In some cases, this has led to seizures and coma.
Since January 2023, UK authorities have seized over 900 fake weight-loss pens. The World Health Organisation issued a global alert in June 2024 about falsified Ozempic products.
How to protect yourself
- Only buy from GPhC-registered pharmacies: Check the General Pharmaceutical Council register
- Be wary of unusually low prices: If it seems too cheap, it probably isn’t genuine
- Avoid social media sellers: Legitimate pharmacies don’t sell prescription medications through Facebook or Instagram
- Check for proper medical assessment: Real providers require a health questionnaire or consultation before prescribing
If you’ve purchased a weight-loss injection and something doesn’t seem right, don’t use it. Report it to the MHRA Yellow Card scheme.
Do ‘natural Ozempic’ alternatives work?
You might have seen supplements marketed as “natural Ozempic” on social media, particularly TikTok. The most commonly mentioned is berberine.
Let’s look at what the research actually shows.
Berberine
Berberine is a compound found in several plants and has been used in traditional medicine for centuries. Some social media claims suggest it works like Ozempic, but that’s inaccurate.
Berberine works by activating an enzyme called AMPK, which affects metabolism. This is an entirely different mechanism from GLP-1 medications like Ozempic, which work by mimicking a hormone that reduces hunger.4
Research on berberine shows modest effects. Studies suggest it may support weight loss of around 1.5-2 kg (3-5 pounds) over 12-16 weeks.5 Compare this to Ozempic’s average of 15% body weight loss (around 12-15 kg for most people).
Berberine is also not regulated as a medicine, so quality and dose can vary across products.
Other supplements
Other supplements sometimes marketed for weight loss include:
- Psyllium husk: A fibre supplement that may help you feel fuller, but doesn’t affect appetite hormones
- Green tea extract: May slightly increase metabolism, but effects on weight are minimal
- Apple cider vinegar: Very limited evidence for weight loss
The bottom line on natural alternatives
No supplement replicates the effects of GLP-1 medications. If you’re looking for significant weight loss support, orlistat (over the counter) or prescription medications like Wegovy and Mounjaro are the evidence-based options.
Weight-loss medication comparison
Here’s how the main options compare:
| Medication |
Type |
Prescription? |
Average weight loss |
Dosing |
| Alli (orlistat 60 mg) |
Pill |
No (OTC) |
4-5% |
3x daily with meals |
| Xenical (orlistat 120 mg) |
Pill |
Yes |
5-8% |
3x daily with meals |
| Wegovy (semaglutide) |
Injection |
Yes |
15-17% |
Weekly |
| Mounjaro (tirzepatide) |
Injection |
Yes |
20-22% |
Weekly |
| Saxenda (liraglutide) |
Injection |
Yes |
6-8% |
Daily |
| Ozempic (semaglutide) |
Injection |
Yes (diabetes only) |
9-15% |
Weekly |
How much do Ozempic and alternatives cost?
The over-the-counter version of orlistat (Alli) costs around £18- £ 25 per month, making it the most affordable option.
Prescription orlistat (Xenical) costs around £30-49 per month from online pharmacies.
In comparison, prescription weight-loss injections cost significantly more:
- Wegovy: £149-£249 per month through Second Nature
- Mounjaro: £229 – £349 per month through Second Nature
- Ozempic: £180-£350 per month privately (though it’s only approved for diabetes, not weight loss)
If you’re prescribed Ozempic on the NHS for type 2 diabetes, you’d only pay the standard prescription charge of £9.90 in England (free in Scotland, Wales, and Northern Ireland).
Frequently asked questions
Can I get Ozempic without a prescription?
No. Ozempic is a prescription-only medication in the UK. Attempting to buy it without a prescription is illegal and potentially dangerous, as you could receive counterfeit products.
Is Rybelsus available over the counter?
No. Rybelsus is an oral form of semaglutide (the same drug in Ozempic and Wegovy) and requires a prescription. It’s currently only approved for type 2 diabetes in the UK.
Do natural alternatives work as well as Ozempic?
No. Supplements like berberine work through different mechanisms and produce much smaller effects. Berberine may support 1.5-2 kg of weight loss over several months, compared to 12-15 kg with GLP-1 medications.
How long does orlistat take to work?
You may start to see results within 2-4 weeks if you’re following a reduced-calorie, lower-fat diet. Most studies show the full effect over 6-12 months of consistent use.
What happens if I eat fatty food while taking orlistat?
Eating high-fat meals while taking orlistat increases the risk of side effects such as oily stools, urgency, and stomach discomfort. Many people find that keeping fat intake lower reduces these issues.
Can I switch from orlistat to Wegovy or Mounjaro?
Yes, with medical guidance. If you’ve tried orlistat and want to explore prescription options, you can check your eligibility for Wegovy or Mounjaro through providers like Second Nature.
Is berberine the same as Ozempic?
No. Despite social media claims, berberine works completely differently from Ozempic. Ozempic mimics a hormone (GLP-1) that reduces hunger. Berberine activates an enzyme (AMPK) that affects metabolism. The weight-loss effects are not comparable.
Where can I buy legitimate weight-loss medication online?
Only purchase from pharmacies registered with the General Pharmaceutical Council (GPhC). They should require a medical assessment before dispensing prescription medications.
Take home message
There’s no over-the-counter Ozempic. The only OTC weight-loss medication in the UK is orlistat (Alli), which works differently and produces more modest weight loss (4-8% vs 15% with Ozempic).
If you’re looking for more effective options, prescription medications like Wegovy and Mounjaro are available through regulated providers. These require a medical assessment but offer significantly better results.
Be cautious about “natural Ozempic” claims on social media. Supplements like berberine don’t work the same way and won’t produce similar results.
Most importantly, avoid buying weight-loss injections from unregulated sources. Counterfeit products have caused serious harm, including hospitalisations. Only use GPhC-registered pharmacies.
Second Nature's Mounjaro and Wegovy programmes
Second Nature provides Mounjaro or Wegovy as part of our Mounjaro and Wegovy weight-loss programmes.
Why choose Second Nature over other medication providers, assuming you're eligible?
Because peace of mind matters.
We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
References
- Wilding, J.P.H., et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 384(11), 989-1002.
- Rucker, D., et al. (2007). Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ, 335(7631), 1194-1199.
- MHRA. (2024). Ozempic (semaglutide) and Saxenda (liraglutide): vigilance required due to potentially harmful falsified products. Drug Safety Update.
- Pang, B., et al. (2019). Application of berberine on treating type 2 diabetes mellitus. International Journal of Endocrinology, 2015:2015:905749
- Ye, Y., et al. (2021). Efficacy and safety of berberine alone for several metabolic disorders: A systematic review and meta-analysis of randomized clinical trials. Frontiers in Pharmacology, 12, 653887.
