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What is the over-the-counter alternative to Wegovy?

Robbie Puddick
Written by

Robbie Puddick

Medically reviewed by

Fiona Moncrieff

3 min read
Last updated May 2024
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Jump to: What’s the difference between Orlistat and Wegovy? | How much do Wegovy and Orlistat cost? | Should I buy Orlistat or Wegovy for weight loss?

You can buy Orlistat (Xenical/Alli) as an over-the-counter alternative to Wegovy in the UK.

However, Orlistat is a very different type of weight-loss medication, and research suggests it’s not as effective as Wegovy in supporting weight loss.

Research has shown that Wegovy can lead to a weight loss of 15-20%, whilst Orlistat may lead to a weight loss of 4-8%.

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What’s the difference between Orlistat and Wegovy?

Wegovy and Orlistat are weight-loss medications approved for use in the UK. However, they are different medications with distinct dosing schedules, costs, and mechanisms of action on the body.

Orlistat is a lipase inhibitor. Lipases are gut enzymes that break down fat from food, enabling the gut to transport fat into the body to be burnt for energy or stored in our fat cells for later use.

Orlistat blocks lipases, preventing some of the dietary fat from our meals from being digested. This leads to fewer calories being absorbed, which can support weight loss.

Orlistat is a prescription medication produced by two pharmaceutical companies in the UK:

  • GlaxoSmithKline: Alli, 60 mg and available over the counter (no prescription)
  • Roche: Xenical, 120 mg and available with a prescription

Wegovy 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.

Wegovy is approved in the UK for individuals living with obesity to help them eat fewer calories and lose weight.

How much do Wegovy and Orlistat cost?

The over-the-counter version of Orlistat will cost around £18 a month, so it’s a very affordable medication.

In comparison, buying Wegovy and the injectable pens required for four weeks from Second Nature will cost £229 a month, rising to £299.

Should I try Orlistat or Wegovy for weight loss?

Orlistat is an affordable medication that is generally well-tolerated. However, it’s less effective than Wegovy. Wegovy is twice as effective as Orlistat for weight loss after one year.

So, if you’re looking for the most affordable weight-loss pill you can purchase over the counter, then Orlistat could be an option.

However, if you have a higher budget and are looking for the most effective weight-loss injection in the UK, semaglutide is a better choice.

Wegovy’s not a magic pill

Semaglutide is designed as an additional tool for weight management and, in most cases, shouldn’t be considered a lifelong medication.

Instead, it should be used to help you kickstart your weight loss and healthy journey while you commit to living a healthier lifestyle.

Ideally, we’d be able to lose weight without medication and lifestyle changes would be enough to support weight loss in the long term.

We’d generally recommend trying Second Nature’s weight-loss programme before considering a weight-loss jab.

Changing your habits is the most sustainable way to achieve long-term weight loss, and it’s also less expensive.

At Second Nature, we’ve been trusted by the NHS since 2017 to support people with type 2 diabetes and obesity to lose weight, manage their blood sugar levels, and lead healthier lifestyles for the long term.

In 2022, the NHS published data in the BMJ that compared the weight loss outcomes of five providers in the National Diabetes Prevention Programme.

Second Nature was more than twice as effective at supporting weight loss than the other four providers.

However, if you’ve decided to try semaglutide (when it’s available) but need support in making positive changes to your lifestyle, Second Nature could be an option for you. But it’s worth noting that we have strict eligibility criteria.

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Write a response

Louise Barnard

30 April, 2024

Im trying to lose weight Im staying in South Africa and it is very difficult to get hold of Ozempic. Is there a easy way for me to get hold of it.


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