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GLP-1s

Wegovy vs Rybelsus

Robbie Puddick
Written by

Robbie Puddick

Medically reviewed by

Fiona Moncrieff

7 min read
Last updated February 2024
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Jump to: What do Wegovy and Rybelsus do to the body? | Do you lose more weight on Wegovy or Rybelsus? | Wegovy vs Rybelsus: Which is better? | Take home message

Wegovy and Rybelsus are the same drug with the active ingredient of semaglutide.

However, Wegovy is an injectable medication taken once a week, and Rybelsus is an oral medication taken once a day.

According to data from randomised controlled trials, Wegovy leads to more average weight loss and blood sugar reductions than Rybelsus.

Their dosing also differs, with Wegovy rising from 0.25 mg weekly to 2.4 mg after five months. Rybelsus starts at 3 mg daily, rising to 14 mg after three months if needed.

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Wegovy and Rybelsus Dosage

Wegovy is approved for obesity in the UK, while Rybelsus is only approved for individuals living with type 2 diabetes.

So, if you were looking for a weight-loss medication, then Wegovy would be the only available choice between the two.

The other weight-loss medications in the UK market are Saxenda (liraglutide) and Orlistat.

Wegovy isn’t a magic pill

These medications are designed as additional tools for weight management interventions and shouldn’t be considered lifelong medications.

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

Consider the use of antidepressants in the treatment of depression. They’re used to open the door to therapy and allow patients time to treat the underlying causes of their mental illness.

Wegovy and other weight-loss injections should be viewed in a similar way. They can support significant weight loss and give individuals the time and space they need to focus on the underlying causes of their obesity while the medication manages their appetite.

At Second Nature, we’ve been used 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.

If you’re considering purchasing Wegovy but need a higher level of support in making positive lifestyle changes, Second Nature could be an option for you.

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.

1) What do Wegovy and Rybelsus do to the body?

When we eat food, our gut releases hormones that help the body regulate hunger and blood sugar levels. GLP-1 (glucagon-like peptide 1) is one of these hormones and has a significant role in managing our appetite.

GLP-1 improves insulin function to lower blood sugar levels and delays gastric emptying, which helps decrease appetite as it takes longer for food to pass through our digestive system.

The hormone GLP-1 also communicates with the brain’s appetite control centre, the hypothalamus, to lower hunger and food-seeking behaviour.

Wegovy and Rybelsus (semaglutide) mimic the actions of the hormone GLP-1 and are known as GLP-1 receptor agonists or GLP-1s.

The actions of semaglutide on the gut and brain make us feel less hungry and lower our desire to eat. This helps us eat fewer calories so that we can lose weight.

How long does it take Wegovy and Rybelsus to work?

Semaglutide is a long-acting medication, so it can take up to 4-5 weeks to reach what’s known as a ‘steady state’ where the levels of the drug maintain higher levels in the blood rather than rising and falling.

So, in the first month or two of taking the medication, we may notice our hunger levels changing as the drug’s blood levels rise and fall.

Key points:

  • When we eat food, our body produces hormones to signal to the brain to lower hunger. GLP-1 is one of those hormones.
  • GLP-1 helps the pancreas release more insulin to lower blood sugar levels and delay stomach emptying to lower appetite
  • Wegovy and Rybelsus are the same drug and contain the active ingredient semaglutide
  • Semaglutide mimics the hormone GLP-1 to lower blood sugar levels and reduce hunger
  • Semaglutide can help us eat less and lose weight

2) Do you lose more weight on Wegovy or Rybelsus?

According to data from randomised controlled trials, Wegovy supports more average weight loss than Rybelsus.

Research has shown that 2.4 mg of Wegovy can support an average weight loss of around 11% after 26 weeks and 16% after one year.

In comparison, research suggests 14 mg of Rybelsus supports an average weight loss of around 4.5% after 26 weeks, ~6.5% less than Wegovy.

Wegovy likely leads to more weight loss as it can maintain higher semaglutide levels in the blood for longer, so its impact on lowering hunger is longer-lasting.

Interestingly, researchers have been investigating higher doses of Rybelsus, up to 50mg per day, and found it can support weight loss of over 20% after 68 weeks.

These results suggest that higher doses of Rybelsus can support weight loss similar to Wegovy 2.4 mg. However, Rybelsus is only approved in doses up to 14mg in the UK and only as a type 2 diabetes medication.

So, based on the currently available doses, Wegovy is generally a more effective medication for weight loss than Rybelsus.

Key points:

  • Research suggests that Wegovy supports more weight loss on average than Rybelsus
  • However, researchers are investigating the impact of higher Rybelsus doses (up to 50 mg daily) and this seems to support similar weight loss to Wegovy
  • Based on currently available doses, Wegovy is generally a more effective weight-loss medication

3) Wegovy vs Rybelsus: Which is better?

As Wegovy and Rybelsus are approved for different chronic conditions (Wegovy for obesity and Rybelsus for type 2 diabetes), there’s no definitive answer as to which is ‘better’ as you wouldn’t have the choice between the two.

However, research suggests that Wegovy supports more weight loss and leads to better blood sugar improvements than Rybelsus based on the currently available doses.

Side effects and safety

All medications have possible side effects, particularly if you live with other health conditions.

Some will be mild but uncomfortable, such as cramping, and others will be more severe, such as shortness of breath. You must report any side effects you experience to your doctor and healthcare team when on medications.

The side effect profiles of Wegovy and Rybelsus are very similar as they’re the same medication.

The most common side effects in both medications are GI-related, such as nausea, diarrhoea, and vomiting, with around 20% of participants experiencing these side effects at least once and 60-75% of patients on these medications experiencing at least one adverse side effect.

Our individual responses to medications will vary, and some people might respond better to Wegovy than Rybelsus and vice versa.

Wegovy and Rybelsus Cost

To purchase Wegovy and the four weeks of injectable pens required costs £229 with Second Nature. This includes access to our NHS-trusted weight-loss programme with access to a registered dietitian or nutritionist.

If you’re prescribed Wegovy as part of a tier 3 weight management programme in England, you’ll pay the standard base prescription fee of £9.95.

To purchase Rybelsus privately would cost around £130 a month. You need a prescription for Rybelsus and must be living with type 2 diabetes.

You may also be prescribed Rybelsus as a type 2 diabetes medication via the NHS; this would cost the standard base fee of £9.95.

Key points:

  • Wegovy and Rybelsus are approved for different conditions in the UK, so neither is better as we wouldn’t have a choice between the two
  • Both medications have a similar side effects profile as they’re the same medication
  • Wegovy costs £229 a month with Second Nature if you’re eligible, and £9.95 with the NHS if you’re on a tier 3 weight management programme
  • Rybelsus costs around£130 a month privately, and £9.95 if you’re prescribed it as a type 2 diabetes medication

Take home message

The recent innovations in GLP-1 medications are pretty remarkable and have caused quite a stir in the world of healthcare.

We’re in new territory where obesity and type 2 diabetes medications treat an underlying cause instead of merely treating the symptoms to support better management.

However, these drugs shouldn’t be seen as miracle cures; they’re not designed to be used for life.

They’ve been designed to be taken alongside lifestyle changes that will enable you to eventually come off the medications and maintain your lower weight for the long term.

Semaglutide is safe and effective for most people in the short to medium term, but we don’t have long-term data to be sure they’re not causing severe adverse effects elsewhere.

At Second Nature, we’re not against using medications to support people in making healthy changes and reducing their risk of chronic disease. Which is why we’ve launched a Wegovy-supported programme.

However, we don’t recommend using medications as a reason not to make healthy lifestyle changes. The causes of obesity and type 2 diabetes aren’t merely rooted in biology but also in psychology and sociology.

With these medications, you may lose weight and reduce blood sugar levels. But will you be happier? Will you be more fulfilled? Will you be content with your life and social relationships?

For that, you may need to consider a lifestyle change,

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