10 best alternatives to Wegovy for weight loss

Are you looking for an alternative to Wegovy for weight loss? 

Well, you have options — and lots of them. While Wegovy (semaglutide) is an effective treatment for weight loss, it’s not the best option for everyone. Maybe your insurance doesn’t cover it, or they denied your prior authorization. Maybe you’re having trouble finding Wegovy in stock. Or maybe, you simply don’t want to use Wegovy (not everyone’s a fan of injectable medications), but you’re still looking for a way to lose weight.

 Here are 10 effective alternatives to Wegovy for weight loss.

If you’re struggling with weight loss, connect with a provider on Klarity today. You can schedule an appointment in as little as 24 hours to see if a prescription for one of these Wegovy alternatives is right for you.

Alternatives to Wegovy to ask your provider about

Wegovy is a once-weekly injectable prescription medication. It’s U.S. Food and Drug Administration (FDA)-approved for weight loss in adults with obesity or overweight with at least 1 weight-related health condition (such as high blood pressure or type 2 diabetes) and pediatric patients aged 12 years and older with obesity. 

Wegovy also reduces the risk of major adverse cardiovascular events in adults with established heart disease and obesity or overweight. 

With diet and exercise changes, clinical trial participants lost an average of 14.9% of their body weight over 68 weeks on Wegovy. 

There are a number of alternatives to Wegovy out there, including other weight loss injections, pills, and even over-the-counter options.

Ozempic rather than Wegovy

Ozempic (semaglutide) is a once-weekly prescription injectable medication that contains the same active ingredient as Wegovy, semaglutide. The main differences between Ozempic and Wegovy include their FDA-approved conditions and their dosage amounts. 

Ozempic is FDA-approved to improve glycemic control in adults with type 2 diabetes. Like Wegovy, it also reduces the risk of major adverse cardiovascular events (death, heart attack, or stroke) in adults with type 2 diabetes and known heart disease.

Ozempic is available in lower dosage strengths than Wegovy, and leads to less weight loss. In clinical trials, people taking Ozempic for type 2 diabetes lost at least 5%, and sometimes more than 10%, of their body weight in 40 weeks. Ozempic also produces fewer, less intense side effects than Wegovy. Common side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation. 

With an average out-of-pocket price of $1,029, Ozempic costs less than Wegovy. However, it’s less likely to be covered by insurance when it’s prescribed off-label for weight loss. But, if you have type 2 diabetes and also need help controlling your blood sugar, Ozempic may be covered by your insurance and help you lose weight.

Currently, Ozempic is listed as available on the FDA Drug Shortages site, but it has been known to experience drug shortages in the past.

Zepbound or Mounjaro as alternatives to Wegovy for weight loss

Zepbound (tirzepatide) and Mounjaro (tirzepatide) are both once-weekly prescription injectable medications that share the same active ingredient: tirzepatide. The key difference is what they are FDA-approved to treat: type 2 diabetes in the case of Mounjaro, and obesity in the case of Zepbound. Mounjaro and Zepbound also differ from Wegovy in that they are GLP-1/GIP agonists, which are shown to help people lose more weight than GLP-1 agonists like Wegovy.

When prescribed for type 2 diabetes, Mounjaro is more likely to be covered by insurance, although prior authorization may be needed. As an obesity medication, Zepbound may be less likely to be covered by insurance.

Both Zepbound and Mounjaro can produce significant weight loss, sometimes more so than Wegovy. In clinical trials of Mounjaro, people with type 2 diabetes lost up to 13.9% of their body weight in 104 weeks. In clinical trials of Zepbound, people lost up to an average of 20.9% of their body weight. 

Similar to Wegovy, Zepbound and Mounjaro can both cause side effects like nausea, diarrhea, vomiting, constipation, and upset stomach. Both Wegovy alternatives also cost upwards of $1,000, although they tend to be a bit more affordable than Wegovy. At this time, some dosage strengths of Zepbound and Mounjaro are in shortage, while others are available.

Compounded semaglutide as a Wegovy alternative

Compounded semaglutide contains the same active ingredient as Wegovy. Compounding pharmacies, online pharmacies, and some providers and health clinics may prescribe compounded semaglutide for weight loss, which can be a more affordable version of Wegovy. 

Compounded medications are custom-made versions of a medication for an individual patient. The ingredients may be combined or altered in some way that makes them more suitable for a patient than the brand-name version, such as creating an injectable form of a tablet for a patient who has difficulty swallowing. Compounded medications also offer relief during drug shortages, which commonly affect Wegovy.

Because compounded medications are made on an individual basis, research isn’t available for their efficacy or safety. 

Saxenda as a alternative to Wegovy

Like Wegovy, Saxenda (liraglutide) is a prescription injectable medication for chronic weight management in adults with obesity or overweight with at least 1 weight-related health condition. It’s also approved for pediatric patients 12 years and older with obesity. Unlike Wegovy, Saxenda is injected on a daily basis.

Saxenda causes less weight loss than Wegovy. In clinical trials, participants taking Saxenda lost at least 5%, and sometimes up to 10%, of their body weight over 56 weeks. Saxenda has similar side effects to Wegovy, including nausea, diarrhea, constipation, vomiting, and injection site reactions.

Saxenda costs the same as Wegovy. As an obesity medication, it may be less likely to be covered by insurance. It’s currently in shortage.

Compounded tirzepatide instead of semaglutide

Compounded tirzepatide contains the same active ingredient as Zepbound or Mounjaro. Like compounded semaglutide, it’s made by a compounding pharmacy rather than the drug manufacturer, whether to suit the needs of an individual patient or to meet demand during a drug shortage. You can find this Wegovy alternative through compounding pharmacies, online pharmacies, and some health clinics.

Qsymia instead of Wegovy

As a daily prescription oral medication, Qsymia (phentermine and topiramate) offers a non-injectable alternative to Wegovy and Ozempic. It’s FDA-approved for weight management in adults with obesity or overweight, with at least 1 weight-related health condition, as well as pediatric patients 12 years and older with obesity.

When they’re on an effective dosage, people can lose at least 3% of their body weight within the first 3 months of taking Qsymia. In clinical trials, participants taking Qsymia lost 5 to 10% of their initial body weight in 56 weeks. 

While Qsymia shares some gastrointestinal side effects with Wegovy, side effects like paraesthesia (the feeling of being on “pins and needles”) and dry mouth are more common. 

Unlike Wegovy, Qsymia is covered by a majority of commercial healthcare plans, although prior authorization may be required. It’s also a much cheaper alternative to Wegovy, with an average out-of-pocket price of $211. It’s currently available and not in a shortage.

Phentermine for weight loss

Phentermine is one of the active ingredients in Qsymia, but you can get it on its own as a generic or the brand name drugs Adipex-P, Lomaira, and Suprenza. It’s FDA-approved for weight loss on a short-term basis in people with obesity or overweight and other risk factors. 

In one study, 62% of participants taking phentermine for short-term use lost at least 3% of their body weight in 3 months. 

Phentermine can be covered by insurance, but prior authorization is usually required. It costs significantly less than Wegovy, with an average out-of-pocket price of only $12.

Wegovy and phentermine share some side effects, but in general, side effects are more common with phentermine and may include dry mouth, jitteriness, and changes in sex drive. As a stimulant, phentermine is a Schedule IV controlled substance and has a high risk for addiction, especially if misused. 

Contrave as an alternative to Wegovy

Contrave (naltrexone and bupropion) is a prescription oral tablet that you take twice a day, in the morning and at night. It’s FDA-approved for chronic weight management in adults with obesity and overweight with at least 1 weight-related condition.

Contrave produces less weight loss than Wegovy, and shares additional side effects beyond the digestive ones common to Wegovy. For example, insomnia, dry mouth, anxiety, and flushing can occur when taking Contrave. 

In clinical trials, patients taking Contrave lost 5 to 10% of their initial body weight in 56 weeks.

Contrave is about half the cost of Wegovy, and can be even cheaper if you use their savings program or have insurance coverage (although, as an obesity medication, Contrave may not be covered). Contrave is currently available and not in shortage.

Xenical or Alli as alternatives to Wegovy

Xenical (orlistat) and Alli (orlistat) are 2 more alternatives to Wegovy for weight loss. They treat obesity in people with obesity or overweight and other risk factors. Xenical is a prescription weight loss pill, while Alli is available over the counter and contains a lower dosage of orlistat. With either Wegovy alternative, you take an oral tablet 3 times a day with a meal containing fat. 

In clinical trials, patients taking Xenical lost an average of 13.4 pounds in 1 year, and 57% of patients lost at least 5% of their starting body weight. In a study of U.S. soldiers, participants lost an average of 7 pounds in 6 months. 

Orlistat’s side effects include urgency when using the bathroom, increased defecation, and oily spotting or flatulence. 

The average price of Xenical is $803, but a cheaper generic version is also available. Alli is much cheaper than both Xenical and Wegovy, with an average cost of $56. Neither medication is experiencing a drug shortage as of the time of publication.

Metformin instead of Wegovy

Metformin is an oral tablet that’s FDA-approved to treat type 2 diabetes in adults and pediatric patients aged 10 years and older. While it isn’t approved for weight loss, people taking it lose weight as an added benefit. Depending on your dose, you take an oral tablet 1 to 3 times a day, with meals. 

Metformin produces significantly less weight loss than Wegovy. In a study of people with prediabetes, patients taking metformin lost an average of 3.5% of their body weight in 2 years.

Metformin shares many side effects with Wegovy, including diarrhea, nausea, and vomiting. One unique side effect is asthenia, or a lack of energy or strength. 

It costs significantly less than Wegovy, at only around $11 for a 30-day supply, but it may not be covered by insurance unless you are prescribed it for type 2 diabetes. If you take this Wegovy alternative for weight loss, your insurance plan may require prior authorization.

How to maximize weight loss on any medication

All of the medications on our list of Wegovy alternatives work best when you adopt healthier eating and exercise habits. In fact, many are FDA-approved specifically for use in combination with a reduced-calorie diet and increased physical activity. 

Eating better doesn’t just mean eating less (although that certainly helps). It also involves eating more nutrition-packed foods and improving your habits around eating. Swap out processed, fatty, and sugary foods for unprocessed foods and veggies. Try different healthy eating habits — such as mindful eating and portion control — to see what works for you. 

As for exercise, it’s okay if you’re not a huge fan of cardio or weight-lifting. The world of exercise is vast and includes activities as wide-ranging as yoga and dance to swimming, biking, and walking. Get creative with other ways to move more throughout your day, from parking further away when running errands or opting for stairs over the escalator.

Key takeaway

• While Wegovy is an effective treatment for weight loss, it’s not your only option.
• Injectable alternatives to Wegovy include Ozempic, Zepbound, Mounjaro, Saxenda, and compounded semaglutide or tirzepatide.
• Weight loss pills offer additional alternatives to Wegovy, including prescription options like Qsymia, phentermine, Contrave, or Xenical, as well as OTC options like Alli.
• When compared to Wegovy, you may lose more weight on Zepbound, Mounjaro, or compounded tirzepatide, while you may lose less weight on Ozempic, Saxenda, Qsymia, phentermine, Contrave, Xenical, or Alli. 
• To maximize weight loss, whether you’re taking Wegovy or a natural alternative, find ways to eat healthier and move more. 

Talk to a provider about alternatives to Wegovy in 24 hours

Find a licensed medical provider to help you with your weight loss journey on Klarity. Appointments are available in as little as 24 hours. Ask about which alternatives to Wegovy are covered by your insurance and which is the best fit for you. 

Sources:

Alli, Alli Product Info and Usage, 2023, https://www.myalli.com/about/product-use/

Cardiovascular Diabetology, Reduction of prevalence of patients meeting the criteria for metabolic syndrome with tirzepatide: a post hoc analysis from the SURPASS Clinical Trial Program, Stephen J. Nicholls et al., Feb. 2024, https://cardiab.biomedcentral.com/articles/10.1186/s12933-024-02147-9

Clinical Trials Arena, Contrave for the Treatment of Obesity, Oct. 2014, https://www.clinicaltrialsarena.com/projects/contraveforthetreatm/?cf-view

Current Obesity Reports, Metformin: Mechanisms in Human Obesity and Weight Loss, Armen Yerevanian et. al., Jun. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520185/

DailyMed, Label: Adipex-P-phentermine hydrochloride tablet, Adipex-P-phentermine hydrochloride capsule, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f5b2f9d8-2226-476e-9caf-9d41e6891c46

DailyMed, Label: Contrave Extended-Release- naltrexone hydrochloride and bupropion hydrochloride tablet, extended release, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=485ff360-32c8-11df-928b-0002a5d5c51b

DailyMed, Label: Metformin hydrochloride tablet, film coated, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=56d13a1c-b289-4528-b23c-60f5427b4552

DailyMed, Label: Mounjaro- tirzepatide injection solution, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0

DailyMed, Label: Ozempic-semaglutide injection solution, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79

DailyMed, Label: Qsymia- phentermine and topiramate capsule, extended release, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=40dd5602-53da-45ac-bb4b-15789aba40f9

DailyMed, Label: Saxenda- liraglutide injection solution, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3946d389-0926-4f77-a708-0acb8153b143

DailyMed, Label: Wegovy- semaglutide injection solution, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b

DailyMed, Label: Xenical- orlistat capsule, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6240792b-9224-2d10-e053-2a91aa0a2c3e

DailyMed, Label: Zepbound- tirzepatide injection solution, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b

Diabetes, Metabolic Syndrome, and Obesity, Clinical utility of phentermine/topiramate (Qsymia) combination for the treatment of obesity, Jin Hee Shin and Kishore M. Gadde, Apr. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626409/

drugs.com, Alli Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/alli

drugs.com, Contrave Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/contrave

drugs.com, Metformin Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/metformin

drugs.com, Mounjaro Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/mounjaro

drugs.com, Ozempic Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/ozempic

drugs.com, Phentermine Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/phentermine

drugs.com, Qsymia Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/qsymia

drugs.com, Saxenda Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/saxenda

drugs.com, Wegovy Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/wegovy

drugs.com, Xenical Prices, Coupons and Patient Assistance Programs, Jun. 2024, https://www.drugs.com/price-guide/xenical

eClinical Medicine (The Lancet), Pharmacotherapy of obesity: an update on the available medications and drugs under investigation, Marlene Chakhtoura et. al., Mar. 2023, https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00059-7/fulltext

JAMA Network, Continued Treatment with Tirzepatide for Maintenance of Weight Reduction in Adults with Obesity: The SURMOUNT-4 Randomized Clinical Trial, Louis J. Aronne, MD, et.al., Dec. 2023, https://jamanetwork.com/journals/jama/article-abstract/2812936

Journal of the Academy of Nutrition and Dietetics, Efficacy of orlistat 60 mg on weight loss and body fat mass in US Army soldiers, Tracey J. Smith et. al., Apr. 2012, https://pubmed.ncbi.nlm.nih.gov/22717217/

Obesity — A Research Journal, Safety and Effectiveness of Longer-Term Phentermine Use: Clinical Outcomes from an Electronic Health Record Cohort, Kristina H. Lewis et. al., Mar. 2019, https://onlinelibrary.wiley.com/doi/10.1002/oby.22430

Qsymia, Multiple ways to save on Qsymia, Feb. 2023, https://qsymia.com/patient/multiple-ways-to-save

The Lancet: Diabetes & Endocrinology, Efficacy and safety of once-weekly semaglutide 2.0 mg versus 1.0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial, Juan P. Frias et. al., Jul. 2021, https://pubmed.ncbi.nlm.nih.gov/34293304/

The New England Journal of Medicine, A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management, Xavier Pi-Sunyer, MD, et al., Jul. 2015, https://www.nejm.org/doi/full/10.1056/nejmoa1411892

The New England Journal of Medicine, Once-weekly Semaglutide in Adults with Overweight or Obesity, John P.H. Wilding, DM, et al., Feb. 2021, https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

U.S. Food & Drug Administration (FDA), Drug Compounding and Drug Shortages, Mar. 2023, https://www.fda.gov/drugs/human-drug-compounding/drug-compounding-and-drug-shortages

U.S. Food & Drug Administration (FDA), FDA Drug Shortages, https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.