Weight Loss
24 min read
Written by Amelia Willson
Published: Jul 16, 2024
Medically Reviewed by Dr. Paul Hetrick
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 Health 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.*
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.
Medication | Form | Amount of weight loss | Prior authorization needed? | Cost | Availability |
Wegovy (semaglutide) | Once-weekly injection | 14.9% in 68 weeks | Yes | $1,430 | In shortage |
Ozempic (semaglutide) | Once-weekly injection | 5%–10% in 40 weeks | Sometimes | $1,029 | Available |
Zepbound (tirzepatide) | Once-weekly injection | 20.9% in 88 weeks | Yes | $1,126 | In shortage |
Mounjaro (tirzepatide) | Once-weekly injection | 13.9% in 104 weeks | Sometimes | $1,135 | In shortage |
Compounded semaglutide | Depends | Unknown | Yes | Depends | Available |
Saxenda (liraglutide) | Daily injection | 5%–10% in 56 weeks | Yes | $1,430 | In shortage |
Compounded tirzepatide | Depends | Unknown | Yes | Depends | Available |
Qsymia (phentermine/ topiramate) | Daily oral tablet | 5%–10% in 56 weeks | Yes | $211 | Available |
Phentermine | Daily oral tablet | 3% in 12 weeks | Yes | $12 | Available |
Contrave (naltrexone/ bupropion) | Twice-daily oral tablet | 5%–10% in 56 weeks | Yes | $668 | Available |
Xenical (orlistat) | Thrice-daily oral tablet | 13.4 pounds in 1 year | Yes | $803 | Available |
Alli (orlistat) | Thrice-daily oral tablet | 7 pounds in 6 months | No | $56 | Available |
Metformin | 1–3x daily oral tablet | 3.5% in 2 years | Sometimes | $11 | Available |
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 (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 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.
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 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.
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 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 (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 (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 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.
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.
Find a licensed medical provider to help you with your weight loss journey on Klarity Health. 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 if any.
*Appointments are generally available within 24 hours. Free initial consultations are available only with select providers. Prescriptions, particularly for controlled substances, may require an in-person evaluation depending on the state of residence and current federal regulations.
The information provided in this article is for educational purposes only and should not be construed as medical advice. Controlled substances may not be appropriate for all patients and any mention of these medications is for educational purposes only, not for marketing or encouraging self-diagnosis. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with clinical autonomy. Nothing in this article is intended to diagnose or treat any condition, including guaranteeing prescription medication of any kind or dosage. Not all providers on Klarity Health prescribe all medications, particularly medications that are controlled substances.
If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.
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