Determine which diabetes drug is most effective for weight loss
More than 1 in 10 people in the U.S. are living with diabetes. It is a condition that occurs when the body cannot produce or effectively use insulin, leading to elevated blood glucose levels. Without insulin, blood glucose rises to unsafe levels. The majority of people living with diabetes have type 2 diabetes.
Several classes of diabetes medications not only help treat type 2 diabetes but also help patients lose weight. However, these drugs are not all FDA-approved as weight management aids.
Healthcare providers prescribe diabetes drugs to regulate blood sugar levels in patients with type 2 diabetes. These drugs have also been shown to lead to weight loss in individuals with obesity or excess body weight.
Diabetes drugs, particularly GLP-1 receptor agonists and SGLT-2 inhibitors, work through different mechanisms to promote weight reduction.
However, diabetes drugs are not prescribed alone. Healthcare providers also prescribe healthy lifestyle changes to be used with the medication. These habits help you maintain your weight reduction journey and make the medication more effective. Healthy lifestyle changes used with diabetes drugs include:
Several diabetes drugs can cause weight loss. These medications have different effects on the body and are taken differently. Let’s break it down.
Glucagon-like peptide-1 (GLP-1) agonists are a group of medications growing in popularity for diabetes and weight loss. GLP-1 is a hormone in our bodies that tells our pancreas to release insulin after we eat.
It also lowers the amount of new glucose your liver produces and helps us feel full between meals. GLP-1 receptor agonists mimic a natural hormone our intestines release called glucagon-like peptide 1, which can promote weight loss.
Ozempic (semaglutide): Ozempic is indicated to improve blood sugar control in adults with type 2 diabetes. It is also FDA-approved to reduce the risk of cardiovascular events like heart attack in adults with type 2 diabetes and cardiovascular disease.
Ozempic comes in a subcutaneous (beneath the skin) self-injectable pen that you take once per week. Ozempic has four dose strengths: 0.25 mg, 0.5 mg, 1 mg, and 2 mg. Dosing starts at 0.25 mg weekly and increases to 0.5 mg weekly after one month, up to a maximum dose of 2 mg weekly.
A review of four randomized-controlled studies, including 3,613 people with obesity but not diabetes, found that the average weight loss with semaglutide was just under 12% compared to placebo. Ozempic typically costs $968.52 per month without insurance.
Rybelsus (semaglutide): Rybelsus is the first oral GLP-1 drug on the market. It contains the same active ingredient as Ozempic (semaglutide) and is indicated to improve sugar control in adults with type 2 diabetes.
Rybelsus is an oral pill you take daily. It should be taken on an empty stomach with plain water only, at least 30 minutes before breakfast. Rybelsus comes in three dose strengths: 3 mg, 7 mg, and 14 mg. The starting dose is 3 mg once a day. After 30 days, it increases to 7 mg daily and may be increased to the maximum dose of 14 mg daily after another 30 days.
According to results from the PIONEER phase 3a clinical trial program, oral semaglutide resulted in an average loss in weight of 8 pounds, or less than 5% of body weight, over 26 weeks (about 6 months) when taking 14 mg of Rybelsus. Rybelsus starts at $1029 per month without insurance.
Mounjaro (tirzepatide): Mounjaro is indicated to improve blood sugar control in adults with type 2 diabetes. Mounjaro contains the active ingredient tirzepatide, which belongs to a novel class of drugs called dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 receptor agonists.
GIP is another hormone your intestine releases after you eat to help regulate blood sugar levels. By activating receptors for both GIP and GLP-1, these drugs can help reduce appetite, promote weight loss, and improve blood sugar control.
Mounjaro is injected once a week. Clinical trials showed that Mounjaro helped patients lose, on average, 41 pounds in 72 weeks. Mounjaro starts at $1,135 per 28-day supply without insurance.
Victoza (liraglutide): Victoza is approved for controlling blood sugar in adults and children ages 10 and older with type 2 diabetes and to help prevent heart attacks and stroke in adults with cardiovascular disease or risk factors for cardiovascular disease.
Victoza is a medication that you inject under the skin daily. It comes in a pre-filled pen. Victoza has three dose strengths: 0.6 mg, 1.2 mg, and 1.8 mg. Dosing starts at 0.6 mg daily and is increased to 1.2 mg after one week.
If you need additional sugar control after one week at the 1.2 mg dose, your healthcare provider may increase your dose to 1.8 mg daily.
Trulicity (dulaglutide): Trulicity now has higher doses available. It initially started with 0.75, then 1.5, and now has doses available in 3 milligrams and 4.5 milligrams.
In a clinical trial involving the highest dose (4.5 mg) of Trulicity, 49% of people with type 2 diabetes lost 5% or more of their body weight, and 14% lost 10% or more at nine months.
Byetta and Bydureon BCise (exenatide): Byetta is approved to improve blood sugar control in adults with type 2 diabetes. Bydureon BCise is approved for blood sugar control in adults and children ages 10 and older with type 2 diabetes.
Byetta is an injectable medication that you take twice daily. It comes in a pre-filled pen and has two dose strengths: 5 micrograms (mcg) and 10 mcg. Dosing begins with 5 mcg twice a day, one hour before breakfast and dinner. After one month, the dose is increased to 10 mcg twice daily. Bydureon BCise extended-release also comes in a pre-filled pen that you inject under the skin once a week. The dose strength for Bydureon BCise is 2 mg.
The average retail price for Byetta is $1019.28 per month without insurance. Bydureon BCise retails for about $998.24 per month without insurance. In one study, 56% of women with overweight or obesity lost 5% or more of their body weight, and 23% lost 10% or more of their weight after three months on this drug.
Another group of diabetes medications called sodium-glucose cotransporter 2 (SGLT2) inhibitors can cause weight loss. SGLT2 inhibitors remove glucose from the blood through urine. Less glucose in the blood means less glucose is available to be turned into fat cells, and this can lead to modest weight loss for some people.
These drugs are designed for blood sugar control in people with type 2 diabetes and to help prevent major cardiovascular issues like heart attack and stroke for people with type 2 diabetes and cardiovascular disease.
Examples of SGLT-2 inhibitors:
SGLT-2 inhibitors are available as pills that are taken every day. SGLT2 medications range from $400-$800 per month without insurance or coupons.
A 2022 review of seven studies found that these drugs may be effective for weight loss in people with obesity, but results were less significant (in this case, less than 5% of body weight) than other drug classes.
Metformin is another diabetes medication that can cause weight loss as a side effect for some people. It's one of the most prescribed diabetes medications because it's effective for lowering blood glucose and has lower-cost generic versions available. It mainly lowers the amount of glucose made and absorbed by the body, and it makes the body more sensitive to its natural insulin.
Metformin is prescribed for blood sugar control in people with type 2 diabetes and prediabetes. It’s a daily oral medication that you take with meals. The average cost of Metformin without insurance ranges from as low as $10 per month for tablets to up to $400 per month for the liquid solution.
It can cause some weight loss, although not as much as the GLP-1 drugs. In one study, about 30% of participants with prediabetes lost more than 5% of their body weight in their first year on metformin.
While semaglutide, tirzepatide, and liraglutide are indicated for type 2 diabetes under the brand names Ozempic, Mounjaro, and Victoza, respectively, the active ingredients in these drugs are now available under different brand names for different indications.
Wegovy and Saxenda have the same active ingredients as diabetes drugs but are specifically approved as weight loss drugs.
For those seeking a cost-effective alternative to brand-name GLP-1 medications, LookMeds offers a compounded version of the best-performing weight loss drug.
This option provides similar efficacy at a more affordable price, ensuring accessibility for patients who struggle with high medication costs.
For those who qualify, LookMeds’ compounded GLP-1 solution provides an excellent balance of affordability, flexibility, and effectiveness in diabetes and weight management.
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Ultimately, all these drugs can be effective treatments for type 2 diabetes and weight loss. Still, research shows that GLP-1 drugs can produce the most significant weight loss. With Saxenda, people can lose about 5-10% of their body weight.
Wegovy and Ozempic can promote weight loss of up to 12-14% of body weight. With a combo GIP/GLP-1 receptor agonist like Mounjaro and Zepbound, people can lose 20% or more of their weight.
The diabetes drug Mounjaro, which contains the active ingredient tirzepatide, has been approved for chronic weight management under the trade name Zepbound. It may be the best diabetic medication for weight loss based on clinical trial results.
The maximum weight loss achieved with Zepbound is 26% from baseline when it is used at a dose of 15 mg once a week, along with lifestyle changes such as a reduced-calorie diet and increased physical activity.
Additionally, LookMeds compounded GLP-1 offers a customized approach to weight management. We provide an alternative for individuals needing compounded formulations customized to their specific needs.
People who have been unable to lose weight with diet and exercise alone may be able to take certain drugs that are used to treat diabetes and approved for weight loss.
To be eligible for a weight loss drug, you should have:
The decision to prescribe a diabetes drug for weight loss is at the discretion of the prescribing provider. Diabetes drugs aren’t suitable for everyone. If you are curious about these treatment options but do not have type 2 diabetes, ask your provider about alternatives to diabetes drugs.
The drugs listed above have been approved by the U.S. Food and Drug Administration (FDA). Their benefits generally outweigh the risks of side effects. Common side effects of these drugs include:
Certain GLP-1 drugs (Ozempic, Rybelsus, Victoza) can increase your risk of developing certain medical conditions.
These drugs should be avoided if you have a history of:
Medications are only one part of the treatment for overweight or obesity and type 2 diabetes. No matter how many medications you take, if you don't get your diet and lifestyle changes in the right direction, then you're going to struggle.
Nutritional guidelines from the Obesity Society recommend dietary changes to help maintain weight loss and prevent malnutrition and muscle loss, which can occur when people take diabetes weight loss drugs. Exercise is another key component that can help with weight loss and management with GLP-1 drugs.
There is no specific amount of time or weight loss that determines how long you can take these drugs for weight loss. If the drugs are working and you aren’t experiencing side effects, your provider may recommend that you keep using them for the treatment of obesity.
GLP-1 drugs have the potential to produce impressive weight loss, but interrupting these medications will result in weight regain. You'll likely need to stay on these medicines long-term—typically a year or more— to see significant and sustained weight loss results.
Most people will need to take these drugs indefinitely to maintain weight loss and blood sugar control.
GLP-1 medications can also be expensive. Without insurance, a one-month supply costs around $1,000 or more in the U.S. Many private health insurance plans (including Medicare and Medicaid) may not cover diabetes medicine used off-label for weight loss.
However, LookMeds offers a much more viable option for users. Our compounded semaglutide costs $299/mo, and our tirzepatide starts at $449/mo. This is a flat rate, meaning even if your dosage increases, the price won’t. We also offer free shipping, telehealth appointments, discreet packing, and more!
Newer diabetes drugs called GLP-1 receptor agonists can promote significant weight loss. In fact, certain GLP-1 medications may help people lose up to 20% of their body weight when combined with diet and exercise.
Some GLP-1 drugs like Ozempic and Mounjaro are approved for treating type 2 diabetes but may be prescribed off-label for weight loss. Other GLP-1s like Wegovy and Zepbound are specifically created to treat obesity and overweight with related health conditions. Other diabetes drugs like SGLT2 inhibitors and metformin may also be used off-label for weight loss, but results are much more modest.
It’s important to work with a knowledgeable healthcare provider if you're considering one of these drugs for weight loss. Your provider can discuss the pros and cons of each medication for your health history and goals, as well as important considerations regarding safety and side effects, to help you make an informed decision.
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