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Who can take Rybelsus for weight loss?

Rybelsus treats Type 2 diabetes but can be prescribed off-label for weight loss
Gerardo Sison medical writer headshot
By | Mar. 31, 2023
Rx pill bottle and prescription pad: Rybelsus for weight loss

Key takeaways

  • Rybelsus contains semaglutide, effective for Type 2 diabetes and weight loss, but is not FDA-approved solely for weight management.

  • Clinical trials show Rybelsus promotes weight loss by decreasing appetite and increasing feelings of fullness, with varied results depending on the individual.

  • Rybelsus is prescribed off-label for weight loss in people with Type 2 diabetes who are obese or overweight with related health conditions.

  • While generally safe, Rybelsus can have side effects and is recommended to be part of a broader health plan including diet and exercise.

In this article:

Weight loss medications have increased interest lately, especially with new options on the market. Rybelsus is a relatively new medication manufactured by Novo Nordisk. It contains semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, taken as an oral tablet once daily. Semaglutide is the same active ingredient in Ozempic, an injectable once-weekly medication.

Rybelsus is FDA approved for managing blood sugar levels in people with Type 2 diabetes mellitus. It is an effective treatment option with benefits other than managing high blood sugar levels. For instance, it has a low risk of low blood sugar (hypoglycemia) and may help promote weight loss. Due to its weight-reducing effects, people with obesity or who are overweight may be interested in oral semaglutide as a weight-loss drug. 

Continue reading to learn more about Rybelsus effects on weight loss, how it works, and who can take it.

Does Rybelsus cause weight loss?

Although Rybelsus is not yet approved solely for weight loss in the United States, it could be an attractive option for people who are obese or overweight with Type 2 diabetes. Initial clinical studies showed that Rybelsus caused a decrease in appetite as a side effect, which may lead to weight loss.

Clinical trials of Rybelsus for weight loss

In a 6-month study, the starting weight of participants who took a placebo, 7 mg of Rybelsus, or 14 mg of Rybelsus was around 194 to 196 pounds. The participants who took the lower dose of Rybelsus lost an average of around five pounds, and those who took the higher dose lost an average of nine pounds. In contrast, study results showed that the placebo group lost around 2 pounds. 

The Semaglutide Treatment Effect in People with Obesity (STEP) trials were conducted to assess how the active ingredient in Rybelsus affects obesity. People with a body mass index of at least 27 kg/m2 were included in the trials. In the first four trials (STEP 1-4), adults who were overweight or obese were treated with a once-weekly 2.4 mg dose of semaglutide. The results of the 68-week trials showed that participants experienced an average weight loss of 15% to 17%, with those who also had Type 2 diabetes losing around 10% of their body weight. 

Not a miracle cure for obesity

The results of taking Rybelsus for weight loss will vary depending on the individual. Although Rybelsus has been shown to be effective for weight loss, the drug is recommended to be taken with a healthy diet and exercise plan. 

Based on the current evidence, it could take around six months to start seeing results in weight loss. The STEP trials suggest that it could take up to over a year to see the maximum benefits of semaglutide for weight loss. One thing to note is that the STEP trials studied the use of a dose of injectable semaglutide that is different from Rybelsus. More research may be needed to assess the effects of oral semaglutide on obesity. 

It is important to take Rybelsus as prescribed by your healthcare provider, especially if they prescribe it off-label for weight management. 

How does Rybelsus cause weight loss?

The active ingredient in Rybelsus, semaglutide, works in a number of ways to improve blood sugar (glucose) levels in people with Type 2 diabetes. As part of a class of drugs called GLP-1 receptor agonists, semaglutide binds to GLP-1 receptors to stimulate insulin secretion. Insulin helps the body’s cells use glucose for energy. In addition, it reduces the secretion of glucagon, a hormone that raises blood glucose levels. 

The way that Rybelsus is effective for diabetes also makes it helpful for weight loss. Rybelsus has been shown to suppress appetite and increase feelings of fullness, which may lead to decreased food intake. It also slows down the emptying of the stomach, which can help people eat less and feel full for longer periods of time. 

Although it does not directly increase metabolism, it may help people lose weight by making them feel less hungry and reducing the amount of food they consume. These effects may help reduce weight gain.

Who can take Rybelsus for weight loss?

Rybelsus is typically prescribed to improve blood sugar control in people with diabetes. It is not yet approved by the FDA for weight loss management. Instead, a doctor or healthcare provider may prescribe Rybelsus off-label as a weight-loss drug. Various clinical trials support the off-label use of Rybelsus as a prescription medication for weight loss. 

People with Type 2 diabetes who are obese may benefit from Rybelsus for weight loss. In addition, people with Type 2 diabetes who are overweight with at least one weight-related condition, such as high blood pressure, heart disease, or high cholesterol, can also benefit from the effects of Rybelsus.

 

Rybelsus dosage for weight loss
Dosage Average weight loss
Starter dose of 3 mg once daily for 30 days. Then, 7 mg once daily.  Around 2 kg or 5 lbs after 6 weeks of 7 mg once daily
Starter dose of 3 mg once daily for 30 days and then 7 mg once daily for 30 days. Then, 14 mg once daily.  Around 4 kg or 8 pounds after 6 weeks of 14 mg once daily

There is no FDA approved Rybelsus dosage for weight loss. These dosages are based on data for Rybelsus used in patients with Type 2 diabetes.

Is it safe to take Rybelsus for weight loss?

Rybelsus is generally considered safe for weight loss when taken as directed by a healthcare provider. However, as with any medication, there are pros and cons to consider. One of the pros is that Rybelsus has been shown to be effective in reducing body weight and blood sugar levels in clinical studies. However, the downside of Rybelsus for weight loss is the potential risks of side effects. 

Some people may experience mild side effects, such as nausea and digestive symptoms, which usually go away on their own. Others may experience more serious side effects, such as an increased risk of thyroid cancer. However, serious side effects are rare. 

Drug interactions may also be a concern. Rybelsus stimulates insulin release, which can increase the risk of hypoglycemia when taken with insulin or other diabetes medications. In addition, Rybelsus may affect the absorption of other oral medications because it causes delayed gastric emptying. For example, studies have shown that taking Rybelsus and levothyroxine together leads to an over 30% increase in levothyroxine levels. 

You should also consult a healthcare provider if you are pregnant, breastfeeding, or planning to become pregnant or breastfeed before taking Rybelsus. It is unknown whether Rybelsus is safe for an unborn baby. However, it is not recommended to breastfeed while taking Rybelsus, as the medication can transfer into breast milk. 

Rybelsus side effects

The most common side effects of Rybelsus include the following:

  • Nausea
  • Stomach or abdominal pain
  • Diarrhea
  • Decreased appetite
  • Vomiting
  • Constipation

Diarrhea, nausea, and vomiting are more common than other side effects when first starting the medication. However, these side effects are generally mild and go away. 

Severe side effects of Rybelsus may include:

  • An increased risk of thyroid cancer
  • Inflammation in the pancreas (pancreatitis)
  • Vision changes
  • Low blood sugar (hypoglycemia)
  • Kidney problems, including kidney failure
  • Gallbladder problems
  • Severe allergic reactions

Rybelsus should not be used in people with a personal or family history of medullary thyroid cancer. Thyroid tumors have been reported in animal studies of semaglutide. 

Tell your doctor or healthcare provider if you have a history of other medical conditions, such as kidney problems, pancreatic issues, or diabetic retinopathy (vision problems caused by diabetes). Tell your healthcare provider if you are taking other medications, including prescription drugs, over-the-counter medication, or herbal supplements, before starting Rybelsus. Medication dosages may need to be adjusted while taking Rybelsus. 

It is important to start at the lowest dose of Rybelsus and gradually increase the dosage as advised by a healthcare provider. Taking the starter dose is meant to help lower the risk of side effects. Consult your healthcare provider for more information about possible warnings or precautions. If you experience any adverse effects that persist while taking Rybelsus, seek medical help right away.

Rybelsus weight loss alternatives

While Rybelsus may be a potential option for weight loss management in people with Type 2 diabetes, there are other options for weight loss. The best alternative will depend on a person’s overall condition and other medications they may be taking. A healthcare provider can offer medical advice on the best treatment option, as these medications may have other possible uses.

Other GLP-1 receptor agonists are available as injectable medications that can manage blood sugar levels and lead to weight loss. Wegovy has the same active ingredient as Rybelsus, semaglutide, and is FDA approved to:

  • Reduce body weight and maintain weight loss in adults and pediatric patients 12 years and older with a body mass index (BMI) of 30 or higher (obesity)
  • Reduce body weight and maintain weight loss in adults with a BMI of 27 or higher (overweight) and at least one weight-related condition, such as high blood pressure or high cholesterol
  • Lower the risk of major adverse cardiovascular events in adults with cardiovascular disease who either have obesity or are overweight

RELATED: Rybelsus vs. Wegovy

Metformin is a diabetes medication that has been shown to cause weight loss over time. Appetite suppressants, such as phentermine, and lipase inhibitors, such as orlistat, are other drugs that can be used for weight loss in people with or without diabetes. 

Rybelsus alternatives for weight loss
Medication Dosage Average weight loss Savings options (coupon)
Xenical, Alli (orlistat) 60-120 mg 3 times daily 5-10% Xenical coupons
Adipex-P (phentermine) 15-37.5 mg once daily 3-7% Adipex-P coupons
Riomet (metformin) 500-1000 mg twice daily 5-7% Metformin coupons
Saxenda (liraglutide) 3 mg daily 3-8% Saxenda coupons
Contrave (naltrexone/bupropion) 8-32 mg naltrexone/90-360 mg bupropion daily in divided doses 5-10% Contrave coupons

How to maximize Rybelsus benefits

The benefits of Rybelsus can be maximized by taking it correctly at the same time every day. It is recommended to take Rybelsus first thing in the morning, at least 30 minutes before eating or drinking anything. Rybelsus should be taken with four ounces of water, no more or less. The tablet should be swallowed whole without being cut, crushed, or chewed. Taking Rybelsus with food or other beverages could decrease the effects of the medication.

Lifestyle changes on top of taking Rybelsus could provide additional benefits for weight loss. Increased physical activity and a reduced-calorie diet are recommended as a part of an effective treatment plan with Rybelsus. 

In addition to these benefits, Rybelsus can improve blood sugar control and cardiovascular health. By following healthy lifestyle changes and the medical advice of a healthcare provider, an individual can maximize the benefits of Rybelsus for improved blood sugar control and weight loss.