Can Rybelsus Cause Weight Loss?

Many of the newer diabetes medications also tout their ability to help you lose weight. 

With much of the world’s population considered overweight or obese, weight loss is a common goal among many.

How much can these medications help you lose weight, and which ones are the most effective? 

Let’s look at Rybelsus and compare it to other medications in terms of its potential ability to help with weight loss.

What is Rybelsus?

Rybelsus is an oral form of the drug semaglutide, a GLP-1 receptor agonist. The United States Food and Drug Administration (FDA) approved Rybelsus in 2019 to treat type 2 diabetes. 

Rybelsus is unique because it’s currently the only oral GLP-1 receptor agonist the FDA has approved.

GLP-1 receptor agonists like Rybelsus work to improve blood glucose levels by increasing insulin secretion while also reducing the secretion of glucagon, a hormone that raises your blood sugar levels. 

Rybelsus also helps slow the rate of digestion, which can make you feel fuller longer after you eat. Delayed stomach emptying can cause weight loss, which is a potential benefit for patients who are overweight or obese with type 2 diabetes.

Rybelsus comes in 3-, 7-, and 14-milligram tablets. The 3-milligram dosing is only used to initiate treatment and isn’t typically a therapeutic dose.

The typical dosing schedule for Rybelsus is as follows:

• Start taking Rybelsus at a dose of 3 milligrams daily for 30 days.
• After taking the 3-milligram dose for 30 days, increase your dose to 7 milligrams daily.
• If you’re not meeting your blood sugar targets after 30 days on the 7-milligram dose, increase your Rybelsus dose to 14 milligrams daily, which is the maximum dose.

What are the side effects of Rybelsus?

All GLP-1 receptor agonists have similar side effects because they work similarly in your body. The most commonly reported side effects of Rybelsus include:

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

While rare, there is a risk of developing more serious complications from taking medications like Rybelsus.

Some rare potential side effects of taking Rybelsus include thyroid tumors/cancer, gallbladder problems, pancreatitis problems, kidney problems, low blood sugar (not as common unless you take Rybelsus with insulin or a sulfonylurea), and worsening of diabetic retinopathy causing vision problems.

If you experience any of the following side effects, it could signify a more serious medical condition. Contact your healthcare provider right away if you experience the following:

• A lump or swelling in your neck (potential thyroid tumors)
• Yellowing of the whites of your eyes and/or skin (gallbladder problems)
• Severe vomiting and diarrhea resulting in dehydration (can worsen kidney problems)
• Changes in your vision (retinopathy concerns)
• Severe abdominal pain (gallbladder problems, pancreatitis)

Does Rybelsus cause weight loss?

Taking Rybelsus can result in weight loss. In a 52-week study, the average weight loss while taking Rybelsus (the dose was increased to 14 milligrams) was around 4.4 kilograms or almost 10 pounds. Patients in that study were already taking metformin at a stable dose to treat their type 2 diabetes.

Another study compared Rybelsus to a once-weekly injection of liraglutide, another GLP-1 receptor agonist. Rybelsus was found to be superior to liraglutide in terms of promoting weight loss.

How does Rybelsus cause weight loss?

Rybelsus might cause weight loss in a few ways. This medication slows the rate at which your stomach empties, which can make you feel more satisfied after eating and less hungry. Rybelsus can cause stomach upset, including nausea and vomiting, which can reduce your typical food intake.

Rybelsus works on GLP-1, a hormone responsible for regulating appetite. Studies show that appetite hormones can be altered in people who are obese, which means you might feel more hungry compared to leaner people. 

In obese subjects, GLP-1 receptor agonists such as Rybelsus appear to restore a hormone activation pattern more similar to lean patients.

How much weight can you lose with Rybelsus?

According to the study referenced earlier, participants taking the maximum dose of Rybelsus lost around ten pounds. According to a study cited on the website for Rybelsus, participants with an average starting weight of 194 pounds lost around 8 pounds, which is around 4% of their baseline weight.

How much weight you might lose with Rybelsus depends on many factors, such as your starting weight, dose, and lifestyle habits. 

What dosage of Rybelsus causes weight loss?

Dosage at both 7 milligrams and 14 milligrams of Rybelsus can result in weight loss. If you take 7 milligrams of Rybelsus, you likely won’t lose as much weight as you would with the 14-milligram dose.

How long does it take for Rybelsus to work for weight loss?

If you follow the schedule for a gradual dose increase for Rybelsus, it will take you 30 days to be able to increase your dose to 7 milligrams and another 30 days to be stable at the 7-milligram dose. 

It will likely take at least that long to start to result in weight loss, and even longer if you need to increase your dose again to 14 milligrams.

Can Rybelsus be used for weight loss in non-diabetics?

Rybelsus isn’t currently approved as a weight loss drug for people without diabetes. The only GLP-1 receptor agonists currently approved as a weight loss drug for non-diabetics are Wegovy (injectable semaglutide) and Saxenda (injectable liraglutide).

Will your doctor prescribe Rybelsus for weight loss?

Your healthcare provider isn’t likely to prescribe Rybelsus for weight loss if you don’t have type 2 diabetes. If you’re interested in a weight loss drug and don’t have diabetes, Wegovy or Saxenda would be a more suitable option since that’s what it’s approved for.

Some healthcare providers may prescribe a medication to be used “off label” or for a reason the medication isn’t intended to treat. 

If that’s the case, your healthcare insurance or prescription insurance might not cover the medication, and you’d have to purchase it out-of-pocket.

Rybelsus vs other weight loss & diabetes medications 

Rybelsus vs Ozempic

Ozempic is a brand name for an injectable form of semaglutide, and the FDA approved it in 2017. The typical dose of Ozempic is between 0.5-2 milligrams weekly.

According to studies, Ozempic lowered the average A1c of 8% by around 1 -1.5% over 30-56 weeks. According to a six-month study, taking 7 milligrams of Rybelsus resulted in a 1.2% reduction in hemoglobin A1c levels (average starting A1c was 8%). With the same average starting A1c of 8%, taking 14 milligrams of Rybelsus resulted in a 1.4% reduction in hemoglobin A1c levels over the six-month study.

In terms of lowering A1c, Rybelsus and Ozempic appear to have similar efficacies.

Ozempic appears to be more effective at promoting weight loss than Rybelsus. In studies on ozempic weight loss, participants lost as much as 15-18% of their starting body weights while taking the maximum weekly dose of Ozempic.

Rybelsus vs metformin

Metformin is in a different medication class than Rybelsus, so it works differently to lower blood glucose. Metformin is a biguanide that helps reduce the amount of sugar your liver makes while improving insulin sensitivity.

The medication metformin tends to lower A1c levels by around 1%, so Rybelsus may be more effective in that area. Metformin weight loss likely won’t be as much weight loss as Rybelsus – it’s considered a “weight neutral” medication, meaning it isn’t likely to make you lose or gain weight.

When comparing Rybelsus vs metformin, some of the benefits of metformin over Rybelsus are its safety (no significant risks of health issues like thyroid tumors, pancreatitis, etc.), tolerance, affordability, and the fact that it doesn’t cause low blood sugar (hypoglycemia) so metformin can be safely used with other diabetes medications.

Rybelsus vs Jardiance

Jardiance is one of the brand names for the drug empagliflozin, a type of SGLT2 inhibitor. SGLT2 inhibitor drugs help treat type 2 diabetes by reducing the amount of glucose excreted in your urine as a result of reducing the amount of glucose reabsorbed in your kidneys. 

In addition to being approved to treat type 2 diabetes, Jardiance is also approved to reduce the risk of cardiovascular death in people with heart failure.

According to a meta-analysis of randomized control trials, when comparing Jardiance vs metformin, Jardiance at 25 milligrams daily (the maximum dose) had similar effects on blood sugar as metformin.

Average reductions in A1c for Jardiance were around 0.65%, and another study cited an average A1c reduction between 0.59-0.82% from taking Jardiance. This means when comparing Rybelsus vs Jardiance, Rybelsus may be more effective at lowering blood sugar.

According to a review of studies, the average reduction in body weight while taking Jardiance was considered significant and ranged from 1.7-1.9 kilograms when compared to a placebo. 

This isn’t quite as much of a weight loss impact as Rybelsus, which appears to have the edge over Jardiance in promoting weight loss.

Rybelsus vs Trulicity

Trulicity is the brand name for dulaglutide, a once-weekly GLP-1 receptor agonist injection. 

According to a 40-week clinical trial, a group of participants receiving 0.75 milligrams weekly of Trulicity reduced their A1c by an average of 1.1%, and the participants receiving 1.5 milligrams of Trulicity lowered their A1c by an average of 1.3% (the starting A1cs ranged from 7-10.5%.)

Trulicity can also promote modest weight loss, with an average Trulicity weight loss of around 4.6 pounds taking .75 milligrams weekly (mid-range of the dosing range).

When comparing Rybelsus vs Trulicity, Trulicity appears to be similar to Rybelsus in blood sugar lowering and weight loss results. Trulicity may also be more convenient for some patients because it’s a once-weekly injection vs daily oral dosing.

Rybelsus vs Victoza

Victoza is the brand name for liraglutide, another GLP-1 receptor agonist approved to treat type 2 diabetes. Victoza is a once-daily injectable medication and comes in prefilled injection pens with typical doses of 1.2 and 1.8 milligrams.

According to a 52-week study, Victoza reduced participants’ A1cs (mean baseline value of 8.2%) by 0.84% with a dose of 1.2 milligrams and by 1.14% with a dose of 1.8 milligrams.

A review of 13 randomized controlled trials in 2011 showed that Victoza lowered hemoglobin A1c values by 0.84%-1.5%. This appears to be around the same as Rybelsus.

In terms of weight loss, Victoza appears to promote more significant weight loss than Rybelsus, with most patients losing 5-10% of their initial body weight. 

Rybelsus vs Wegovy

Wegovy is an injectable form of semaglutide that is approved as a weight loss medication only. It’s intended to treat patients aged 18 and older who are considered overweight or obese.

A study was done on almost 2,000 overweight or obese adults who didn’t have diabetes. Participants taking Wegovy lost an average of 35 pounds over the 68-week study, which was around 15% of their starting body weight. Overall, 83% of people taking Wegovy lost at least 5% of their body weight.

Losing 5-10% of your initial body weight is considered significant, so Wegovy is more effective at promoting weight loss compared to Rybelsus.

Rybelsus vs Saxenda

Saxenda is the brand name for liraglutide, an injectable medication used to treat obesity in people aged 12 years and older – it isn’t intended to treat diabetes.

The FDA approved Saxenda in 2014 as a weight loss medication for adults with a BMI over 27 and children aged 12-17 years old who are considered obese. 

According to a study, 60% of people taking Saxenda achieved a weight loss of 5% or more, which equates to an average of 12 pounds lost from their baseline.

Around 33% of people taking Saxenda experienced significant weight loss of 10% or more, or around 23 pounds lost on average.

While it is rarer, around 6% of people taking Saxenda lost over 20% of their initial body weight, the equivalent of around 47 pounds on average. All of these results occurred over 56 weeks.

Saxenda appears to be more effective than Rybelsus in terms of promoting weight loss. Because it isn’t intended to treat type 2 diabetes, Saxenda can’t be compared to Rybelsus in that way.

Can Rybelsus cause weight gain?

Rybelsus isn’t likely to cause weight gain, but it isn’t impossible to gain weight while taking it. If you change your lifestyle habits in ways that don’t promote weight loss, you might gain weight with Rybelsus, especially at lower doses.

Tips to lose weight while taking Rybelsus

To further boost your weight loss capabilities while taking Rybelsus, consider:

• Eating a balanced diet and being mindful of your added sugar intake. Added sugar can worsen insulin resistance, making it harder to control your blood sugar levels and lose weight.

• Being active for at least 30 minutes most days of the week improves insulin sensitivity and can help promote weight loss.

• Getting adequate sleep at night, which plays a role in hunger and fullness hormones, and insulin sensitivity.

Conclusion

Rybelsus is a GLP-1 receptor agonist, a medication that treats type 2 diabetes.

The medication Rybelsus can result in weight loss due to its impact on stomach emptying and satiety hormones.

Rybelsus is less effective at promoting weight loss compared to medications used specifically for weight loss, such as Wegovy and Saxenda.

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