Rybelsus for weight loss: does it work?

Rybelsus (semaglutide) is an oral diabetes medication that contains the same active ingredient as Ozempic and Wegovy. Ozempic and Wegovy cause weight loss, but they also require weekly self-injections. For those interested in an oral alternative, is Rybelsus for weight loss a good option? 

Rybelsus may be prescribed off-label for weight loss, but it typically produces smaller results than other semaglutide drugs. 

Below, we explain how to take Rybelsus for weight loss, along with the side effects and results you can expect.

As a glucagon-like peptide-1 (GLP-1) agonist, Rybelsus works for weight loss by:

• Slowing down digestion, so you feel full sooner 

• Acting on receptors in the brain to reduce hunger cues and your overall appetite 

• Lowering blood sugar, helping prevent hunger spikes and crashes  

Rybelsus weight loss results can vary. Here’s a look at how much weight people lost in different studies of Rybelsus:

The studies above are based on people with type 2 diabetes, who tend to lose less weight on GLP-1s than people without diabetes. 

In a 2025 study of fewer than 100 people without diabetes, those taking 14 mg of Rybelsus (the maximum dose) daily lost nearly 6% of their body weight (13 pounds) and shaved 5.5 cm (about 2.2 inches) off their waistlines at one year.

• What it is: Oral GLP-1 medication for type 2 diabetes 

• Administration: Daily in the morning, at least 30 minutes before food, liquids, or other medications

• Dosage strengths: Ranges from 1.5 mg to 14 mg, depending on the formulation

• Weight loss results: Up to 8 pounds in six months, according to research in people with diabetes

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You take Rybelsus once daily first thing in the morning — at least 30 minutes before any food, liquids, or other medications. 

The Rybelsus tablet should be swallowed whole with up to 4 ounces of plain water only.

The active ingredient in Rybelsus, semaglutide, starts working soon after you take it. Within one hour of taking your dose on an empty stomach, Rybelsus reaches its peak concentration in your bloodstream. 

But it may take longer for you to see results. In clinical studies, people notice weight loss within the first three months of taking Rybelsus. During that time, they may lose a little over 6 pounds.

Lifestyle factors, such as diet and exercise, can make a difference in results. Rybelsus (and the other medications mentioned in this article) are meant to be used in addition to regular exercise and a healthy diet. 

Rybelsus has a list price of $997.58. But the price you pay may vary depending on your pharmacy, insurance coverage, and the reason you’re taking Rybelsus. 

If your healthcare provider prescribes Rybelsus for type 2 diabetes, and you have a private or commercial insurance plan, you may be eligible to pay as little as $10 per month with the manufacturer savings offer. 

When Rybelsus is prescribed off-label for weight loss, however, it’s unlikely to be covered by insurance, and you may have to pay the full out-of-pocket cost.

The most common side effects of Rybelsus include:

• Nausea

• Abdominal pain

• Diarrhea

• Decreased appetite

• Vomiting

• Constipation 

Rybelsus interactions

It’s safe to use Rybelsus with most medications, but some drug interactions to be aware of include:

• Insulin and insulin secretagogues: Because Rybelsus is highly effective at lowering blood glucose levels, it may cause hypoglycemia (low blood sugar) when combined with other blood sugar-lowering medications. Your healthcare provider may adjust your dose of insulin to reduce the chances of this happening.

• Oral medications: Since Rybelsus slows down digestion, it can affect how the body absorbs other oral medications. For example, Rybelsus can affect Synthroid (levothyroxine), a medication for an underactive thyroid. To help prevent this interaction, it’s recommended to take other oral medications (such as Synthroid) at least 30 minutes after your Rybelsus dose.

Rybelsus warnings

While rare, serious side effects can occur with Rybelsus, including:

• Diabetic retinopathy complications (diabetes-related vision changes)

• Hypoglycemia (when used with insulin or similar medications)

• Severe gastrointestinal reactions

• Allergic reactions

• Pancreatitis

• Kidney or gallbladder problems

• Pulmonary aspiration during general anesthesia or deep sedation

Like other GLP-1s, Rybelsus comes with a boxed warning (the FDA’s strongest warning) that it should not be taken if you have a personal or family history of certain thyroid cancers, including medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2). Studies on mice have shown an increased risk of MTC with Rybelsus, though these effects have not been seen in humans.

Rybelsus is available in two formulations, each of which comes in three strengths: 

• Formulation R1: 3 mg, 7 mg, and 14 mg

• Formulation R2: 1.5 mg, 4 mg, and 9 mg

Originally, Rybelsus was only available in the Formulation R1. Formulation R2 was developed to allow for a higher bioavailability (how much of the active ingredient gets absorbed to be effective in your system) in lower dosage strengths.  

As mentioned, the weight loss effects of Rybelsus are quite modest. At higher doses, though, it shows promise as a potential weight loss drug according to recent studies of 25 mg and 50 mg doses of oral semaglutide. Thus far, the evidence paints a pretty clear picture: higher doses of oral semaglutide can lead to more weight loss. 

Novo Nordisk announced that the company submitted oral semaglutide for approval as a weight loss drug. But it may not come to market until 2026. 

Here’s a quick look at how Rybelsus compares to other medications for type 2 diabetes and weight loss.

Rybelsus vs. Ozempic

What they are: 

• Ozempic is a GLP-1 receptor agonist that contains the same active ingredient as Rybelsus, but in an injectable form. It’s FDA-approved to treat type 2 diabetes, reduce cardiovascular risk in people with type 2 diabetes and heart disease, and reduce the risk of kidney decline in people with type 2 diabetes and chronic kidney disease

• Rybelsus is an oral GLP-1 that’s approved for type 2 diabetes and to reduce cardiovascular risk in people with type 2 diabetes and heart disease.

Weight loss results: 

• Ozempic causes an average weight loss of 13–15 pounds in people with type 2 diabetes after 10 months.

• Rybelsus causes an average weight loss of 9 pounds in people with type 2 diabetes after six months.

Administration:

• Ozempic is injected once a week, on the same day each week.

• Rybelsus is taken by mouth once daily in the morning.

Cost:

• Ozempic costs $997.58 — the same as Rybelsus.

Ozempic produces more weight loss than Rybelsus. Rybelsus and Ozempic cause similar gastrointestinal side effects since they share the same active ingredient. 

If you are looking for more weight loss, or you also have heart or kidney disease, Ozempic may be a better option than Rybelsus.

Rybelsus vs. Mounjaro

What they are:

• Mounjaro (tirzepatide) is an injectable GIP/GLP-1 receptor agonist that’s approved for type 2 diabetes.

• Rybelsus is an oral GLP-1 that’s prescribed for type 2 diabetes and to reduce cardiovascular risk in people with type 2 diabetes and heart disease.

Weight loss results:

• In about a year and a half, people taking Mounjaro lose up to 15% (with type 2 diabetes) or up to 21% (without diabetes).

• In that same time frame, 1 in 3 people taking Rybelsus lose at least 5% of their body weight. 

Administration:

• Mounjaro is injected once a week, on the same day each week.

• Rybelsus is taken by mouth once daily in the morning.

Cost:

• Mounjaro has a list price of $1,079.77 — about $100 more than Rybelsus without insurance.

• Rybelsus costs $997.58 for a one-month supply.

As a dual GIP/GLP-1 receptor agonist, Mounjaro’s active ingredient — tirzepatide — targets two types of hormone receptors, as opposed to just one like Rybelsus. Researchers think this explains why Mounjaro typically produces more weight loss than other GLP-1 medications. 

Rybelsus and Mounjaro cause similar gastrointestinal side effects. 

If your goal is weight loss and you don’t mind a weekly injection, Mounjaro may be the more effective option if you’re able to pay a bit more per month for your Rx.

Rybelsus vs. Victoza

What they are:

• Victoza (liraglutide) is an injectable GLP-1 receptor agonist that’s approved for type 2 diabetes and related cardiovascular risk.

• Rybelsus is an oral GLP-1 that’s prescribed for type 2 diabetes and to reduce cardiovascular risk in people with type 2 diabetes and heart disease.

Weight loss results:

• After one year of taking Victoza, people with type 2 diabetes lose 4.5–5.5 pounds. 

• People taking Rybelsus lose that much weight (or more) in about half that time.

Administration:

• Victoza is injected once a day.

• Rybelsus is taken by mouth once daily in the morning.

Cost:

• Victoza has a list price of $543.51–$815.27, depending on the prescribed dosage — about $175–$450 less than Rybelsus out-of-pocket. Victoza is also available as a generic, which has a much lower price.

• Rybelsus costs $997.58 for a one-month supply.

Victoza shares a lot of similarities with Rybelsus: They are taken daily, cause similar side effects, and are approved to manage type 2 diabetes and reduce cardiovascular risks. 

Victoza can be a more affordable option, but it tends to produce less weight loss than Rybelsus. 

Rybelsus vs. other GLP-1s for weight loss 

What they are:

• Injectable GLP-1s that have been approved specifically for weight loss include Wegovy (semaglutide), Saxenda (liraglutide), and Zepbound (tirzepatide).

• Rybelsus is an oral GLP-1 that’s prescribed for type 2 diabetes and to reduce cardiovascular risk in people with type 2 diabetes and heart disease.

Weight loss results: 

• Between a year to a year and a half, people taking Wegovy lose up to 15% of their body weight, people taking Saxenda lose up to 7.4%, and people taking Zepbound lose up to 21%. 

• In that same timeframe, only about one in three people taking Rybelsus lose 5% of their body weight.

Administration:

• Wegovy and Zepbound are injected once a week; Saxenda is injected daily. 

• Rybelsus is taken by mouth once daily in the morning.

Cost:

• Saxenda and Wegovy both have a list price of $1,349.02 per month — about $350 more than Rybelsus. Zepbound has a list price of $1,086.37 — about $100 more than Rybelsus.

• Rybelsus costs $997.58 for a one-month supply.

The GLP-1s that have been approved for weight loss cause significantly more weight loss than Rybelsus. They may also be approvedA for other conditions, such as fatty liver disease in the case of Wegovy or obstructive sleep apnea in the case of Zepbound. 

These additional indications may help you secure insurance coverage.  However, they all cost more than Rybelsus if you end up paying out-of-pocket. 

All three weight loss injections share the same gastrointestinal side effects of Rybelsus. But they tend to have longer lists of side effects in general, which may be another consideration.

Rybelsus vs. weight loss pills 

What they are:

• Weight loss pills include Xenical (orlistat), Contrave (bupropion/naltrexone), and Qsymia (phentermine/topiramate). 

• Rybelsus is an oral GLP-1 that’s prescribed for type 2 diabetes and to reduce cardiovascular risk in people with type 2 diabetes and heart disease.

Weight loss results: 

• In one year, people taking Xenical lose up to 3.8% of their body weight, people taking Contrave lose 4.8%, and people taking Qsymia lose 8.6%. 

• In a year and a half, only about one in three people taking Rybelsus lose 5% of their body weight.

Administration:

• Qsymia is taken once daily by mouth, similar to Rybelsus. Contrave is taken twice a day, and Xenical is taken three times a day.

• Rybelsus is taken by mouth once daily in the morning.

Cost:

• Xenical ($908 per month) and Contrave ($843.56 per month) are only about $90–$150 cheaper than Rybelsus. Qsymia is about $600 less, with an average price of $306.45 per month.

• Rybelsus costs $997.58 for a one-month supply.

Weight loss pills produce more weight loss than Rybelsus and are generally cheaper, too — especially Qsymia. However, they can produce different side effects because of how they work. 

• Xenical causes weight loss by reducing how much fat your body absorbs from food, which can produce side effects, such as oily stool, spotting, and increased defecation. 

• Qsymia and Contrave are both stimulants that suppress appetite. This means they carry a risk of dependency and produce side effects like trouble sleeping and dry mouth. 

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Rybelsus is a daily oral medication for type 2 diabetes that may be prescribed off-label for weight loss. Beyond that, here’s what you need to know: 

• The weight loss effects of Rybelsus are relatively modest, with people losing 6–8 pounds over a year.

• It contains the same active ingredient as Ozempic and Wegovy — semaglutide — and works by slowing digestion and curbing appetite to help you eat less.

• Rybelsus is taken once daily in the morning on an empty stomach, at least 30 minutes before food, liquids, or other medications.

• Other GLP-1 injections and weight loss pills produce more weight loss than Rybelsus, but they’re generally more expensive out-of-pocket.