Can you take Rybelsus for weight loss if you don’t have diabetes?

Rybelsus is an oral prescription medication for diabetes that contains semaglutide. Yup, the same active ingredient as that in Ozempic and Wegovy, both of which are known for producing weight loss. So, can Rybelsus be taken for weight loss in non-diabetics? 

Technically, yes, people without diabetes can take Rybelsus for weight loss. But they would be doing so off-label, and other medications may be more effective for that use. (Remember: You should only take drugs that are prescribed to you by a healthcare provider, no matter if they’re off- or on-label.)

Below, we’ll review those options and share how much weight you can expect to lose on Rybelsus if you don’t have diabetes.

Yes, you can take Rybelsus if you don’t have diabetes — that is, as long as it’s prescribed by and under the care of a licensed healthcare provider. 

Rybelsus is approved by the US Food and Drug Administration (FDA) to treat type 2 diabetes. So, if your healthcare provider prescribes it for weight loss, it’s considered an off-label prescription. Meaning, it’s being prescribed for a reason other than the FDA-approved indication. 

Off-label prescribing is a permitted and common practice that allows healthcare providers to use their expertise to determine the best treatment option for a particular patient.

“While Rybelus can produce weight loss, it's generally not the first choice for weight management alone,” says Fernando Ovalle, Jr, MD, a double board-certified obesity medicine specialist and plastic surgeon. “The injectable formulations of semaglutide — Wegovy and Ozempic — deliver higher doses and demonstrate significantly greater weight loss outcomes, typically around 15% of body weight compared to Rybelsus's 6%-10%.”

Having said that, there are scenarios when a provider may prescribe Rybelsus for weight loss in patients without diabetes, Dr. Ovalle says. These include when a person:

• Can’t use injectable semaglutide due to a fear of needles

• Prefers oral medication

• Can’t afford Wegovy

• Has modest weight loss goals (~5%–10%)

• Is assessing whether they can tolerate GLP-1s before transitioning to injectables

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When someone without diabetes takes Rybelsus, they’ll typically lose weight. 

In one study of non-diabetics, people lost nearly 6% of their body weight after one year of taking Rybelsus. 

Dr. Ovalle says Rybelsus offers several other health benefits for people without diabetes, including:

• Reduced hunger and increased satiety, making it easier to stick to a weight loss diet

• Improved blood pressure and cholesterol levels

• Lowered risk of type 2 diabetes in people who have prediabetes or are otherwise at risk

• Better sleep, mobility, and quality of life (weight loss often improves these health markers in people with obesity)

Potential side effects of Rybelsus in non-diabetic users

The side effects of Rybelsus are the same, regardless of whether you have diabetes, Dr. Ovalle says. These side effects include:

• Nausea

• Abdominal pain

• Diarrhea

• Decreased appetite

• Vomiting

• Constipation 

Generally, Rybelsus side effects are dose-dependent, meaning they are worse with higher doses. However, they tend to improve as you gradually increase the dose and adjust your diet, Dr. Ovalle says.

People with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2) should not take Rybelsus. Rare but potential risks of taking Rybelsus include:

• Acute pancreatitis

• Diabetic retinopathy (diabetes-related vision changes)

• Hypoglycemia (low blood sugar)

• Kidney or gallbladder problems

• Allergic reactions

• Severe gastrointestinal reactions

• Pulmonary aspiration during general anesthesia or deep sedation

No, Rybelsus is not approved for weight loss. 

The FDA has only approved Rybelsus to:

• Improve blood sugar control in adults with type 2 diabetes, along with diet and exercise

• Reduce the risk of major cardiovascular events like heart attack or stroke in adults with type 2 diabetes 

Research on Rybelsus and weight loss in non-diabetic patients 

Most of the research on Rybelsus for weight loss has been conducted in people with type 2 diabetes, since it’s a diabetes medication. 

However, there is a small study of 93 adults without diabetes that’s worth calling out. 

In this study, those who took 14 mg of Rybelsus daily for one year:

• Experienced an average weight loss of 5.7% or about 13 pounds 

• Lost a little more than 2 inches off their waistlines 

Rybelsus works by mimicking GLP-1, a natural hormone that regulates appetite and glucose metabolism. By mimicking GLP-1 and activating its receptors, Rybelsus:

• Slows down stomach emptying, helping you feel full sooner

• Sends signals to your brain that reduce appetite, so you’re satisfied with smaller portions

• Lowers blood sugar, helping prevent spikes and crashes  

Together, these effects can cause you to eat less and, in turn, lose weight.

People without diabetes may lose nearly 6% of their body weight (13 pounds) after a year on Rybelsus, according to a small study. 

People with diabetes tend to lose weight on Rybelsus. For example, research shows people taking Rybelsus for diabetes may lose 7.5 pounds after a year and a half of treatment. 

Other oral GLP-1s, as well as higher doses of oral semaglutide (the so-called Wegovy pill), are currently being studied for weight loss. 

• Oral Wegovy is a higher-dose version of oral semaglutide whose 25 mg dose is currently awaiting FDA approval. In clinical trials, adults with overweight or obesity who took 25 mg daily lost 15% of their body weight after 64 weeks, and those who took 50 mg daily lost 15% after 68 weeks. 

• Orforglipron is an oral GLP-1 for weight loss and diabetes that’s still in development. In clinical trials, adults with overweight or obesity lost an average of 9.4% to 14.7% of their body weight after 36 weeks. 

There are several other medications that are currently approved for weight loss — unlike Rybelsus, which is only approved for type 2 diabetes. These include injectable GLP-1s and oral weight loss pills.

FDA-approved GLP-1 weight loss injections include:

• Wegovy (semaglutide). Wegovy contains the same active ingredient as Rybelsus but in injectable form. In clinical trials, this once-weekly injection produced an average weight loss of 14.9% in 68 weeks.

• Saxenda (liraglutide). Saxenda is a daily injection. In clinical trials, it produced an average weight loss of up to 8% in one year.

• Zepbound (tirzepatide). Zepbound is a weekly injection that’s not only a GLP-1 but also a GIP. Meaning, it targets two hormones instead of one to cause even more weight loss. In clinical trials, it produced an average weight loss of up to 25% in 88 weeks.

FDA-approved weight loss pills include:

• Xenical (orlistat). This thrice-daily pill works by reducing the amount of fat your body absorbs from the foods that you eat. In clinical trials, people taking Xenical lost 10% of their body weight in one year.

• Qsymia (phentermine/topiramate). This daily pill is a stimulant that suppresses your appetite. In clinical trials, people lost up to 9% of their body weight in one year.

• Contrave (naltrexone/bupropion). This twice-daily pill is another stimulant that suppresses your appetite. In clinical trials, people lost about 6% of their body weight in one year.

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While Rybelsus can produce modest weight loss in people without diabetes, it’s not FDA-approved for that purpose. Plus, it’s less effective than injectable GLP-1 drugs. Here’s what you need to know if you’re curious about Rybelsus and weight loss and you’re not diabetic: 

• Rybelsus may help non-diabetic patients lose about 6% of their body weight in a year.

• Rybelsus works by mimicking the natural GLP-1 hormone to reduce appetite, slow digestion, and lower blood sugar — all of which can lead you to eat less and lose weight.

• Side effects of the drug, like nausea and diarrhea, are similar for people with and without diabetes.

• Those seeking greater weight loss results may want to consider alternatives, such as injections like Wegovy, Zepbound, or other FDA-approved weight loss medications.