Does Rybelsus cause weight loss?

Obesity in the U.S. affects around 100 million (41.9%) adults and almost 15 million (19.7%) children. Poor diet and low levels of physical activity can affect your overall health and are significant risk factors for obesity. Obesity is associated with several chronic conditions such as heart disease, high blood pressure, heart attack, stroke, type 2 diabetes (T2DM), cancer, and osteoarthritis. Losing even a modest amount of weight can improve your blood pressure, blood cholesterol, and blood sugar, reducing your risk of these chronic conditions. For some people, diet and exercise are not enough to get their weight under control, so their healthcare provider may prescribe a medication to help. One of these medications they may give you is a GLP-1 agonist such as Rybelsus.
Rybelsus (semaglutide) is an FDA-approved once-daily oral medication along with diet and exercise to control blood sugar levels in adults with type 2 diabetes mellitus (T2DM). It is the only semaglutide product that is not an injection. While not approved, Rybelsus is also sometimes used as a weight loss drug. Studies have shown that most people who take Rybelsus will lose weight.
During the PIONEER 2 study with Rybelsus, people taking the 14 mg dose lost an average of 8.4 lb after 26 weeks when it was added to metformin. In the PIONEER 3 study, people taking 7 mg of Rybelsus lost an average of 4.8 lb while those taking 14 mg lost 6.8 lb after 26 weeks. The PIONEER 4 study showed even more weight loss. People taking 14 mg of Rybelsus lost almost 10 lb after 26 weeks. Those taking a placebo lost 1.1 lb.
New studies looking at higher doses of oral semaglutide have shown weight loss results that were similar to Wegovy. The OASIS 1 trial looked at weight loss in adults taking oral semaglutide 50 mg compared to those taking a placebo for 68 weeks. The people taking oral semaglutide lost an average of around 17% of their starting body weight. This is comparable to the results from the largest Wegovy trial, which showed about a 15% average weight loss. Because of these findings, Novo Nordisk plans to request FDA approval for this indication in 2023. If it is approved by the FDA, it will probably be marketed under a different brand name.
Read on and find out all you need to know about Rybelsus as we answer some frequently asked questions.
Rybelsus FAQs
What conditions does Rybelsus treat?
Rybelsus (semaglutide) is a prescription drug manufactured by Novo Nordisk. It is approved along with lifestyle changes such as a low-calorie diet and exercise by the U.S. Food and Drug Administration (FDA) to improve blood glucose levels in adults with T2DM. Rybelsus is also sometimes used off-label as a weight loss medication.
Rybelsus has a boxed warning against its use in people with a personal or family history of certain types of thyroid cancer. It should also be avoided if you have type 1 diabetes.
How does Rybelsus work?
The active ingredient in Rybelsus is semaglutide, which belongs to a drug class called glucagon-like peptide 1 or GLP-1 receptor agonists. GLP-1 is a natural hormone released by your gut when you eat. Rybelsus works by activating GLP-1 receptors. This causes your pancreas to release more insulin while stopping the secretion of sugar from your liver into the bloodstream. It also slows down digestion to help you eat less and lose weight.
What doses of Rybelsus are available?
Rybelsus is available as an oral tablet in the following strengths:
- 3 mg
- 7 mg
- 14 mg
How do you take Rybelsus?
Take Rybelsus exactly as your healthcare provider prescribes it to you. It is typically taken on an empty stomach when you first wake up with no more than 4 ounces of water. It should be taken at least 30 minutes before your first food, beverage, or other oral medications. Swallow Rybelsus tablets whole and do not crush, split, or chew them. If you miss a dose, skip the missed dose and go back to your regular schedule.
Are there any drug interactions with Rybelsus?
When Rybelsus is taken with other drugs, it can change how they work or make some side effects more likely or severe. You should ask your healthcare provider if any of the prescription medications, over-the-counter (OTC) drugs, vitamins, or supplements you take may interact with Rybelsus, including:
- Other diabetic medications such as insulin, sulfonylureas, and metformin
- Oral medications, since Rybelsus slows down gastric emptying (how fast your stomach empties) and can change how much of these meds are absorbed
What are the side effects of Rybelsus?
The most common side effects of Rybelsus seen in clinical trials when compared to placebo include:
- Nausea
- Diarrhea
- Abdominal pain
- Decreased appetite and weight loss
- Constipation
- Vomiting
Other possible side effects of Rybelsus can include:
- Bloating
- Indigestion and reflux
- Gas
Rarely, Rybelsus may cause some more serious side effects such as:
- Serious, life-threatening allergic reactions, including anaphylaxis
- Increased risk of certain thyroid tumors including medullary thyroid carcinoma (MTC) or a certain inherited disease (multiple endocrine neoplasia syndrome type 2 or MEN 2)
- Pancreatitis (inflammation of the pancreas)
- Increased risk of complications from diabetic retinopathy
- Low blood sugar (hypoglycemia), especially if it is used with other diabetes medications
- Kidney problems including dehydration
- Gallbladder problems and gallstones
Contact your healthcare professional for medical advice about any possible adverse effects you experience while taking Rybelsus. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Who should not take Rybelsus?
Rybelsus should not be taken if you are allergic to semaglutide or any inactive ingredients in this product. You should also avoid this medication if you have a family or personal history of medullary thyroid carcinoma or if you have Multiple Endocrine Neoplasia syndrome type 2.
What should you tell your healthcare provider before taking Rybelsus?
Be sure your provider is aware of any other medical condition you have before starting Rybelsus, including:
- Problems with your pancreas or kidneys
- Vision problems related to your diabetes
- Are pregnant or plan to become pregnant
- Are breastfeeding or plan to breastfeed
How long should you take Rybelsus for weight loss?
Some people may start losing weight within the first few weeks of starting Rybelsus. However, most of the studies cited above looked at weight loss after 26 weeks of Rybelsus. After this time people lost up to almost 10 lb from their starting body weight.
Can Rybelsus affect your heart?
The active ingredient in Rybelsus is semaglutide. It is available in an injectable form under the brand name Ozempic. Ozempic is approved to lower blood sugar levels as well as reduce the risk of major cardiovascular events (heart attack and stroke) in people with T2DM and heart disease. While Rybelsus is not approved for this indication, it helps regulate blood sugars and most people lose weight while on it. Losing weight and having normal blood sugar levels can reduce your risk of heart disease, heart attack, and stroke.
Can you take Rybelsus and metformin together?
Yes, metformin and Rybelsus can be taken together. Metformin is typically the first medication used to treat T2DM. If you need more blood sugar control, Rybelsus can be added, since they both work in different ways. It is important to remember to not take them at the same time. Rybelsus needs to be taken 30 minutes before any other oral medication.
Related Medications
- Wegovy (semaglutide)
- Ozempic (semaglutide)
- Mounjaro (tirzepatide)
- Saxenda (liraglutide)
- Victoza (liraglutide)
- Trulicity (dulaglutide)