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Ozempic vs. Phentermine for Weight Loss — Which is Better?
Phentermine has been an FDA-approved weight loss drug for many years, but a recent study suggests that diabetes medication Ozempic might be effective as well. How do the two drugs compare?
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Ozempic vs. Phentermine: Which Is Better (and Safer) for Weight Loss?
Written by Alyssa Billingsley, PharmD
Published on February 25, 2021
Key takeaways:Ozempic, a medication used in type 2 diabetes, is currently under review by the FDA to be approved for weight loss in overweight or obese adults.
Phentermine is a less expensive option to help you lose weight, but it should only be used for a few weeks.
Both Ozempic and phentermine can help to curb your appetite so that you eat fewer calories, but they work differently in your body to have this effect.
MesquitaFMS/E+ via Getty Images
There are currently eight available medications that are FDA-approved to help you lose weight, and there may be another added to the list as early as this summer. Ozempic, the type 2 diabetes medication manufactured by Novo Nordisk, is currently seeking FDA approval to be used for weight loss in adults.
Phentermine has been around for decades as an affordable short-term option for weight loss. But how do newer medications, like Ozempic, compare in terms of safety and efficacy? Here we’ll review the key differences that you should know.
What is Ozempic?
Ozempic (semaglutide) is an injectable medication that is administered once weekly to help with blood sugar control in type 2 diabetes, and it may also lower the risk of major cardiovascular events (like heart attack and stroke) in people with both type 2 diabetes and heart disease.
People taking Ozempic for diabetes also tend to lose weight, so the manufacturer conducted clinical trials to see if people without diabetes would see the same benefit. They found this to be the case and filed a new drug application (NDA) with the FDA to expand the medication’s use to include weight loss in adults who are overweight or obese.
If approved, Ozempic would be the second medication in its class to be approved for weight loss in adults. Saxenda, which is also manufactured by Novo Nordisk, was the first to be approved.
How does Ozempic work?
Ozempic works by mimicking a hormone called glucagon-like peptide-1 (GLP-1). GLP-1 plays a role in digestion and appetite regulation, causing you to feel full so that you eat fewer calories.
After you’ve eaten a meal, Ozempic stimulates your pancreas to release insulin and blocks a hormone that causes your liver to release sugar. It also slows down how quickly food leaves your stomach (called gastric emptying), causing you to feel full for longer. But this can also cause some unpleasant side effects, like nausea and vomiting.
While other medications in its drug class sometimes need to be administered daily, Ozempic only needs to be used weekly since it continues to work in your body for a longer period of time.
How long does it take to lose weight on Ozempic?
To see the most amount of weight loss on Ozempic once it’s approved, you’ll likely need to gradually increase your dose over time until you reach the target dose (2.4 mg once weekly). For example, dose adjustments were made every 4 weeks or so during the clinical trials, as long as they were tolerated by participants.
But even before you reach the target dose, you may start to see some weight loss. One of the phase 3 trials measured weight loss leading up to the full dose at 20 weeks, finding that most people were able to lose weight during this time. Participants saw additional weight loss over the course of the next 48 weeks of the trial.
What is phentermine?
Phentermine is a stimulant medication that is used short-term to help you lose weight by curbing your appetite. It is currently approved for use in combination with diet and exercise in adults with a body mass index (BMI) greater than or equal to 30 mg/kg² alone or 27 mg/kg² if you have other risk factors, like high blood pressure or high cholesterol. It isn’t recommended if you are under 17 years old.
Phentermine was approved in 1959, so it’s been around for awhile. Its chemical structure is similar to that of amphetamines, but it hasn’t been found to have the same dependency or withdrawal issues. However, it is considered to be a controlled substance, and it still has misuse and dependency warnings.
Phentermine is available in 15 mg, 30 mg, and 37.5 mg strengths (capsules, tablets, and orally disintegrating tablets) that are taken midmorning or divided into two doses. It is also available as a lower-dose 8 mg tablet called Lomaira that is taken three times daily before meals. You can find it in combination with topiramate (Topamax) as the brand name Qsymia, as well.
How does phentermine work?
Unlike Ozempic, phentermine has stimulating effects. It works by stimulating your central nervous system, which influences chemicals in your brain to make you think that you’re full.
You’ll typically take it an hour or two after eating breakfast in the morning, and it’ll work to help curb your appetite over the course of the day. For example, taking one 30 mg capsule daily has been shown to lessen your appetite for 12 to 14 hours.
How long does it take to lose weight on phentermine?
Phentermine is currently indicated for short-term use, which is typically about 12 weeks. You should expect to lose at least 5% of your starting body weight during this time.
What Is Ozempic and What Is Ozempic Used For?
Experts explain what is ozempic, how does ozempic work, ozempic side effects, and ozempic for weight loss.
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What Is Ozempic and What Is Ozempic Used For?
Ozempic Is Touted on TikTok as a Weight-Loss Miracle. The Reality Is Not So Simple
April 20, 2022 by TAYLOR ANDREWS
There's a reason why "quick weight loss" is searched more than 12,000 times per month on Google. In a society that glamorizes diet culture — whether by labeling foods as "good" or "bad," or by making "what I eat in a day" videos a viral TikTok trend — it's easy to become obsessed with the food you're eating and how it affects the number on the scale. The marketplace is already inundated with harmful diet pills, fasts, and cleanses, and yet it always seems like something new is being hyped up as a path to fast weight loss. Recently, for instance, TikTok has been touting Ozempic.
Ozempic (the brand name for semaglutide) is a medicine made for adults with type 2 diabetes. It's used to improve people's blood sugar levels, and according to the website, it lowers the risk of heart attack, stroke, or death in adults with type 2 diabetes and known heart disease.
So how did Ozempic become known as a possible weight loss drug? It recently gained a lot of buzz on TikTok, where videos using the tag #ozempic have garnered 55.6 million views. One video about it went viral on TikTok earlier this year, for instance. The creator's caption read, "where has this been all my life — 7 kgs down" in reference to an injectable dosage of Ozempic shown on screen.
Some of the comments on the video include:
"6 months on it and almost 30 kg down xx."
"34 lbs and now maintenance 🙌🏽 PCOS lifesaver."
"I've been on it for 3 months lost 15kgs :)"
And while you may be thinking "yeah, no way" — the comments about the rapid weight loss results may actually be supported by facts. In a study where Ozempic was added to one or more diabetes pills, adults with type 2 diabetes weighing 197 pounds lost 12 pounds in one year on a 1 mg weekly dosage.
But here's the thing: Ozempic is not a weight loss drug, nor is it even permitted to be used for weight loss in patients who don't have type 2 diabetes in the US, the website states. So though TikTok videos about the drug have been reached by many, it's important to understand what exactly Ozempic is, who it can be prescribed to, and how it may (or may not) aid in weight loss.
Related:
Injectable Drug Wegovy Can Help People Lose 35 Pounds in Over a Year
What Is Ozempic and How Does Ozempic Work?
In simple terms, Ozempic is a medicine that increases the amount of insulin released into the body, says Bayo Curry-Winchell, MD, urgent care medical director and physician at Carbon Health and Saint Mary's Hospital. Insulin, which is a hormone, is vital, and it "allows every meal, snack, or drink you consume to be converted to a form of energy your body needs daily to function," she adds. So because people with type 2 diabetes often have low or nonexistent levels of insulin in their bloodstream, Ozempic will increase the amount of insulin, allowing the body to better process or break down food.
"This is an important step in controlling the amount of sugar in the blood (glucose), since, without [insulin], a person is left with excess blood sugar (hyperglycemia) that has nowhere to go, which ultimately would cause damage or harming to vital organs such as your brain, eyes, and kidneys," says Dr. Curry-Winchell.
As for how it aids in weight loss: Daniel Boyer, MD, says that "Ozempic prevents and reduces calorie overdose, a major contributing factor to weight gain, by suppressing appetite and reducing the preference for foods high in fats." Dr. Curry-Winchell further explains that Ozempic slows down the process of digesting a meal and targets an area in your brain that controls whether you decide to have more food or not.
While these effects can be seen as benefits for people with type 2 diabetes (since weight loss may help blood glucose levels decrease to the nondiabetic range, which could minimize or prevent future complications, according to the National Institute of Diabetes and Digestive and Kidney Diseases), that doesn't mean Ozempic can or should be used by anyone in order to lose weight. After all, weight alone is not a reliable indicator of health. Plenty of people who are considered overweight by current measures are metabolically healthy, and plenty of people who aren't considered overweight are not, as demonstrated by research in JAMA Internal Medicine. Using prescription medication for weight loss when it's not specifically directed by a doctor and it hasn't been approved for such a use can be at best, unnecessary, and at worst, dangerous.
Who Qualifies for an Ozempic Prescription?
Despite what you may see in the TikTok comments, Ozempic has only been approved by the FDA for managing symptoms of type 2 diabetes in adults — not for any other conditions like PCOS, says Dr. Boyer. In fact, while the drug website mentions that the medication can help people "lose some weight," it clarifies that "Ozempic is not for weight loss" and is instead "proven to lower blood sugar and A1C." There's no way to know whether Ozempic is safe or effective when used strictly for weight loss. It's something that should only be taken when prescribed by a doctor who's familiar with your individualized health history and needs, especially considering the not-insignificant potential side effects.
Weight
Wegovy — intended to help with obesity — and Ozempic, used to manage Type 2 diabetes, both contain the compound semaglutide; the former has been shown to help reduce body weight by 15 percent and the latter, by around 10 percent.
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New weight-loss drug costs $1,300 a month — or pounds can pile back on
By Michael Kaplan
May 30, 2022 11:12am Updated
Ozempic -- a drug intended for treating Type 2 diabetes -- helped Beth Rubin (who has a family history of the condition) stop feeling hungry and drop more weight than she anticipated.
Stephen Yang for NY Post; Shutterstock
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Beth Rubin liked being skinny. And for some 14 years, after losing 40 pounds, she enjoyed a slender physique.
“My happiest day,” the recently retired Wall Street executive told The Post,“was when I gave away my ‘big’ clothing.”
Then the pandemic hit. Her caloric intake increased and the weight piled back on. After gaining 10 pounds, Rubin knew that something had to be done — and traditional dieting had ceased to work.
“In December I told my weight-loss doctor that I needed help,” Rubin, 59, said. “I knew what I had to do [to lose weight] but I always felt hungry. My doctor told me that my body was looking for calories.”
At the advice of her physician, Dr. Katherine H. Saunders, Rubin turned to a new strategy — the diabetes drug Ozempic. It includes a a compound, semaglutide, that is intended for the obese and those with Type 2 diabetes — but is being used more and more by people who need to lose just 5 or 10 pounds. It’s found in both the weight-loss drug Wegovy and injectable Ozempic ; the former has been shown to help reduce body weight by 15 percent and the latter, by around 10 percent.
Beth Rubin, seen here in a photo before she lost weight on the obesity-fighting medication Wegovy.
Semaglutide “is a hormone that is produced while we eat; it tells the brain that we are full,” Dr. Saunders, cofounder of Intellihealth, a company focused on medicated management of obesity, told The Post. “It helps people to feel less hungry, to feel full faster and to stay full longer. But it does so when we actually are less full” than would be the norm.
And it can be costly. Dr. Abe Malkin, founder of Concierge MD in Los Angeles, has seen people paying $1,300 per month for Wegovy. He understands the appeal.
“Certain patients in LA want to look good and feel good, and this is a way to maximize the gains when you start a weight-loss program,” he told The Post. On the other end of it, Dr. Malkin added, “Getting the last few pounds off can be difficult. It is effective for people, regardless of the weight, whether you need to lose five pounds or 50.”
Rubin has been taking Ozempic since December and said she’s lost 19 pounds, exceeding her expectations.
Stephen Yang for NY Post
Officially, Wegovy is recommended for patients who have a body mass index of 27 or higher, with at least one weight-related medical condition.
But there is a catch: Once you stop, the hunger pangs return. So for those who want to stay slender, it can be a lifetime of $1,300 dole-outs each month, which Dr. Saunders describes as “prohibitive for most people.”
Fortunately for Rubin, who has a family history of diabetes, her insurance provider covers Ozempic. Its efficacy, via self-injection “into my tummy” every week, exceeded her wildest dreams.
Wegovy, which, like Ozempic, contains semaglutide, is recommended for patients who have a body mass index of 27 or higher, with at least one weight-related medical condition.
AP
“I wanted to lose 10 pounds — and I wound up losing 19,” said Rubin, who began taking the medication last December. “I have not been this light since I was in my early 20s. People are calling me ‘skinny,’ and I had not been called ‘skinny’ in a long time. That in itself is positive reinforcement.”
But taking the drug can come with complications. Rubin reports that, for the first five or six weeks, she was newly plagued by acid reflux and heartburn.. Plus food did not taste as good. At the start, when the effects are most pronounced, Rubin told The Post, “I had to push myself to eat. I was not hungry at all. I had to eat slowly and watch my meals. If I ate too much, my doctor told me, I would get sick.
An avid traveler, Rubin lost half a pound in while in Paris — still eating bread, but wanting less of it.
“There were times I ate a little too much, and I did not feel well.”
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