Metformin Vs. Ozempic: Comparison of Weight Loss Drugs
Reviewed by Mike Bohl, MD, MBA, MPH, MS, ALM
With the rise in popularity of weight loss medications such as Wegovy, Ozempic, Mounjaro, and metformin, you may be curious about how these options compare. Are there advantages to one over the other? How do their side effects and drug interactions differ?
Both metformin and Ozempic can be beneficial for weight management. This article will provide a comprehensive overview of the differences between metformin and Ozempic for weight loss, including information on side effects, costs, and more.
Uses of Metformin and Ozempic:
Both Ozempic and metformin are approved by the FDA for the treatment of type 2 diabetes mellitus, a condition where the body does not produce enough insulin – a hormone crucial for utilizing sugar for energy.
Obesity or being overweight (defined as a BMI of 27 kg/m or higher) can increase the risk of type 2 diabetes. According to the American Diabetes Association (ADA), weight loss may help prevent the development of diabetes.
While both drugs are FDA-approved for blood sugar control and are prescribed off-label for weight loss, let’s delve into the specifics of Ozempic.
Ozempic, also known by its active ingredient semaglutide, is FDA-approved to assist individuals with type 2 diabetes in managing their blood glucose levels. It is an injectable medication that can be used in conjunction with lifestyle changes, such as diet and exercise, or other diabetes medications like insulin or metformin.
Ozempic (as well as Wegovy) is recommended for individuals with obesity or who are overweight (BMI of 27 or higher). These drugs may also help prevent other health issues associated with excess weight, such as high blood pressure or high cholesterol.
Curious about metformin, the alternate weight management drug? Here’s what you need to know.
Metformin, a biguanide medication used to regulate blood sugar levels, is an oral medication approved by the FDA for individuals with type 2 diabetes. It is also used off-label to manage gestational diabetes and treat polycystic ovary syndrome (PCOS), but should not be used by those with type 1 diabetes.
But how do the weight loss effects of these two medications compare?
Effectiveness of Metformin vs. Ozempic for Weight Loss:
In a study from the ’90s, metformin was shown to not only help prevent diabetes but also led to a significant reduction in weight and waist measurements for participants. The drug reduced diabetes rates by 31% over three years, and further studies revealed that participants lost an average of 3.8 kg (8.4 pounds) over 29 weeks.
A more recent meta-analysis of 21 trials in 2020 found that metformin had a clinically
A study comparing semaglutide injection to a placebo in individuals without diabetes discovered that the semaglutide group experienced a significantly higher average weight loss of nearly 15%, compared to a 2.4% average weight loss in the placebo group.
But how do these diabetes medications aid in weight loss? Ozempic belongs to a class of drugs known as glucagon-like peptide-1s (GLP-1s) receptor agonists. These medications mimic the naturally occurring hormone GLP-1 and target specific brain areas that regulate appetite.
The exact mechanism of metformin is not fully understood, but researchers propose that it reduces glucose production in the liver, leading to lower glucose levels in the bloodstream. By enhancing insulin response and regulating blood sugar levels, metformin can also reduce the risk of serious health conditions such as heart disease and vision loss. Metformin may additionally promote weight loss by acting as an appetite suppressant and increasing insulin sensitivity.
When it comes to administration, Ozempic is given through subcutaneous injections into the belly, upper arm, or thigh. Starting with a weekly dosage of 0.25mg, the dose is typically increased to 0.5mg after four weeks. In contrast, metformin is an extended-release oral medication usually initiated at a daily dose of 850mg for diabetes, with the option of a slow increase to 1000mg or higher over time.
Both medications carry potential side effects. Ozempic may cause common side effects like nausea, heartburn, constipation, and diarrhea. In rare cases, pancreatitis or gastrointestinal ileus can occur. On the other hand, metformin side effects may include gastrointestinal disturbances, chest discomfort, headaches, hypoglycemia, and weakness. It is crucial to start with a lower dose and gradually increase it under medical supervision to minimize adverse effects. Consult a healthcare provider to determine the most suitable medication and dosage for your specific needs.
One potential side effect of metformin is lactic acidosis, a condition where lactic acid accumulates in the blood due to the muscles’ inability to break down glucose. It is important to note that metformin, approved by the FDA in 1994, is an older medication compared to Ozempic, which was approved in 2017. This age gap means there is more research available on the safety and efficacy of metformin in comparison to Ozempic.
Cost is a significant factor to consider when it comes to necessary medications, and the price difference between Ozempic and metformin is particularly crucial given their impact on weight loss. These medications are often not covered by health insurance, leading to high costs. Without insurance, Ozempic can average around $900 to nearly $1000 per month.
On the other hand, metformin costs can vary depending on dosage and insurance coverage, but it is generally much more affordable than Ozempic since it is a generic medication. For example, Hers offers access to metformin as part of a comprehensive weight loss program starting at $79 per month, making it a more cost-effective option.
When comparing metformin and Ozempic for weight loss, both are FDA-approved drugs for managing diabetes and lowering blood sugar levels. While they can be prescribed off-label for weight management, they function differently. Ozempic is a weekly injection that targets appetite, while metformin is a daily oral medication that helps the body respond better to insulin and maintain healthy blood sugar levels.
Common side effects of both medications may include nausea and diarrhea. Metformin, being an older medication, has more extensive research on its side effects and effectiveness compared to Ozempic. However, Ozempic is typically more expensive as it lacks a generic version and is often not covered by insurance.
Ultimately, the choice between metformin and Ozempic for weight loss depends on individual preferences, costs, and healthcare provider recommendations. Lifestyle changes such as a healthy diet, regular exercise, and sufficient sleep are also crucial for successful weight management. It is advisable to consult your healthcare provider for more information on weight loss medications and personalized recommendations.
