Ozempic vs Metformin For Weight Loss


Written by:

The increasing popularity of weight loss drugs like Wegovy®, Ozempic, Mounjaro and metformin may have you wondering how all these options stack up. Are there benefits to one over the other? How do side effects or drug interactions compare?

Both metformin and Ozempic can have positive impacts on weight management. We’ll cover everything you need to know about metformin vs Ozempic for weight loss, from side effects to cost and more.

Metformin vs Ozempic: Uses

Ozempic and metformin are both FDA-approved to treat type 2 diabetes mellitus, a common condition when the body doesn’t produce enough insulin. This hormone is made by your pancreas and helps your body use sugar for energy. 

Having obesity or being overweight (defined as a body mass index or BMI of 27 kg/m or more) can raise your risk of type 2 diabetes, so losing weight may help prevent you from developing diabetes, according to the American Diabetes Association (ADA).

While both drugs are approved by the FDA for blood sugar control and prescribed off-label for weight loss, let’s start with the details on Ozempic.

If you’ve seen the news or read celebrity gossip lately, there’s a good chance you’ve heard of Ozempic. One of the brand names for the active ingredient semaglutide — others are Rybelsus and Wegovy — Ozempic is FDA-approved to help people with type 2 diabetes control their blood glucose levels (or their high blood sugar levels).

Ozempic is an injectable medication that may be used in combination with lifestyle changes like diet and exercise or with other diabetes medications like insulin or metformin.

Ozempic (and Wegovy) are supposed to be prescribed to people who have obesity or are overweight — in other words, those who have a body mass index (BMI) of 27 or higher. These drugs may also be used to prevent other health problems associated with excess weight such as high blood pressure or high cholesterol.

Curious about metformin, the other weight management drug? Here’s everything you need to know.

A biguanide medication used to control blood sugar levels, metformin is an oral medication that’s FDA-approved for people with type 2 diabetes. Off-label, metformin is also used to manage gestational diabetes (a type of diabetes that develops during pregnancy) and treat polycystic ovary syndrome (PCOS). It should not be used by people with type 1 diabetes.

But exactly how effective at weight loss are these two medications?

(Related: Metformin For Weight Loss: Does It Work?)

Effectiveness of Metformin vs Ozempic for Weight Loss

When metformin was tested on patients with diabetes in a large study in the ‘90s, researchers found that not only did the drug help prevent diabetes, but it also led to a significant decrease in weight and waist measurements for participants.

Specifically, metformin reduced participants’ diabetes by 31 percent over three years, and further studies found that those taking the drug for 29 weeks also lost 3.8 kg (or 8.4 pounds).

A more recent 2020 meta-analysis of 21 trials testing metformin found the drug had a clinically significant impact on lowering BMI, especially for those who were considered to have obesity.

Finally, a study of 154 people on metformin for weight loss found that participants lost an average of 5.6 to 7 kg (that’s roughly between 13 and 15 pounds).

Ozempic also has a notable effect on weight loss.

One study comparing a weekly semaglutide injection to a placebo in those without diabetes found a higher average weight loss in the semaglutide group — almost a 15 percent average decrease in weight, compared to a 2.4 percent average decrease in the placebo group.

But how does each of these diabetes medications actually work to help you lose weight?

Ozempic is in a class of drugs called glucagon-like peptide-1s (GLP-1s) receptor agonists. These drugs mimic GLP-1, a naturally occurring hormone, and target areas of the brain that regulate appetite.

Researchers aren’t entirely sure how metformin works, but the current top theory is that it causes your liver to make less glucose, which means less glucose is released into your bloodstream.

Said another way, metformin keeps your blood sugar in a healthy range by helping your body respond better to the insulin it makes. By regulating your blood sugar levels, metformin can also help reduce your risk of serious health issues like heart disease or loss of vision.

Metformin may also induce weight loss by working as an appetite suppressant. Like Ozempic, metformin increases the amount of GLP-1 hormone you make, which tells your brain that you’re full and helps reduce the amount of calories you eat.

Metformin has also been shown to increase insulin sensitivity, meaning your body can use more of the insulin it produces and get more energy from your food intake.

How to Take Ozempic vs Metformin

Ozempic is a subcutaneous injection. This means the drug is injected into the tissue layer between the skin and muscle of the belly, upper arm or thigh.

Most people start with a weekly Ozempic dosage of 0.25mg, then increase the dose to 0.5 mg after four weeks.

Unlike Ozempic, metformin is an extended-release oral medication with a recommended starting (one month) dosage of 850mg once a day for diabetes. For weight loss, Hers offers access to a type of metformin called metformin XL at 500mg, which can be increased to 1000mg (and potentially more) over time.

It’s important to start at a lower dosage and increase it slowly, with the help of a healthcare provider, in order for your body to get acclimated to the medication. Your dosage will depend on your medical conditions, your weight and more. You should connect with a healthcare provider for medical advice on Ozempic vs metformin and what dosage is best for you.

(Related: Weight Loss Injections: Are They Safe?)

Side Effects of Ozempic vs Metformin

Of course, both Ozempic and metformin come with a risk of side effects (really any medication does), but there are some distinct differences between them.

With Ozempic, the most common side effects include nausea, heartburn, constipation and diarrhea, which can be moderately severe in some people. In some cases, people using Ozempic can develop pancreatitis, a potentially serious condition.

There’s also an increasing amount of research and postmarketing reports of patients who started taking Ozempic suffering gastrointestonal ileus, or temporary stomach paralysis — enough that the FDA issued an update to Ozempic’s drug label. 

Clinical trials have found that semaglutide has no negative drug interactions with common cholesterol or blood thinner medications.

Metformin, on the other hand, can cause side effects, including diarrhea, nausea, vomiting, abdominal pain or constipation.

Less common, but still usually minor, side effects of metformin include chest discomfort, headaches, sweating, hypoglycemia (low blood sugar) and weakness. A less frequent but severe side effect of metformin is lactic acidosis, where lactic acid builds up in the blood because the muscles can’t break down glucose.

It’s also worth noting that metformin is a much older medication than Ozempic — metformin was approved by the FDA in 1994 and Ozempic was approved in 2017 — which means there more research available about the safety and efficacy of metformin compared to Ozempic.

Cost of Metformin vs Ozempic

Cost is a big concern for any necessary medication, and the price of Ozempic vs metformin is especially important as they make headlines for their impact on weight loss. These medications usually aren’t covered by health insurance, making them quite costly.

Ozempic and Wegovy typically aren’t covered by insurance, which can make them quite costly. Without insurance, Ozempic can average around $900 per month and even approach $1000.

Metformin costs can vary, depending on your prescribed dosage and whether your insurance covers the medication. However, it’s going to be a fraction of the price of Ozempic as it’s a generic medication. Hers offers access to metformin as part of a comprehensive weight loss program, starting at $79 per month.

So, if cost is a consideration, metformin has the clear advantage.

(Related: Are Weight Loss Drugs Covered By Insurance?)

Metformin vs Ozempic for Weight Loss: Which Is Better?

Now you know all the facts on metformin and Ozempic for weight loss, so let’s compare these two medications and if one is better.

  • Both are FDA-approved diabetes drugs that lower blood sugar levels, though they work through different mechanisms. They may also both be prescribed off-label for weight management, as having obesity or being overweight can increase the risk of diabetes.

  • While Ozempic is a weekly injection that works to target your appetite, metformin is a daily oral medication that helps your body better respond to insulin and keep your blood sugar in a healthy range.

  • You may experience side effects like nausea and diarrhea from either medication.

  • As an older medication, metformin has a lot more research into its side effects and efficacy than Ozempic. 

  • Ozempic is usually much more expensive than metformin, as there’s no generic version available and it’s usually not covered by health insurance.

Either of these prescription drugs may be recommended as a diabetes treatment or to reduce weight, which can help prevent diabetes or other health conditions caused by excess weight. Your healthcare provider can discuss more information about these and other weight loss medications with you.

Whatever treatment you choose, you should also plan to make lifestyle changes for weight loss, such as eating a healthy diet, getting regular exercise, aiming for seven to nine hours of sleep and more. There are also other weight loss treatments out there that don’t require the use of needles or injections.

This article originally appeared on Hers and was syndicated by MediaFeed.org.

More from MediaFeed:

25 Weight-Loss “Tricks” You Should Stop Immediately

25 Weight-Loss “Tricks” You Should Stop Immediately

When it comes to diet and nutrition, we all want to find “the answer” that will fix our alleged problems. As a result, we often latch onto crazy diet ideas that, in the moment, sound like the perfect solution. But these too-good-to-be-true “solutions” can hurt more than help us in our attempts to achieve weight loss and gain healthy habits.

Here are some of the most common diet myths exposed.


The protein-pushing keto craze sure makes it seem like carbs should be avoided at all costs. But do grains deserve their bad reputation?

“People often say that carbs are fattening,” says Kristin Kirkpatrick, MS, RD, LD. “But complex carbohydrates, like whole grains, are not ‘fattening’ foods.’”

In other words, avoid refined carbohydrates like white bread, rice and processed snacks, but keep those whole grains for a healthy balance.

Getty Images | Sean Gallup

While diet sodas may be a better alternative than their full-sugar counterparts, medical studies are starting to show that the artificial sweeteners may actually cause us to eat more calories later in the day. If you want to keep the fizz and ditch the artificial sweetener, try flavored carbonated water instead.

Getty Images | Scott Olson

Like carbs, the type of fats we eat makes a difference. That, in combination with how many calories we eat each day, determines our body weight. Trans fats, typically found in many fried foods, can cause cardiovascular disease. However, saturated fats do not have the same effect and can, in fact, help keep us satisfied longer, leading to fewer calories consumed.

Getty Images | Lisa Lake

Maybe you’ve only been eating the egg whites to avoid raising your cholesterol. Well, maybe you don’t have to anymore.

“Unless you are genetically predisposed to high cholesterol or cardiovascular disease, eating the eggs AND yolks can actually help you,” says Darin Hulslander, CEO and owner of DNS Performance and Nutrition. “For one, yolks are high in antioxidants, vitamins, and minerals. Egg yolks also elevate high-density lipoproteins, which are the ‘good’ proteins that can help remove plaque from the arteries.”


If you count calories, you might think losing weight is as simple as staying under a certain number every day. Unfortunately, this is not necessarily true. You can eat 200 calories of lean protein or 200 calories of chocolate, but the body processes each differently. Depending on what you eat, your body can store or burn more calories. So, use those calories wisely!

Getty Images | Joe Raedle

Reading headlines such as “red meat could lead to cancer” is frightening. And while some studies indicate there is an association with red meat consumption and cancer, it’s important to note that this doesn’t mean it causes cancer. Eating red meat in moderation is not dangerous.

Getty Images | Justin Sullivan

The American Heart Association recommends that people consume less than 1,500 milligrams of sodium (salt) each day. Excessive sodium can lead to high blood pressure. However, this doesn’t mean we have to eat bland food. Use salt in moderation and, if you have high blood pressure, talk with your doctor on the best guidelines for your individual needs.

Getty Images | Justin Sullivan

Sure, peanut butter is a good source of protein and fat. However, you need to be careful about what kind you put in your pantry. Many national brands of peanut butter are filled with extra sugar, fats and preservatives that counteract any health benefits. Check the label and pick up a jar with as few ingredients as possible to get the healthiest version of this favorite snack.

Getty Images | Justin Sullivan

Calories can’t tell time. The time of day of when you eat only matters if you tend to overindulge at the end of the day and eat too many calories. If you happen to eat a late dinner or snack but stay within your normal calorie range for the day, it should all even out in the long run. However, many people mindlessly eat at night because they are bored or tired, and this is what leads to weight gain.

Getty Images | Robin Marchant

This is the one case where all calories are pretty much alike. Multiple studies show that eating the same amount of calories in either a few larger meals or more frequent smaller ones have the same outcome on the body. In other words, this is a case where 1,000 calories in a day are the same, no matter how often you eat during the day.

Getty Images | Steffi Loos

With labels like “Lean Cuisine” and “Healthy Choice,” it’s easy to think that pre-packaged frozen meals are not only convenient but also a better choice to help us in our diet goals. This isn’t always the case. Many of these pre-packaged meals contain too much sodium, which can lead to water retention and bloat. Also, many offer too few calories, which can lead to hunger later on in the day. Check the labels carefully and make sure you’re making the best choice.


When looking to avoid processed carbohydrates, many people reach for wheat or multigrain bread over white. But be careful! Make sure you’re picking up 100% wheat or whole grain bread. Otherwise, you could be just be getting mostly white bread with a little wheat flour mixed in — or even just food coloring to make it look brown!

Getty Images | Spencer Platt

This nutrition myth has been around forever, but it’s just not true for most people. Medical studies show that among extremely active people such as marathon runners and skiers, taking at least 200 milligrams of vitamin C every day can possibly cut the risk of getting a cold in half. But for most people, taking daily vitamin C did not seem to actually reduce the risk of getting a cold.

Getty Images | Jack Taylor

Wouldn’t it be great if there were such a thing as a negative-calorie food? You know, the kind that burns more calories when we eat it than it has? Sadly, there is no such thing, even when it comes to something as healthy as a piece of celery.

“Regardless of the [calories] in the food, you’re always going to be able to get something out of it,” says Stephen Secor, a professor of biological sciences at the University of Alabama.

Getty Images | Sean Gallup

Organic is simply how ingredients are grown, usually pesticide-, herbicide- and insecticide-free. An organic label does not mean it’s healthier than non-organic foods. Even things like sugar, granola bars and boxed mashed potatoes can be organic. So, don’t rely on an organic label to tell you if something is automatically better for your diet.

Getty Images | Sean Gallup

While cutting out gluten from your diet can help if you have celiac disease, it isn’t really a factor in weight loss.

“Unless you suffer from celiac disease, there’s not much scientific support to back the claim that eating gluten-free is healthier or a smart strategy for weight loss,” says Ashvini Mashru MA, RD, LDN. “Cutting gluten out of your diet most often leads to a reduction in overall calories, simply due to the sheer amount of grain-based foods that we eat on a regular basis.”

Getty Images | Jason Kempin

Fewer calories consumed means weight loss, right? Not so fast!

“In fact, studies have proven it to be the opposite: skipping meals promotes weight gain,” says Cheryl Forberg, RD, nutritionist for “The Biggest Loser.” “When we skip a meal, by the time we eat, we’re so hungry we consume too much, too fast and choose the wrong foods.”


Foods like asparagus and lemons are known as natural diuretics. And while these kinds of foods may not hurt when it comes to holding onto excess water, eating large amounts of them will not help get rid of belly bloat or weight.

Getty Images | Miles Willis

Your daily cup of coffee may give you a good dose of caffeine, which is a stimulant to your body. However, that caffeine jolt does not boost your metabolism enough to be a weight loss cure-all. Also, depending on what you add to your coffee (cream, flavorings, sugar), you could be adding extra calories to your day. So if you love a cup of joe, keep it basic and black, if possible.

Getty Images | Bryan Thomas

This is a short-term fix with many long-term problems. By severely cutting daily calories for extended periods of time, your entire metabolism can change to actually hold onto weight! Also, your body needs adequate nutrition to stay healthy. If you want to lose weight and keep it off forever, you need a modest calorie restriction plan that you simply continue and never stop.


You cannot outrun a bad diet. It’s as simple as that. Exercise is great for our cardiovascular health and for building good muscle tone. And yes, it does help regulate our weight. But the amount of exercise you have to do to counteract a few extra slices of pizza isn’t sustainable or reasonable. So work in a healthy diet plan along with your regular workouts for optimal results.

Getty Images | Hagen Hopkins

In a pinch, these convenience items are helpful in maintaining a healthy diet. But things like shakes and nutrition bars are not meant to be long-term replacements for healthy meals. Check the ingredients for artificial sweeteners if you buy these items. Your best bet: Make these at home and use them occasionally.

Getty Images | John Sciulli

Yes, some people should probably cut back on sugar in order to make their diet healthier. But naturally sweet foods such as fruits are sources of important vitamins and minerals. The sweets to avoid are those with added sugars and syrups.

Getty Images | Scott Olson

Good news! While fresh vegetables are always a healthy option, so are most frozen varieties. Over time, fresh vegetables can lose nutrients, while frozen ones can retain them longer. Make sure you pick up frozen vegetables without added sauces, cheese or sodium to keep them as close to fresh as possible.

Getty Images | Sean Gallup

Can you imagine life without ice cream, cookies or cake? You don’t have to in order to follow a healthy eating plan. In fact, planning to have some of your favorite treats occasionally can ensure you don’t feel deprived and end up splurging later on.

This article originally appeared on TheDelite and was syndicated by MediaFeed.

Getty Images | Monica Schipper


Featured Image Credit: CR / iStock.