With weight loss drugs like metformin and Ozempic gaining popularity, it's essential to understand how they compare. So we had a doctor weigh in on their effectiveness, cost and side effects to help you choose the best option for your health goals.
"They share a role in managing type 2 diabetes, but they differ significantly in their mechanisms and effects," reveals obesity medicine physician Michael L. Glickman, MD. Here's everything you need to know about metformin vs Ozempic so that you can decide which one might be right for you.
Metformin vs. Ozempic: How the two compare
"Metformin, a prescription first-line oral medication, primarily reduces glucose production in the liver and improves patients' insulin sensitivity," says Dr. Glickman. "Ozempic, on the other hand, is a GLP-1 receptor agonist that slows digestion, normalizes blood sugar levels, enhances insulin secretion after meals and reduces appetite. It also influences brain reward circuits to help reduce food intake."
What are they FDA-approved to treat?
Metformin is FDA-approved as a treatment option for type 2 diabetes and is sometimes used off-label for conditions like polycystic ovary syndrome (PCOS), reveals Dr. Glickman. Ozempic is a brand-name medication for the active ingredient semaglutide, which is also approved to manage blood sugar levels in people with type 2 diabetes.
"Ozempic's sister drug, Wegovy, which is also semaglutide, is FDA-approved for weight loss," adds Dr. Glickman.
Metformin is taken as a daily oral tablet whereas Ozempic is administered via a weekly injection, he says.
How much weight can you lose on metformin vs. Ozempic?
While metformin is widely used for glucose control and has a modest impact on weight, Ozempic is more effective for both glucose regulation and substantial weight loss, Dr. Glickman explains. Indeed, clinical trials reveal distinct differences in weight loss outcomes: Metformin typically results in a 5% weight loss, while Ozempic shows a more significant 15% weight loss, making it a potentially stronger choice for those prioritizing weight management.
How quickly do they work?
Metformin begins working within just a few days to lower blood sugar, but its full effects may take up to two weeks, explains Dr. Glickman. And when it comes to Ozempic? "It often provides noticeable improvements in appetite and weight loss within the first few weeks. The full benefits are seen over several months to a year with continued titration of the dose to optimize its effectiveness," he says.
How much do metformin and Ozempic cost?
Metformin, a less expensive generic medication, can cost under $5 a month for a 30-day supply. Ozempic is pricier. Without insurance, it can cost up to $968.52 a month. That said, your insurance may provide at least partial coverage, and there are patient assistance programs that in some cases can help bring the cost down to just $25 a month.
Metformin vs. Ozempic: Which is right for you?
"Patients whose primary focus is on weight loss or those who struggle with overeating and cravings often benefit more from Ozempic or Wegovy, while metformin is more suitable for those needing glucose control without injections," says Dr. Glickman. He adds that other important factors to consider are the cost of the medications themselves as well as their potential side effects.
As for the most common side effects, both drugs may lead to nausea and diarrhea. In the case of metformin, one way to avoid such GI upset is by taking it with a meal rather than on an empty stomach.
Something to watch for when it comes to Ozempic is fatigue. That's because when GLP-1 semaglutide medications curb calorie intake, they may also dial down energy levels, leaving you feeling sluggish. To boost your pep while on Ozempic, the age-old advice still applies: Try to get more sleep, stay hydrated and reduce stress as much as possible.
Deciding between metformin and Ozempic depends on your health goals, budget and preferences. Consult with your healthcare provider for a personalized plan to ensure the best results for your weight loss and glucose control needs.