Semaglutide vs Ozempic vs Wegovy: What's the Difference?

The Simple Answer (Then We'll Explain)

Semaglutide is the active drug. Ozempic and Wegovy are brand names for that same drug, just marketed for different purposes with different dosing schedules.

Think of it like ibuprofen (the drug) being sold as Advil or Motrin (the brand names). Same medication, different packaging and marketing.

Breaking Down Each Option

Ozempic (Semaglutide for Diabetes)

FDA Approval: Type 2 diabetes management

Available Doses: 0.25mg, 0.5mg, 1mg, 2mg

Typical Cost: $900-$1,000/month without insurance

Ozempic was the first semaglutide product to hit the market (2017). It's specifically indicated for improving blood sugar control in adults with type 2 diabetes. The weight loss that occurred in clinical trials was technically a "side effect," though obviously a welcomed one.

Many doctors prescribe Ozempic off-label for weight loss because it contains the exact same medication as Wegovy, just typically at lower maximum doses.

Wegovy (Semaglutide for Weight Loss)

FDA Approval: Chronic weight management

Available Doses: 0.25mg, 0.5mg, 1mg, 1.7mg, 2.4mg

Typical Cost: $1,200-$1,400/month without insurance

Wegovy received FDA approval in 2021 specifically for weight management in adults with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related condition.

The key difference? Wegovy goes up to 2.4mg—a higher maintenance dose than Ozempic's typical 1mg or 2mg. That extra 0.4mg can make a noticeable difference in weight loss outcomes for some people.

Compounded Semaglutide (Generic Alternative)

Regulation: Made by licensed compounding pharmacies under FDA oversight

Available Doses: Customizable, typically matching Wegovy's dosing schedule

Typical Cost: $199-$345/month

Compounded semaglutide has become popular due to ongoing shortages of brand-name versions and significantly lower costs. These are made by specialized pharmacies that create medications from raw ingredients under strict quality standards.

The Dosing Differences That Actually Matter

Both Ozempic and Wegovy use the same titration (gradual dose increase) approach to minimize side effects:

The difference between 1mg (typical Ozempic) and 2.4mg (Wegovy) resulted in about 5-7% more body weight loss in clinical trials. For someone weighing 200 pounds, that's an additional 10-14 pounds of weight loss on average.

Which One Should You Choose?

Choose Ozempic If:

• You have type 2 diabetes (it's approved for this)
• Your insurance covers Ozempic but not Wegovy
• You're trying the medication off-label for weight loss and want to start conservatively
• You experience side effects at lower doses and don't want to go higher

Choose Wegovy If:

• You're primarily focused on weight loss (it's specifically approved)
• You want the full 2.4mg dosing option
• Your insurance covers weight loss medications
• You want to avoid "off-label" use

Choose Compounded Semaglutide If:

• Cost is a major factor ($199-$345 vs $900-$1,400)
• You don't have insurance coverage for weight loss medications
• You want access to the full Wegovy dosing schedule
• Brand name shortages are affecting availability in your area

The Insurance Coverage Complication

Here's where things get messy: many insurance plans cover Ozempic for diabetes but explicitly exclude Wegovy for weight loss. This has led to a few workarounds:

Safety Profile: Any Differences?

No. Since they're the same medication, they have the same safety profile, side effects, and contraindications. Common side effects include:

• Nausea (usually temporary during dose increases)
• Diarrhea or constipation
• Abdominal discomfort
• Decreased appetite (this is partly how it works)
• Occasional vomiting

The main difference in side effect experience comes from dosing—higher doses (like Wegovy's 2.4mg) may produce more pronounced side effects in some individuals.

What About Rybelsus?

Rybelsus is another brand name for semaglutide—but it's an oral tablet instead of an injection. It's approved for type 2 diabetes but requires daily dosing and tends to be less effective for weight loss compared to the injectable versions.

Most people serious about weight loss stick with the weekly injections (Ozempic, Wegovy, or compounded semaglutide) rather than daily oral tablets.

The Bottom Line

If you're confused by all the names, just remember: Ozempic, Wegovy, and compounded semaglutide are all the same drug. The differences are in:

• FDA indication: Diabetes vs weight loss
• Maximum dose: 2mg vs 2.4mg
• Cost: $900-$1,400 (brand) vs $199-$345 (compounded)
• Insurance coverage: Varies wildly by plan

For most people seeking weight loss without diabetes, compounded semaglutide offers the best combination of effectiveness, affordability, and access.