Several classes of diabetes medications not only help treat type 2 diabetes, they also help patients lose weight. However, these drugs are not FDA-approved as weight management aids.

How do diabetes drugs help patients lose weight? And who should take these drugs? This article will provide a broad look at diabetes drugs that cause weight loss. We’ll investigate how these drugs work, their possible side effects, and who they may be right for.

How do diabetes drugs help with weight loss?

Healthcare providers prescribe diabetes drugs to regulate blood glucose (blood sugar) levels in patients with type 2 diabetes. These drugs have also been shown to lead to weight loss in individuals with obesity or excess body weight.

Diabetes drugs, particularly GLP-1 receptor agonists and SGLT-2 inhibitors, work through different mechanisms to promote weight reduction.

GLP-1 receptor agonists cause weight loss by:

• Lowering blood sugar by encouraging the pancreas to release insulin
  
• Reducing your overall appetite
  
• Slowing down the emptying of the stomach (making you feel fuller longer)
  
  

SGLT-2 inhibitors cause weight loss by:

• Releasing excess blood sugar through the urine
  
  

Diabetes drugs are not prescribed alone. Your provider will also prescribe healthy lifestyle changes to be used with the medication. Healthy lifestyle changes help you maintain your weight loss and make the medication more effective.

Healthy lifestyle changes used with diabetes drugs include:

A healthy diet: Your provider will recommend a diet rich in vegetables, fruits, whole grains, and lean proteins. They may also recommend cutting your calorie intake and avoiding high-fat, sugary, and overly processed foods.

More exercise: Your provider will recommend an appropriate exercise program for you and your fitness level.

Patients who took weight loss medication with healthy lifestyle changes lost, on average, 10% of their body weight, while patients who just used medication lost 3-6%.

What diabetes drugs help with weight loss?

Several diabetes drugs can cause weight loss. These medications have different effects on the body and are taken differently.

The nine diabetes drugs also prescribed for weight loss are:

1. Ozempic (contains the active ingredient semaglutide)
   
2. Rybelsus (contains the active ingredient semaglutide)
   
3. Victoza (contains the active ingredient liraglutide)
   
4. Trulicity (contains the active ingredient dulaglutide)
   
5. Mounjaro (contains the active ingredient tirzepatide)
   
6. Canagliflozin (generic for Invokana)
   
7. Empagliflozin (generic for Jardiance)
   
8. Dapagliflozin (generic for Farxiga)
   
9. Metformin (generic for Fortmeza and Glutmeza)
   
   

These nine drugs vary in how they are taken and when you should take them. They are detailed below.

Glucagon-like peptide-1 (GLP-1) receptor agonists are perhaps the most famous class of diabetes drugs used for weight loss. These drugs are primarily manufactured by Novo Nordisk and Eli Lilly.

GLP-1 diabetes drugs include:

• Ozempic (semaglutide)
  
• Victoza (liraglutide)
  
• Trulicity (dulaglutide)
  
  

Cost breakdown:

• Ozempic: $814/30-day supply
  
• Victoza: $667.59/30-day supply
  
• Trulicity: $788.51/ 30-day supply
  
  

GLP-1 receptor agonist injections are applied once a week. They have been shown to help patients lose more than 10-15 lbs in a little over a year (56 weeks).

GLP-1 agonists also help prevent cardiovascular complications such as:

• High blood pressure
  
• Heart attack
  
• Heart disease
  
  

Moujaro, made by Eli Lilly, is a unique diabetes drug. Mounjaro contains the active ingredient tirzepatide, which belongs to a novel class of drugs called dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists.

Mounjaro is injected once a week. Clinical trials showed that Mounjaro helped patients lose, on average, 41 pounds in 72 weeks.

Mounjaros starts at $995.91/ 30-day supply.

Rybelsus is the first and only GLP-1 pill approved by the FDA. It contains semaglutide, which is the same active ingredient in Ozempic.

Rybelsus is taken every day. Rybelsus has been shown to help patients lose around 8 pounds in 6 months.

Rybelsus starts at $842.48 per month.

SGLT-2 inhibitors include:

• Canagliflozin(generic Invokana)
  
• Empagliflozin (generic Jardiance)
  
• Dapagliflozin (generic Farxiga)
  
  

Cost breakdown:

• Invokana: $589.22/ 30-day supply
  
• Jardiance: $528.69/ 30-day supply
  
• Farxiga: $557.92/ 30-day supply
  
  

SGLT-2 inhibitors are available as pills that are taken every day.

SGLT-2 inhibitors have been shown to help patients lose 3-5 pounds in 6 months.

Metformin is available in its generic form or under the brand names Glucophage and Glumetza.

Metformin is usually taken once a day with food. It has been shown to help patients lose over 12 pounds in 6 months.

Metformin starts at $76.29 for a 30-day supply.

Do diabetes drugs cause side effects?

The U.S. Food and Drug Administration (FDA) has approved the drugs listed above. Their benefits generally outweigh their risks of side effects. Still, some patients may experience side effects while taking these drugs.

Common side effects of these drugs include:

• Diarrhea
  
• Constipation
  
• Stomach pain
  
• Low blood sugar
  
  

Certain GLP-1 drugs (Ozempic, Rybelsus, Victoza) can increase your risk of developing certain medical conditions. These drugs should be avoided if you have a history of:

• Gallbladder problems
  
• Pancreatitis
  
• Kidney disease
  
• Liver disease
  
• Personal or family history of medullary thyroid carcinoma (MTC) (thyroid cancer)
  
• Multiple endocrine neoplasia syndrome type 2 (MEN2)
  
• Diabetic retinopathy (eye problems)
  
• High cholesterol or triglyceride levels
  
• Any digestive disorders
  
  

Talk to your healthcare provider about any medications you take and your medical history before starting treatment with any diabetes drug.

Who should take a diabetes drug for weight loss?

None of the drugs detailed in this article have been FDA-approved for weight loss. Their use as a weight management aid is strictly off-label. "Off-label" means a doctor uses a medication to treat a condition or symptom for which it was not explicitly designed or officially approved.

Diabetes drugs are usually prescribed to patients who:

• Have a body mass index over 30 (obesity)
  
• Have overweight (a BMI over 25) with type 2 diabetes
  
  

The decision to prescribe a diabetes drug for weight loss is strictly at the discretion of the prescribing provider. Diabetes drugs aren’t suitable for everyone, but understanding your options can help you and your provider make the best decision for you. If you are curious about these treatment options but do not have type 2 diabetes, ask your provider about alternatives to diabetes drugs.

What are the alternatives to diabetes drugs?

Yes. Wegovy and Saxenda are similar to diabetes drugs but are specifically approved as weight loss drugs.

Wegovy: Wegovy is a once-weekly injectable medication. It has a higher dose of semaglutide than Ozempic. The most potent Ozempic is 2 mg, while Wegovy has 1.7 mg and 2.0 mg dosages.

Saxenda: Saxenda is injected daily. Saxenda is a higher-dose version of Victoza.

These GLP-1 agonists have been shown to lead to more weight loss. They also come with an increased risk of side effects.

Zepbound is a more potent version of Mounjaro, specifically approved as a treatment for obesity. However, it has yet to be released. Ask your provider about this medication and its availability.

How Sesame can help

Start your weight loss journey with Sesame’s online weight loss program. During your first visit, you can discuss your weight loss goals and the best type of prescription weight loss medication for you. Providers will prescribe medication if appropriate and can provide ongoing support with unlimited messaging.

Note that all prescriptions are at the discretion of the prescribing provider.

Sources:

• (2024). Standards of Care in Diabetes—2024. American Diabetes Association.
  
• Jensterle, M., Rizzo, M., Haluzík, M., & Janež, A. (2022). Efficacy of GLP-1 RA Approved for Weight Management in Patients With or Without Diabetes: A Narrative Review. Advances in therapy.
  
• Pratama, K. G., Tandarto, K., & Hengky, A. (2022). Weight loss effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors in patients with obesity without diabetes: a systematic review. Acta endocrinologica.
  
• Seifarth, C., Schehler, B., & Schneider, H. J. (2013). Effectiveness of metformin on weight loss in non-diabetic individuals with obesity. Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology and German Diabetes Association.
  
• Trujillo JM, Nuffer W, Smith BA. GLP-1 receptor agonists: an updated review of head-to-head clinical studies Therapeutic advances in endocrinology and metabolism.
  
• Wadden, T.A., Chao, A.M., Machineni, S. et al. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial. Nat. Med.
• Wadden TA, Berkowitz RI, Sarwer DB, Prus-Wisniewski R, Steinberg C. Benefits of Lifestyle Modification in the Pharmacologic Treatment of Obesity: A Randomized Trial. JAMA.