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Ozempic vs. Orlistat

Published on 
February 3, 2025
Virta Team

Ozempic and Orlistat differ fundamentally in their mechanism and results. Ozempic, a GLP-1 agonist, improves blood sugar and offers moderate weight loss, while Orlistat, a lipase inhibitor, blocks fat absorption for modest weight loss. Ozempic is approved for type 2 diabetes and cardiovascular risks, while Orlistat targets weight loss and weight management only. Side effects differ significantly: Ozempic causes nausea, whereas Orlistat is linked to gastrointestinal issues like oily stools. Ozempic costs $875/month, far exceeding Orlistat’s $100/month. Neither faces current shortages.

How Ozempic Works

Slows gastric emptying, reduces appetite, and enhances feelings of fullness, leading to lower calorie intake. It also stimulates insulin release and reduces glucagon secretion, improving blood sugar control.

Common Side Effects

Nausea, vomiting, diarrhea, constipation, and abdominal pain.

Serious Potential Side Effects

Pancreatitis, gallbladder issues, kidney problems, and increased heart rate, thyroid cancer, anaphylaxis (or serious allergic reactions)

How Orlistat Works

Blocks the breakdown and absorption of dietary fat in the intestines. Unabsorbed fat is excreted in the stool, reducing calorie intake and promoting weight loss.

Common Side Effects

Oily or fatty stools, frequent bowel movements, flatulence with discharge, and abdominal discomfort.

Serious Potential Side Effects

Rare liver damage and malabsorption of fat-soluble vitamins (A, D, E, K), kidney problems, and severe allergic reactions

Brand Name

Ozempic
Orlistat

Generic Name

semaglutide
Orlistat

Overview

Primarily prescribed for type 2 diabetes to improve blood sugar control. Also used for cardiovascular event risk reduction in patients with type 2 diabetes and established cardiovascular disease. Off-label use for weight management due to its appetite-suppressing effects.
Blocks fat absorption in the intestine, helping with weight loss and weight maintenance by reducing the calories absorbed from dietary fat.

Year Approved

2017 for weight management 2020 for cardiovascular risk reduction
1999

Category

GLP-1
Other

Indicated for

Type 2 diabetes management; reducing risk of major cardiovascular events in adults with type 2 diabetes and cardiovascular disease
Weight loss in overweight or obese adults; weight maintenance to prevent regain after weight loss

Administration type

Injectable
Oral

Also used (but not approved) for

Weight Management

Frequency

Once / week
Up to 3x / day

Typical dose range

0.25–2.0 mg
120 mg 3x day

Average cost per month

$875
$60–$100

Availability

No current shortages
No current shortages