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Rybelsus vs. Orlistat

Published on 
February 3, 2025
Virta Team

Rybelsus and Orlistat take distinct approaches to weight management. Rybelsus, a GLP-1 receptor agonist, reduces appetite and improves glucose control, offering moderate weight loss. Orlistat, a lipase inhibitor, blocks fat absorption, resulting in modest weight loss without glucose benefits. Rybelsus causes nausea, while Orlistat is linked to gastrointestinal side effects like oily stools. Rybelsus costs $875/month, significantly more than Orlistat’s $100/month. Neither drug currently faces shortages.

How Rybelsus 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, diarrhea, vomiting, and abdominal pain.

Serious Potential Side Effects

Pancreatitis, thyroid tumors (potential risk), gallbladder issues, kidney problems, and 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

Rybelsus
Orlistat

Generic Name

Semaglutide
Orlistat

Overview

GLP-1 receptor agonist available in tablet form, used to manage type 2 diabetes and also shown to aid in weight loss by reducing appetite.
Blocks fat absorption in the intestine, helping with weight loss and weight maintenance by reducing the calories absorbed from dietary fat.

Year Approved

2019
1999

Category

GLP-1
Other

Indicated for

Type 2 diabetes management
Weight loss in overweight or obese adults; weight maintenance to prevent regain after weight loss

Administration type

Oral
Oral

Also used (but not approved) for

Weight Management

Frequency

Once / day
Up to 3x / day

Typical dose range

3–14 mg
120 mg 3x day

Average cost per month

$875
$60–$100

Availability

No current shortages
No current shortages