Man checking weight with bathroom scale and wondering which diabetic drug causes the most weight loss

Which Diabetic Drug Causes the Most Weight Loss?

Written on June 28, 2023 by Theresa Vuskovich, DMD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

If you have type 2 diabetes (T2D), diabetic drugs can affect your weight in different ways.[1] Some medications for T2D cause weight loss or weight gain, while others do not affect your weight.[1] When taking diabetic drugs that cause weight loss, the amount of weight lost varies based on many factors, including your age, starting weight, and lifestyle.

Understanding how diabetic medications affect your weight is important if you have T2D and want to lose weight. This article explains how diabetic medications affect weight loss and which diabetic drug causes the most weight loss.

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Metformin

Metformin is the first-line therapy for individuals with T2D to improve glycemic control.[1] In addition to controlling blood sugar levels, metformin is beneficial for managing weight and can also cause weight loss by suppressing your appetite.[1] Weight loss caused by metformin varies from 0.6-13%.[1]

Metformin is also sometimes prescribed off-label for patients with prediabetes.[1] Research shows metformin may prevent the progression of prediabetes to T2D.[1] However, there is some controversy about its use since metformin is not approved by the Food and Drug Administration (FDA) to treat prediabetes.

The most common side effects of metformin are nausea, vomiting, and diarrhea, which occur in 20% to 30% of patients.[1] There is also a risk of a B12 deficiency with long-term use.[1] B12 is an essential vitamin for the formation of red blood cells, DNA synthesis, and healthy nerves.[3] B12 is only found in animal or fortified products.[3]. Consequently, when taking metformin and following a plant-based diet, it is important to monitor your B12 levels.[1]

Liraglutide

Liraglutide is a glucagon-like peptide 1 (GLP-1) receptor agonist for patients who have obesity or who are overweight with at least one weight-related comorbidity, including T2D.[4] Liraglutide was initially approved by the FDA to help patients with T2D manage their blood sugar levels.[4] Clinical trials showed liraglutide caused weight loss, and the FDA later approved liraglutide for weight management.[4]

Liraglutide works by suppressing your appetite, which can lead to clinically significant weight loss.[4] Clinically significant weight loss refers to losing at least 5% of your body weight, resulting in a reduced risk of heart disease.[5] However, the weight loss needed to improve your health can vary based on your starting weight and weight-related comorbidities.[5]

According to the American Diabetes Association (ADA), individuals taking 3 milligrams of liraglutide lost, on average, 6% of their body weight after a year.[2] Liraglutide is sold under the brand name Saxenda®.[4]During a pivotal clinical trial, patients with T2D lost approximately 5.4% of their body weight after a year.[4] Your weight loss results will vary based on how well you adhere to the medication and lifestyle choices.[1]

Liraglutide is often prescribed in combination with metformin for patients with T2D who are overweight or have obesity.[1] When taking liraglutide, nausea, vomiting, diarrhea, and esophageal reflux are common side effects.[4] Liraglutide may increase your risk of thyroid C-cell tumors, pancreatitis, and low blood sugar.[4]

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Semaglutide

Similar to liraglutide, semaglutide is a GLP-1 initially studied to treat T2D, but research revealed patients experienced clinically meaningful weight loss while taking the medication.[6-8] As a result, semaglutide is approved for patients with T2D to improve glycemic control and for weight management for individuals who have obesity or who are overweight and have at least one weight-related comorbidity.[6-8]

Semaglutide is sold under three brand names, Ozempic®, Wegovy®, and Rybelsus®.[6-8] Ozempic® and Rybelsus® are approved by the FDA to treat patients with T2D, while Wegovy® is approved by the FDA for weight management.[6-8] However, Ozempic® and Rybelsus® are prescribed off-label for weight management.

Ozempic®, Wegovy®, and Rybelsus® have similar safety profiles.[6-8] However, there are differences between them.[6-8] They are administered differently, prescribed at different dosages, and cause varying levels of weight loss.[6-8] Ozempic® and Wegovy® are once-weekly injections, while Rybelsus® is a daily pill.[6-8]

During a pivotal clinical trial for Wegovy®, patients with T2D who were overweight or had obesity lost, on average, 6.2% of their body weight.[8] GLP-1s are often prescribed in combination with other diabetic medications, which can affect the amount of weight you will lose.[1] Semaglutide medications can also cause gastrointestinal side effects and can increase your risk of thyroid C-cell tumors, pancreatitis, and low blood sugar.[6-8]

Other Diabetic Drugs

There are many diabetic drugs available that cause weight loss, and not all of them are covered in this article. Other diabetic drugs that may cause weight loss for individuals with T2D are sodium-glucose cotransporter-2 (SGLT2) inhibitors, dual glucagon-like peptide 1/glucose–dependent insulinotropic polypeptide receptor agonists, and amylin mimetics.[1,2] Consult your healthcare provider for additional information.

What is The Best Diabetes Medication for Weight Loss?

Now that you know more about diabetic drugs that cause weight loss, the question becomes which one is the best for you. Your healthcare provider can help you determine your best option, track your progress, and adjust your medications as needed. Many factors affect weight loss, and an individualized care plan is the best weight management approach.

Get Your Weight Down to a Science

The Weight Care+ program via Everlywell is an online weight management program designed to give you the tools you need to manage your weight. The program provides virtual care visits with a licensed nurse practitioner who will determine which tests, lifestyle changes, and medications you may need. The Weight Care+ program gives you the right tools to monitor your type 2 diabetes and weight.

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References

  1. Barlow B. Management of obesity in patients with diabetes. U.S. Pharmacist. Published November 19, 2021. Accessed June 13, 2023. URL.
  2. ElSayed NA, Aleppo G, Aroda VR, et al. 8. Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of care in diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S128-S139. doi:10.2337/dc23-S008. URL.
  3. Vitamin B12. National Institutes of Health. Accessed June 15, 2023. URL.
  4. Saxenda® Prescribing Information. Novo Nordisk. Accessed June 15, 2023. URL.
  5. Horn DB, Almandoz JP, Look M. What is clinically relevant weight loss for your patients and how can it be achieved? A narrative review. Postgraduate Medicine. 2022;134(4):359-375. doi:10.1080/00325481.2022.2051366. URL.
  6. Ozempic® Prescribing Information. Novo Nordisk. Accessed June 15, 2023. URL.
  7. Rybelsus® Prescribing Information. Novo Nordisk. Accessed June 15, 2023. URL.
  8. Wegovy® Prescribing Information. Novo Nordisk. Accessed June 15, 2023. URL.
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