Rybelsus for Weight Loss in the UK – is it Safe or Not?

Rybelsus tablets are a prescription medication for type 2 diabetics that help to manage blood sugar (glucose) levels. Rybelsus comes in the form of oral tablets that are taken every day, and is usually prescribed alongside beneficial lifestyle changes, such as dieting and exercise.

Rybelsus tablets contain the active ingredient semaglutide. Studies have also shown that Rybelsus can have a positive effect on weight loss, as semaglutide also affects the parts of your brain that control and regulate hunger and appetite.

Is Rybelsus available in the UK?

Yes, Rybelsus tablets are available in the UK, but are only approved as a treatment for type 2 diabetes. You can get Rybelsus online from licensed online pharmacies or on the NHS. Rybelsus and weight loss have been linked but there are more suitable approved weight loss treatments. There are some private services which can provide an off-label prescription, but ZAVA does not do this.

Rybelsus pills treat type 2 diabetes by increasing the amount of insulin your body produces. Insulin is a hormone which converts sugar into energy. Rybelsus also reduces the overall amount of sugar that can get into your bloodstream, which lowers your blood sugar levels. This makes it easier for a diabetic to manage high blood sugar when changes in diet haven’t helped enough.

Rybelsus (semaglutide) works for weight loss by slowing down how long it takes for your stomach to empty after eating a meal, so you feel fuller for longer. It also works as an appetite suppressant, which helps you lose weight by reducing how much food you need to eat.

Rybelsus pills contain the active ingredient semaglutide, which is a type of medication known as a glucagon-like peptide 1 (GLP-1) receptor agonist. GLP-1 is a naturally occurring hormone that helps your body manage your blood sugar levels and is released after you’ve eaten, and semaglutide mimics this hormone.

When you take Rybelsus tablets, it will increase the amount of insulin that is produced in your pancreas. Insulin converts glucose into energy, so less sugar is absorbed into your blood. It also reduces the amount of glucose produced in your liver, so there is less sugar to be absorbed into your blood.

Another effect of Rybelsus is that it affects an area in the brain which is responsible for your appetite. It does this by activating GLP-1 receptors in your body, which then send signals to your brain that you’ve eaten. This slows the movement of food through your small intestine, which makes you feel more full and satisfied for longer, making it easier to reduce your calorie intake and snack less.

Pros and cons of Rybelsus

Pros of Rybelsus tablets:

• Taken orally, which can be more convenient for some people than injectable weight loss treatments like Wegovy or Mounjaro
• Helps to manage blood sugar levels
• Can help with weight loss
• Can improve cardiovascular health

Cons of Rybelsus tablets:

• Is less effective than injectable medications for type 2 diabetes and weight loss
• Must be taken every day, while some other type 2 diabetes and weight loss medications only need taken once a week
• Comes as an oral tablet, so may not be preferred if you don’t like swallowing tablets

Rybelsus uses include:

• regulating and managing blood sugar levels in type 2 diabetic patients
• weight loss, although this is an off-label use and it’s not approved for weight loss in the UK

Diabetes

Rybelsus is used to help patients with type 2 diabetes to control their blood sugar levels, alongside beneficial lifestyle changes such as exercise and dieting.

Rybelsus and weight loss are still under discussion, with some private healthcare services offering it as an off-label treatment. Rybelsus for weight loss is not currently licensed in the UK. We do not recommend getting Rybelsus off-label for weight loss, as this has been causing a shortage of diabetes treatments. There are also a number of approved and regulated weight loss treatments that are more effective and can be prescribed solely for weight loss.

Rybelsus is not recommended for weight loss as it’s not approved and licenced in the UK. It can help you to lose weight if you have type 2 diabetes but this is a side effect of the medication, as it’s used to regulate blood sugar. The active ingredient, semaglutide, is used in other treatments made specifically for weight loss such as Wegovy.

How effective is Rybelsus for weight loss?

A 2021 study comparing the effectiveness of injected and oral semaglutide found that oral semaglutide reduced body weight by 3.7kg, while patients on a placebo only lost 1.4kg after 26 weeks. Those taking injected semaglutide lost 4.5kg. This shows that while Rybelsus for weight loss is effective, injectable semaglutide medications such as Wegovy are a more effective option.

There are ongoing studies into the effectiveness of higher dose oral semaglutide. The manufacturer of Rybelsus is testing a higher dosage version, which they say have comparable results to injected weight loss treatments.

Is Rybelsus approved for weight loss in the UK?

No, Rybelsus for weight loss is not approved in the UK. A doctor can still prescribe it as an off-label use of the medication though. However, there are other comparable medications created specifically for weight loss that may be better options.

Rybelsus tablets are taken once per day, at the same time every day. You should swallow the tablet whole with some water. After taking Rybelsus you should avoid eating, drinking, or taking any other oral medications for 30 minutes. It is recommended that you take Rybelsus on an empty stomach, preferably in the morning before you have eaten any food.

Is Rybelsus safe to take long term?

Yes, Rybelsus tablets are designed to be taken as a long term treatment, and are generally well tolerated by most people who take it. It is made to help patients with type 2 diabetes manage their blood sugar levels for years. While there are some risks associated with taking Rybelsus long-term, they are no worse or more likely than other medications.

What Rybelsus dosages are available?

Rybelsus is currently available at dosages of 3 mg, 7 mg, and 14 mg tablets. When taking Rybelsus, you will slowly increase your dosage over the course of your treatment. You should only ever increase your dosage with the guidance of a doctor.

Like with all medications, Rybelsus comes with the risk of side effects. This medication is usually well tolerated, which means that side effects are usually mild and go away in a few weeks as your body gets used to the medication.

Common side effects of Rybelsus include:

• Gastrointestinal issues such as stomach pain, diarrhoea, heartburn, and feeling bloated
• Feeling and being sick
• Flu-like symptoms
• Low energy or tiredness
• Feeling dizzy

What are the long term side effects of Rybelsus?

The only long term side effect of Rybelsus is an increased risk of diabetic retinopathy complications. Diabetic retinopathy affects a part in the back of your eye called your retina. If you have diabetic retinopathy, your doctor may suggest an alternative treatment or regular check-ups. This wouldn't apply if you’re taking Rybesus for weight loss and don’t have diabetes.

While Rybelsus is a safe medication that is reported to be well tolerated by most people, it is not suitable for everyone. Rybelsus may not be suitable for people with certain health conditions, or are on certain medications. You should not take Rybelsus if you have:

• inflammation of the pancreas (pancreatitis) or a history of pancreas problems
• type-1 diabetes
• severe stomach or intestinal problems
• an allergy to any of the ingredients in Rybelsus

What should you avoid eating on Rybelsus?

When taking Rybelsus for weight loss or type 2 diabetes, you want to avoid foods that are high in sugar and trans fats. These foods can counteract the benefits of the medication, or make gastrointestinal side effects worse. Rybelsus foods to avoid include:

• Foods high in refined sugars, such as cakes, sweets, and soft drinks
• High fat processed foods, such as sausages, pies, and crisps
• Dairy products, such as high-fat cheese, full-fat milk, and butter
• Fattier cuts of meat like steak, bacon, and pork belly

Rybelsus pills can interact with some medications, which can make it less effective or even have harmful side effects. Make sure you speak to your doctor if you are taking any of the following:

• Asthma medications, such as Albuterol
• Diuretics
• Sulfonylureas
• Insulin
• Medications for underactive thyroid

Rybelsus is a safe medication, but it might not be right for you. There are a number of other medications similar to Rybelsus that can be used to treat type 2 diabetes and help with weight loss. These also contain a GLP-1 receptor agonist.

What is the best alternative to Rybelsus for weight loss?

As Rybelsus for weight loss is not an approved weight loss treatment, a better alternative would be a medication created specifically to treat weight loss:

• Wegovy also contains semaglutide and is injected once-weekly. It works on the parts of your brain that control hunger levels, making you feel fuller for longer. It’s an approved and regulated weight loss treatment that can be prescribed by ZAVA Online Doctor.
• Mounjaro is an injectable weight loss pen that is taken once-weekly. It contains tirzepatide, which is a GLP-1 agonist like semaglutide. It’s also a glucose-dependent insulinotropic polypeptide (GIP) which can enhance the effects of GLP-1.
• Saxenda is a weight loss injection that contains liraglutide, another GLP-1 receptor agonist. It works in the exact same way as Wegovy. Saxenda is currently long-term out of stock but you can switch to Wegovy or Mounjaro, which only needs to be taken once a week, rather than everyday.
• Mysimba is another alternative that may be better suited for those who are uncomfortable with injections. Mysimba is a weight loss tablet that works slightly differently to Rybelsus and Saxenda, but has the same effect of reducing your appetite.
• Orlistat is a weight loss tablet that works differently to Rybelsus and Mysimba. Instead of reducing your appetite, orlistat works by reducing the amount of fat your body absorbs from food, and passes it on as waste through your stools. You can also find orlistat under the branded name Xenical.
• alli is an over the counter version of orlistat with a lower dose, but does not require a prescription. Your pharmacist or doctor will still need to ask you a few questions first, to make sure it’s a safe and suitable treatment option for you.

Rybelsus alternatives for treating type 2 diabetes include:

• Ozempic - A self-injectable treatment which contains a GLP-1 receptor agonist called semaglutide (also found in Wegovy weight loss injections). Ozempic is a long-acting medication taken once a week that improves how your body uses insulin and glucagon (hormones involved with controlling blood sugar levels). It’s usually given when other diabetes treatments, such as Metformin, aren’t enough to manage blood sugar levels.
• Metformin - Metformin contains metformin, comes in the form of an oral tablet, and improves how your body handles insulin. There are different dosages and types of Metformin and your doctor can change your dose if you need it. It doesn’t cause weight gain unlike some other type 2 diabetes treatments.

In conclusion, while Rybelsus is a safe and effective medication that is shown to cause weight loss in patients who take it, it would be better to take medications that are made specifically for treating weight loss. Medications such as Wegovy, Mounjaro, Mysimba, and orlistat may be more effective options for you.

NICE (BNF) (2024). Semaglutide: https://bnf.nice.org.uk/drugs/semaglutide/, retrieved 01/02/2024

EMC (2024). Rybelsus 3 mg: https://www.medicines.org.uk/emc/product/11507/pil#about-medicine, retrieved 01/02/2024

EMC (2023). Wegovy 0.25 mg, FlexTouch solution for injection in pre-filled pen: https://www.medicines.org.uk/emc/product/13799/smpc#gref, retrieved 01/02/2024

NHS (2022). Metformin: https://www.nhs.uk/medicines/metformin/, retrieved 01/02/2024

NHS (2023). Obesity treatment: https://www.nhs.uk/conditions/obesity/treatment/, retrieved 01/02/2024

Pubmed (2021). Efficacy of Semaglutide in a Subcutaneous and an Oral Formulation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269445/, retrieved 01/02/2024