Trulicity vs Ozempic: which GLP-1 drug triumphs for weight loss?

Whether by drug brand name or class of medication, it seems like everyone knows what GLP-1 receptor agonists are. It’s not surprising given the social media-fueled frenzy around medications like Ozempic® (semaglutide). While this drug has been approved by the U.S. Food and Drug Administration (FDA) to treat type 2 diabetes, that’s not why you’re hearing about it. Over the course of the last year, Ozempic, GLP-1 agonists like semaglutide have reached zeitgeist notoriety via the rumored connections to the drastic weight loss of celebrities like Mindy Kaling and Chelsea Handler. On TikTok, #ozempic has surpassed 1.2 billion views and some of the medications in this class are now on the FDA’s Drug Shortages list.

So how do other GLP-1 receptor agonists stack up against Ozempic? Let’s look at Ozempic vs. Trulicity® for weight loss.

Manufactured by US-based Eli Lilly, Trulicity, a brand name for dulaglutide, is another FDA-approved medication for the treatment of type 2 diabetes. It hasn’t gotten as much attention as Novo Nordisk’s Ozempic, but it’s also shown significant weight loss in study participants. 

But which drug is more efficacious—and ultimately, which one is right for you? We’ve narrowed it down to the most important factors: how they work, how much weight you can expect to lose, how much each medication costs and what side effects might look like. We’ll also touch on alternatives. Let’s get into it—here’s what you must know about Trulicity vs. Ozempic for weight loss.

Ozempic vs Trulicity: How do they work?

Trulicity and Ozempic are GLP-1s, or glucagon-like peptide 1 agonists. GLP-1 is a naturally occurring hormone in your body that normally is produced during meals, and it helps control appetite and regulate hunger. GLP-1 medications are synthetic versions of the same hormone and they signal your pancreas, letting it know how much insulin to produce to regulate blood sugar levels. Both Ozempic and Trulicity come in prefilled subcutaneous (under-the-skin) injectable pens.

More on Ozempic

Ozempic is the brand name for semaglutide (the same active ingredient in the FDA-approved weight-management drug Wegovy®). In December 2017, the FDA approved Ozempic for treating type 2 diabetes. Semaglutide works by lowering blood glucose levels and slowing gastric emptying, meaning it causes food to move more slowly through the digestive process so you feel fuller longer.

More on Trulicity

Similarly, Trulicity lowers blood glucose levels, controls the amount of insulin your body produces, and slows stomach (or gastric) emptying. The FDA approved Trulicity (dulaglutide) in September 2014 for treating type 2 diabetes, so it’s been on the market nearly a decade.

On top of that, Trulicity is also FDA-approved to help lower the risk of major adverse cardiovascular events (like heart attacks or stroke) in people with type 2 diabetes who have cardiovascular disease or multiple cardiovascular risk factors.

Ozempic vs Trulicity: How much weight can you lose?

Addressing behavior change is an important part of sustainable weight loss with GLP-1 medications like Ozempic and Trulicity. “In the absence of strong habits around diet, exercise, sleep and mental health, patients prescribed GLP-1s will likely see rapid weight regain if they stop taking the medication,” said Dr. Rekha Kumar, Chief Medical Officer at Found. So while these medications work, Found’s stance is that a full evaluation of a patient’s medical history, as well as biological and behavioral factors, is needed to tailor a treatment plan that is unique to their profile. 

As far as the data goes, we looked at two different clinical trials to determine how Trulicity (dulaglutide) and Ozempic (semaglutide) stack up when it comes to weight loss. A 2016 clinical trial funded by Novo Nordisk, Ozempic's manufacturer, pitted Ozempic and Trulicity in a head-to-head trial (known as SUSTAIN 7) that looked at this question. 

In the SUSTAIN 7 40-week trial, 1,201 adult patients with type 2 diabetes mellitus and an HbA1 7 or greater were given either a 0.75 mg or 1.5 mg dose of Trulicity or a 0.5 mg or 1 mg dose of Ozempic. Those given the starting doses of Ozempic showed more weight loss, losing an average of about 14 pounds compared to about 6 pounds with the 1.5 mg dose of Trulicity. Those on Ozempic lost more than twice the weight as those on Trulicity. 

However, in a randomized clinical trial published in Diabetes Care in 2021, participants with an average body mass index (BMI) of 34 were given weekly doses of dulaglutide (Trulicity) at 0.5 mg, 3 mg, or 4.5 mg. When weighed at 36 weeks, those receiving the highest weekly dosage lost an average of about 10 pounds, depending on their BMI.

The fine print here is that the recommended maximum dose of Ozempic is 2 mg, while the recommended max Trulicity dose is 4.5 mg. So the amount of weight you may lose could be nearly equal with either of the meds, depending on your dose.

How much do Ozempic and Trulicity cost?

The list prices for Trulicity and Ozempic are comparable. Trulicity runs at $930.88 per month and Ozempic at $935.77. Many insurance companies do cover some or all of the cost of these medications when prescribed for the treatment of type 2 diabetes. 

However, insurance coverage for GLP-1 receptor agonists remains challenging in recent months. When surveying our patient population, we found that insurance coverage has dropped by 50% since December 2022, with nearly 70% of insurance plans showing no coverage of the drug class for both anti-obesity or diabetes indications in June 2023. This trend is largely tied to overprescribing, supply issues, a frenzy of media coverage and unprecedented consumer demand for these medications. 

As insurance companies, employers and consumers grapple with GLP-1 access, non-GLP-1 medications continue to power medication-assisted weight loss for many. Drugs like metformin are widely available, cost effective, and don’t involve injections—and most importantly, when they’re prescribed and used appropriately, they work. It’s important to know that non-GLP-1 medications have side effects and risks, too. For example, common side effects of metformin include nausea, vomiting, diarrhea, and acid reflux. A more serious but less common side effect of metformin is lactic acidosis, which can result in death, hypothermia, hypotension, and resistant bradyarrhythmias. Studies show taking metformin long term may, in rare cases, lead to complications such as pancreatitis, hepatitis, abnormal blood clotting, abnormal vitamin B12 levels, and reactive hypoglycemia. Find detailed side effects and risk information for specific medications here.

What are the side effects of Ozempic and Trulicity?

With most GLP-1s, some side effects are pretty common. You may experience the following with Trulicity and Ozempic:

Ozempic and Wegovy side effects

Mild side effects: gastrointestinal issues, such as nausea, vomiting, diarrhea, constipation, and abdominal pain. 

Severe side effects: 

• Possible thyroid tumors, including cancer
• Low blood sugar
• Gallbladder problems
• Inflammation of your pancreas (pancreatitis)
• Serious allergic reactions
• Kidney problems (kidney failure)
• Changes in vision (diabetic retinopathy complications)

As a warning, Novo Nordisk advises not to take Ozempic or Wegovy if you or any in your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2).

Trulicity side effects

Mild side effects: nausea, diarrhea, vomiting, abdominal pain,  decreased appetite, indigestion, and fatigue.

Serious side effects: 

• Risk of thyroid tumors 
• Pancreatitis
• Hypoglycemia
• Severe allergic reactions
• Acute kidney injury
• Severe gastrointestinal problems
• Changes in vision (diabetic retinopathy complications)
• Acute gallbladder problems

Eli Lilly warns not to take Trulicity if you or any in your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2).

Ozempic vs Trulicity: Which is best?

Medication-assisted weight loss is unique to the individual. You may experience side effects with one that you may not with the other. Or you might find that neither Trulicity nor Ozempic are a good fit for your unique biology and weight loss goals. 

Our final analysis on Trulicity vs. Ozempic: depending on the dose, both drugs have similar side effect warnings and weight loss results.

No matter what you decide, your doctor will be there to help you along the way. Be cognizant that your weight-loss journey is a marathon and not a sprint; there’s no “quick fix” for sustainable weight loss. 

GLP-1*

GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.

About Found

Found is among the largest medically-supported weight care clinics in the country, serving more than 200,000 members to date. To start your journey with Found, take our quiz.