Rybelsus: losing weight with a pill? The facts about Ozempic pills

Rybelsus or Ozempic: pill or injection?

Rybelsus and Ozempic contain the same active substance; the difference lies in how it is taken. A daily tablet versus a weekly injection. What suits you best depends mainly on your goal and on what you can realistically keep up.

The tablet requires discipline. You take it in the morning on an empty stomach with no more than half a glass of water, and then wait at least 30 minutes before eating, drinking or taking other medicines. If you do not stick to this, your body barely absorbs the substance and the medicine simply does not work well. With a peptide like semaglutide, absorption through the stomach wall is the big challenge. More about the Ozempic diet.

For many people, the injection is therefore easier to keep up: one fixed moment a week, no daily rules around breakfast. The injection doses are also better suited to weight loss. That is why medical weight loss programmes in the Netherlands, such as medical weight loss with injections, almost always use the weekly injection in practice.

Losing weight with Rybelsus: what can you expect?

The reality: at the doses available in the Netherlands, up to 14 mg, weight loss with Rybelsus usually remains modest. Those doses are designed to regulate blood sugar in type 2 diabetes, not to treat obesity.

The research into weight loss with semaglutide tablets therefore used much higher doses. In the OASIS 1 trial, published in The Lancet, adults with overweight or obesity without diabetes who took a daily 50 mg tablet lost an average of 15.1% of their body weight in 68 weeks, compared with 2.4% in the placebo group. Of the participants, 69% lost more than a tenth of their weight. In the follow-up study OASIS 4, the basis for the new 25 mg Wegovy tablet, the average was 16.6% after 64 weeks: comparable to the weekly injections.

Do not expect a nosedive on the scales. The dose is built up step by step to limit side effects, and the effect grows over months. What users usually notice first, after about four weeks, is that the constant feeling of hunger disappears.

We recognise this in our own programmes: the battle against cravings disappears, and that is precisely what suddenly makes eating less sustainable. Do stay realistic about the role of medication. It is an aid that temporarily makes your biology work with you; what you eat and how much you move determine whether the result lasts. Stopping is part of the conversation too: without an adjusted lifestyle, the weight often comes back after stopping.

Is the Ozempic pill available in the Netherlands?

Yes and no. Rybelsus is available at pharmacies in the Netherlands, but only on prescription and officially only for type 2 diabetes. The semaglutide tablet that is specifically intended for weight loss, the 25 mg Wegovy tablet, was approved in the European Union on 15 July 2026 as the first GLP-1 tablet for weight management, following a positive opinion from the European Medicines Agency. In the United States that pill has been on the shelves since January 2026; it is not yet available at Dutch pharmacies.

Until then: a doctor can prescribe semaglutide for obesity, but only after a careful medical assessment of your health, the medicines you use and your medical history.

What you should never do is order from web shops that offer "Ozempic pills" without a prescription. That trade is illegal, and the Dutch Health and Youth Care Inspectorate and pharmacists have long warned about counterfeits: the wrong dose, the wrong substance or no active substance at all. You then literally do not know what you are swallowing, and if you have complaints, nobody is keeping an eye on you.

Tried everything and still not losing weight? At Qlinic, your own BIG-registered doctor (the BIG register is the Dutch register of healthcare professionals) personally supports you with medical weight loss, with home delivery via a registered pharmacy. Take the eligibility check →

Rybelsus price and insurance cover in the Netherlands

The price of Rybelsus depends on the dose and differs per pharmacy. If you use the pill to lose weight, you pay the full price yourself. You can find the current pharmacy price per dose on medicijnkosten.nl from Zorginstituut Nederland (the Dutch National Health Care Institute), or ask your own pharmacy.

The rule for reimbursement is simple: for overweight without diabetes, Rybelsus is not covered by basic health insurance (basisverzekering). You can read exactly how this works for other weight loss medication, and which conditions you then have to meet, in our article on weight loss medication covered by insurance.

If you choose a supervised medical weight loss programme, you pay for the whole package rather than for separate boxes. At Qlinic, a programme with semaglutide (Ozempic) costs €250 per month, or €699 per three months, plus a one-off supervision fee of €400. Everything is included: the medication, home delivery and personal follow-up by our doctor every four weeks. A programme with tirzepatide (Mounjaro) costs €350 per month or €999 per three months. All current rates can be found under the cost of medical weight loss.

Side effects and downsides of Rybelsus

The most common side effects of Rybelsus are nausea, diarrhoea, constipation and abdominal pain; headaches and tiredness also occur. They mainly occur in the first weeks and after a dose increase, and disappear for most people within about four weeks. In the OASIS 1 trial, 80% of participants had stomach and bowel complaints, mostly mild to moderate. Rare but serious side effects, such as inflammation of the pancreas or gallstones, are another reason never to start without a doctor.

The pill form also has a few practical downsides:

• Daily discipline: taking it every morning on an empty stomach, with a sip of water, and waiting 30 minutes before eating and drinking.
• Variable absorption: if you take the tablet slightly differently, it works considerably less well.
• Risk of mix-ups: since early 2026 there have been new Rybelsus tablets with better absorption, in strengths of 1.5, 4 and 9 mg, which temporarily exist alongside the old strengths. This creates a risk of incorrect use and overdose, warns the College ter Beoordeling van Geneesmiddelen (CBG, the Dutch Medicines Evaluation Board).

Good supervision largely deals with this. With us, you can contact the doctor about side effects, and every four weeks the doctor assesses whether your dose is still right or whether things need to slow down. You can always pause or stop completely, in consultation.

Who is Rybelsus suitable for?

Semaglutide for weight loss is intended for adults with obesity, meaning a BMI of 30 or higher, or with overweight from a BMI of 27 combined with a weight-related condition such as high blood pressure, type 2 diabetes or unfavourable cholesterol. Not sure where you stand? Calculate your BMI in half a minute.

At least as important as that number is your medical history. Medication is intended for people who keep failing to lose weight on their own: you have lost weight and bounced back, you eat sensibly and exercise, and still nothing changes. Do you recognise this, for example because you are going through menopause and your body seems to behave differently from ten years ago? Then there is often more going on than a lack of willpower. We previously wrote in detail about why you are not losing weight.

Not everyone is eligible. With certain conditions, during pregnancy or breastfeeding and in combination with some medicines, semaglutide is not suitable. Whether it suits you, and if so in which form, is therefore always assessed by a doctor.

Starting safely with medical supervision

The only safe route to semaglutide is through a doctor: they assess whether the medicine suits you and write the prescription, after which a registered pharmacy supplies it. Everything outside that route, from foreign web shops to offers on social media, is illegal and risky. In our article on how to buy Ozempic we explain that legal route step by step.

At Qlinic we have made the programme as accessible as possible, in three steps:

1. Consultation and intake: you complete the online eligibility check and then have a personal consultation with our BIG-registered doctor, who stays your doctor throughout.
2. Prescription and home delivery: if medication is right for you, the doctor arranges the prescription and you receive the medication at home via a registered Dutch pharmacy.
3. Losing weight with follow-up: every four weeks you discuss your progress, side effects and dose with that same doctor, one to one.

Small-scale and personal, then: no anonymous call centre and no changing faces. You keep the same doctor throughout your programme, and most people notice the first effect after about four weeks: less hunger, more calm around food. We have now helped around 50 people in this way, who give us an average of 5.0 on Google.

Would you like to know whether medical weight loss is right for you? Our doctor personally assesses your application, so you quickly know where you stand, with no obligation. Take the eligibility check →

Frequently asked questions about the Ozempic pill

Can I lose weight with Ozempic pills?

Yes, you can lose weight with the tablet form of semaglutide (Rybelsus), although the effect is limited at the Dutch doses of up to 14 mg. In research with higher doses, 25 to 50 mg, participants lost an average of 15 to 16.6% of their body weight. The pill only works in combination with a healthy diet and exercise, and is only available on prescription.

How much weight do you lose after 1 month of Ozempic?

After one month, weight loss is usually still small, because you start with a low build-up dose. What you do clearly notice after about four weeks is less hunger. The actual weight loss then builds up over months; in studies, the greatest effect was only reached after more than a year. How much you lose varies greatly from person to person.

Is the Ozempic pill available?

Yes, the semaglutide tablet Rybelsus is available on prescription in the Netherlands, but only registered for type 2 diabetes. The 25 mg Wegovy weight loss tablet has been approved in the European Union since 15 July 2026 and is already on the market in the United States, but is not yet available at Dutch pharmacies.

What are the downsides of Ozempic pills?

The main downsides are stomach and bowel complaints such as nausea, diarrhoea and constipation, the strict daily intake on an empty stomach with a 30-minute wait, and the lack of reimbursement when used for weight loss. In addition, weight loss at the available doses is smaller than with the weekly injections, and the kilos often come back after stopping abruptly.

Can you buy Ozempic pills without a prescription?

No. In the Netherlands, semaglutide is only available on prescription, in any form. Suppliers selling the pills without a prescription are acting illegally and regularly supply counterfeits. If you want to use semaglutide, the safe route is always through a doctor and a registered pharmacy.

Is Rybelsus covered by insurance for overweight?

No, for overweight without diabetes Rybelsus is not covered by basic health insurance. Your health insurer only covers Rybelsus for type 2 diabetes, under conditions. If you use semaglutide to lose weight, you pay the costs yourself. Read more about whether Ozempic is covered by insurance.

What is the difference between Rybelsus and Ozempic?

Rybelsus is a daily tablet, Ozempic a weekly injection; both contain semaglutide and are registered for type 2 diabetes. You have to take Rybelsus on an empty stomach with a 30-minute wait, while the injection requires one fixed moment per week. For weight loss, the injection is usually used in practice, because the doses are higher.