As obesity rates continue to climb globally, more people are seeking effective medicines to aid with weight loss. Although Ozempic has recently become a household name for weight loss, it is important to note that it is not officially approved for this purpose. Fortunately, there are several viable alternatives to Ozempic available in Germany.

Among them are Wegovy and Mysimba, each offering a different approach to achieving weight loss. If you’re curious about how these two medicines compare to one another, you’ve come to the right place. In this article, we will explore the mechanisms of action, effectiveness, potential side effects, and costs associated with Wegovy and Mysimba. This will help you and your doctor make an informed decision about which option may be better for you.

What are Wegovy and Mysimba?

Both Wegovy and Mysimba are prescription medicines used for weight management, but they work in very different ways.

• Wegovy (semaglutide) is a GLP-1 receptor agonist. It was originally developed for diabetes treatment but is now approved for weight loss. It works by mimicking a natural hormone that helps regulate appetite and food intake. Overall, Wegovy focuses on appetite suppression and metabolic regulation.
• Mysimba (naltrexone/bupropion) is a combination medicine that targets brain areas that control hunger signals and feelings of fullness. It helps reduce emotional eating and control food cravings.

Both medicines are intended for people with obesity (BMI ≥ 30) or those who are overweight (BMI ≥ 27) with weight-related health conditions like type 2 diabetes or high blood pressure ^1,2.

Mysimba vs Wegovy: How are they administered?

One notable difference between Wegovy and Mysimba is the way they are administered.

Similar to Ozempic, Wegovy is a once-weekly injection. Mysimba, on the other hand, is a tablet, taken orally. This makes it a good option for patients who dislike needles.

Is Wegovy or Mysimba more effective for weight loss?

According to the available clinical trial results, this is how effective Wegovy and Mysimba are:

Wegovy clinical trial results

In the STEP-1 trial, patients took either Wegovy or placebo along with lifestyle interventions. The reported results were:

• Patients taking Wegovy lost on average 14.9% of their body weight over 68 weeks, compared to 2.4% in the placebo group;
• 50.5% of Wegovy patients lost >15% of their body weight, compared to 5% of the placebo group ³.

Mysimba clinical trial results

Across four main studies, Mysimba was compared to placebo – both alongside lifestyle interventions. The key outcomes were:

• Patients taking Mysimba lost an average of 8.1% of their body weight. In the placebo group, the result was 4.9%;
• 30% of Mysimba patients lost >10% of their body weight ⁴.

Based on these results, Wegovy appears to be a more effective option for significant weight loss. Mysimba can be a good alternative in case Wegovy is not suitable for you, or if your goal is to control food cravings and emotional eating.

Wegovy vs Mysimba: Side effects

Like all medicines, Wegovy and Mysimba have potential side effects. Here’s a brief overview of how they compare.

Wegovy side effects

• Most common: Nausea, vomiting, diarrhea, constipation, stomach pain, fatigue.
• Serious: Increased risk of thyroid tumors (based on animal studies), pancreatitis, acute gallbladder disease, acute kidney injury, hypoglycemia, serious hypersensitivity reactions, diabetic retinopathy complacations in patients with type 2 diabetes, heart rate increase, and suicidal behavior.
• Not recommended for: People with a personal or family history of medullary thyroid cancer, as well as anyone who has had an allergic reaction to semaglutide or a similar medicine in the past ¹.

Mysimba side effects

• Most common: Nausea, constipation, vomiting, dizziness, dry mouth.
• Serious: Increased risk of seizures (especially in people with a history of epilepsy), risk of depression and suicidal thoughts, allergic reactions, severe cutaneous adverse reactions, raised blood pressure, cardiovascular disease, Brugada syndrome, liver and renal impairment, serotonin syndrome.
• Not recommended for: Individuals with significantly compromised kidney or liver functions, those suffering from uncontrolled hypertension, those with a history of seizures, plus patients dealing with certain psychological disorders, brain tumors, substance withdrawal, or currently on opioid medications ².

It’s clear that both medicines have side effects. While some can be quite serious, they are rare for both medicines. Your doctor will best be able to determine if Wegovy or Mysimba are an option for you, based on your medical history and current condition.

Wegovy vs Mysimba: How much do they cost?

The price of weight loss medicines can be an important factor in choosing between Wegovy and Mysimba (if they are recommended by your doctor). Here is a quick comparison of the (approximate) costs of either medicine per month, and its availability in Germany.

Which is better for you – Wegovy or Mysimba?

The only person who can answer this question is your doctor. However, to help you have a conversation with them, here’s a summary of who each medicine may be more suitable for.

• Wegovy may be more suitable if:

  • You need significant weight loss (10-15% of body weight).
  • You don’t mind taking weekly injections.
  • Your obesity is related to a metabolic disorder.
  • You have no history of medullary thyroid cancer.

• Mysimba may be more suitable if:

  • You struggle with food cravings and emotional eating.
  • You prefer oral tablets instead of injections.
  • You have no history of seizures, high blood pressure, or mood disorders.
  • You want a more affordable option.

How to get the weight loss medicine you need

If your doctor prescribes Wegovy for your weight loss, you can find it in Germany.

Mysimba is currently not available in Germany.