Written and medically reviewed by W. van Donselaar, doctor, BIG 79020681301, on 16 June 2026.
Ozempic isn’t suitable for everyone. Sometimes this is due to side effects, sometimes to the indication, and sometimes to personal preference. There are several ways to lose weight under medical supervision. Other GLP-1 medications are one option, but certainly not the only one. Below, you can read about the alternatives available, when each option makes sense, and how to make the right choice together with your doctor.
Other GLP-1 agents
Within the same class as Ozempic, there are three other GLP-1 medicines available in the Netherlands for weight loss:
- Wegovy: the same active ingredient (semaglutide), but specifically authorised for obesity and used at a higher dose (2.4 mg per week).
- Mounjaro: The active ingredient, tirzepatide, acts on two hormones simultaneously (GLP-1 and GIP); in trials, it resulted in greater weight loss on average than semaglutide.
- Saxenda: active ingredient: liraglutide; administered as a daily injection rather than a weekly one; has been on the market for longer and is better known for weight loss.
Switching to another GLP-1 receptor agonist is often a logical first step if Ozempic is not effective enough or if the side effects are too severe. Tirzepatide acts on a different receptor and is tolerated differently by some people. You can read a detailed comparison in Ozempic or Mounjaro.
Non-GLP-1 medication
There are also weight-loss medicines that do not work via the GLP-1 system. In the Netherlands, there are two main ones:
Mysimba (naltrexone plus bupropion) acts on different areas of the brain to GLP-1 agents, namely those involved in reward and hunger. On average, its effect on weight is less pronounced than that of GLP-1 agents. For some people, however, it works better, particularly when binge eating or emotional eating plays a major role.
Xenical (orlistat) works in the gut and inhibits the absorption of fat from food. It is not a prescription medicine that suppresses appetite, and is prescribed less frequently than it used to be. Eating fatty foods can lead to side effects affecting bowel movements.
Both of these medicines work differently to Ozempic. Your doctor will assess whether they are suitable for you, based on your medical history, eating habits and previous experience.
Are you considering one of these treatments? With our health check, you can find out quickly and easily whether you’re eligible.
Non-pharmacological approaches
As well as medication, there are two main approaches that do not involve pills or injections.
GLI programme (Combined Lifestyle Intervention): A two-year programme offering intensive support with diet, exercise and behaviour, covered by the basic health insurance package for those with a BMI of 25 or above with additional health conditions, or 30 or above without such conditions. Your GP can refer you. For many people, this provides a solid foundation, particularly for those with a BMI in the lower range (around 27 to 30) and no further risk factors. It helps to foster behavioural changes that continue to have a positive effect even after the programme has ended.
Bariatric surgery: a surgical procedure to reduce the size of the stomach or reroute the bowel. Suitable for severe obesity (BMI of 40 or above, or 35 or above with serious comorbidities such as type 2 diabetes or heart disease) and where previous treatment programmes have proved ineffective. It is a major operation with permanent consequences, and is always carried out following a specialist pre-operative assessment.
Which route is best for which situation?
Which option is best depends on your BMI, any underlying health conditions, your history of weight loss and your personal preference. A few general guidelines can help you decide.
For a BMI of 27 to 30 with no other risk factors, a GLI programme is often a good starting point. Medication is considered if the programme proves ineffective or if there are additional health conditions. For a BMI of 30 or higher, GLP-1 medication combined with lifestyle support is usually the first course of action. For a BMI of 40 or above, or 35 with severe comorbidities, bariatric surgery is considered as an option, often alongside or following medication-based treatments.
Side effects of Ozempic can often be managed by adjusting the dose, gradually increasing the dose, or switching to another GLP-1 medication. This is usually the first step before considering a fundamentally different approach. A doctor can help you weigh up these options.
Do the check if you’d like to know which medical pathway is right for your situation and how an initial consultation with us works.
What are the most common mistakes?
Three patterns we often come across during the orientation phase:
- Assuming that all alternatives are ‘more or less the same’: Mysimba works very differently from Ozempic, and bariatric surgery is a major procedure with lasting consequences. They are not interchangeable options.
- Consider surgery straight away if medication reaches its first plateau: Often, adjusting the dose or switching to another GLP-1 medication is a better first step. Surgery is a major decision.
- Skipping the GLI programme because ‘it takes too long’: For many people, two years of free intensive support provides the most sustainable foundation, even if medication is added later on.
For product information on the GLP-1 agents we support, see the medication overview.
Key points blog
What alternatives are there to Ozempic?
What alternatives are there to Ozempic?
Three main approaches: other GLP-1 agents (Wegovy, Mounjaro, Saxenda), other non-GLP-1 medication (Mysimba is naltrexone plus bupropion, Xenical is orlistat), or non-medication approaches (GLI programme, bariatric surgery). Which option is right for you depends on your BMI, any underlying conditions and your personal preference.
Is a lifestyle programme enough instead of medication?
Is a lifestyle programme enough instead of medication?
For some people, yes. For those with a BMI of around 27 to 30 and no underlying health conditions, a GLI programme (available free of charge for two years through your GP) can be a good starting point. For those with a BMI of 30 or above, or who have reached a plateau, medication or surgery often remains an option.
When is surgery an option?
When is surgery an option?
Bariatric surgery is considered for patients with a BMI of 40 or above, or 35 or above with serious underlying conditions, and where previous treatment programmes have proved ineffective. It is a major step with long-term consequences; it should always follow a specialist assessment.