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TL;DR Rybelsus (oral semaglutide) is a GLP-1 receptor agonist that delivers stronger weight loss (12-15% of body weight) and A1C reduction (-1.8%) than metformin (3-5% weight loss, -1.5% A1C), but costs roughly $936-$998 per month compared to metformins $4-$10 generic price
The 22.8% weight loss and 81.4% liver fat reduction at this dose captures nearly all the benefit of the 12mg tier with meaningfully fewer side effects
GLP-1-based therapies such as retatrutide carry a low intrinsic risk of hypoglycaemia when used as monotherapy
The difference comes from tirzepatides dual GIP/GLP-1 mechanism versus semaglutides single GLP-1 action
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