The U.S. Food and Drug Administration (FDA) has approved a pill version of the widely acclaimed weight-loss medication Wegovy, marking the first daily oral treatment for obesity. This development gives drug manufacturer Novo Nordisk a competitive advantage over Eli Lilly, whose oral drug, orforglipron, is still undergoing review.
Both Wegovy and orforglipron belong to the GLP-1 class of medications, which mimic a natural hormone in the body that regulates appetite and feelings of fullness. In recent years, the injectable forms of Wegovy and Lilly’s Zepbound have transformed the landscape of obesity treatment in the U.S. and globally, addressing a chronic disease that affects around 100 million Americans.
According to company representatives, the Wegovy pills are expected to be available in a matter of weeks. The introduction of oral options for obesity treatment may broaden access and lower costs, potentially expanding the growing market for such medications.
Approximately 1 in 8 Americans have reported using injectable GLP-1 medications, although affordability remains a significant barrier for many. Dr. Fatima Cody Stanford, an obesity specialist at Massachusetts General Hospital, emphasized that having a choice between different forms of medication is essential for patient care, pointing out that there is a population that can greatly benefit from pill options.
The newly approved Wegovy pills contain 25 milligrams of semaglutide, the same active ingredient found in the injectable forms of Wegovy and Ozempic, as well as in Rybelsus, a diabetic treatment approved in 2019. In clinical trials, those taking the oral version of Wegovy experienced an average weight loss of 13.6% over about 15 months, compared to a mere 2.2% loss in participants taking a placebo. This result is similar to the average weight loss achieved with injectable Wegovy, which is approximately 15%.
Chris Mertens, a 35-year-old pediatric lung doctor from Menomonee Falls, Wisconsin, participated in a Novo Nordisk trial in 2022 and reportedly lost around 40 pounds using the Wegovy pill. He noted that the medication effectively reduced his appetite and intrusive thoughts about food, allowing him to sometimes skip meals without even realizing it.
In contrast, the participants in a clinical trial for Lilly’s orforglipron, specifically those taking the highest dose, experienced an average weight loss of 11.2% over nearly 17 months—again, compared to a 2.1% loss for those on a placebo. While both the oral Wegovy and orforglipron demonstrated less weight loss compared to Lilly’s injectable Zepbound, which targets both GLP-1 and GIP hormones yielding a 21% average weight loss, they each carry typical side effects, including nausea and diarrhea.
Convenience is one of the advantages the daily pills provide, although Wegovy requires taking the medication with a sip of water each morning on an empty stomach, followed by a 30-minute wait before eating or drinking. This design stems from the need to ensure the drug is absorbed by the bloodstream without being broken down in the stomach. Lilly’s orforglipron, by comparison, does not have such dosing restrictions and is currently under consideration for expedited approval via the FDA’s new priority voucher program, with a decision anticipated by spring.
Manufacturing pills is generally less expensive than injectable drugs, which may mean that the costs for these new oral treatments could be lower. Earlier in the year, the Trump administration announced that it had collaborated with drug companies to negotiate reduced prices for GLP-1 drugs, often priced above $1,000 per month. The starting monthly cost for the Wegovy pill will be $149 from selected providers, with more detailed pricing information expected in January.
It remains uncertain whether patients will prefer the daily pills over weekly injections. While many may prefer to avoid needles, some individuals do not mind the weekly injections. Mertens, for instance, opted for injectable Zepbound after regaining weight following the Wegovy trial, stating that he appreciated the daily routine provided by the oral medication.
Dr. Angela Fitch, an obesity expert and chief medical officer at a health care company known as knownwell, expressed that regardless of the format, the primary advantage will be in making weight-loss medications more accessible and affordable. The focus, she asserts, should be on providing effective medications at more reasonable prices to benefit larger populations.
