Losing weight has officially become more convenient. The popular GLP-1 obesity treatment Wegovy is now available as a once-daily pill.
On Monday evening, the Food and Drug Administration approved Novo Nordisk’s high-dose oral formulation of semaglutide for obesity. In clinical trials, people taking the pill lost substantially more weight than those taking a placebo. The drug is expected to be available to the public early next year.
The Wegovy pill
Semaglutide and similar drugs mimic the GLP-1 hormone, which helps regulate our appetite and metabolism, among other things. It’s the active ingredient in Novo Nordisk’s obesity medication Wegovy as well as its diabetes drug Ozempic.
Both Wegovy and Ozempic are taken weekly via a subcutaneous injection, though the former can be prescribed at a higher maximum dose. In 2019, the FDA approved Rybelsus, a semaglutide-based pill, but only for treating diabetes. This newest approval is the first given to a GLP-1 oral drug explicitly for treating obesity. The newly approved pill—which will maintain the Wegovy branding—is also approved for a higher maximum dosage of semaglutide (25 milligrams) than Rybelsus (14 milligrams).
In the pivotal OASIS-4 trial, people taking the Wegovy pill lost an average of 13.6% of their baseline weight over 64 weeks, compared to an average of 2.2% weight loss seen in the placebo group. These numbers are in line with the clinical trial results seen with injectable Wegovy. About a third of participants in the treatment group lost 20% or more of their weight. The adverse effects linked to the pill also appear to be comparable to the original Wegovy. Most were gastrointestinal, such as nausea, and were generally mild to moderate in severity.
“With today’s approval of the Wegovy pill, patients will have a convenient, once-daily pill that can help them lose as much weight as the original Wegovy injection,” said Mike Doustdar, president and CEO of Novo Nordisk, in a statement from the company.
The future of obesity treatment
The Wegovy pill’s approval should start an intriguing arms race over the next generation of obesity treatments.
Early next year, for instance, the FDA will decide whether to approve Eli Lilly’s experimental GLP-1 pill, orforglipron. Though the weight loss results seen with orforglipron are below that of the Wegovy pill, some research has suggested the latter could become a reliable maintenance treatment for people who have already lost weight with a more effective GLP-1 drug.
In 2026, the FDA will also decide on approval for Novo Nordisk’s combination treatment CagriSema, which mixes semaglutide with cagrilintide, a mimic of the hunger-related hormone amylin, for a more potent weight loss effect. And by late 2026 or 2027, the FDA will evaluate Eli Lilly’s triple-agonist retatrutide, a drug that has provided the largest weight loss results in trials seen with any medication to date. There are still many other candidates in the pipeline, some of which might offer their own advantages, such as fewer side effects.
As interesting as all this innovation is, it won’t necessarily come cheap. These GLP-1 drugs have historically cost a pretty penny (Wegovy was originally priced at over $1,000 a month without insurance). The drug makers have begun to lower prices, and in Canada, a generic version of semaglutide will be available early next year. But whether costs will shrink enough to make these drugs readily affordable to anyone who benefits from them remains to be seen.