The popular weight-management drug Wegovy is now available in pill form after receiving FDA approval, expanding access to a medication that has already proven effective in helping adults manage obesity and related health issues. While previously only available as a weekly injection, the new oral semaglutide formulation offers an alternative delivery method for patients seeking weight loss assistance.
How the Pill Works Differently
Both the Wegovy pill and the injection contain semaglutide, a GLP-1 receptor agonist that mimics a natural hormone to control appetite and blood sugar. However, the way the drug enters the bloodstream differs significantly.
- Injection: Absorbed directly into the blood under the skin.
- Pill: Must pass through the stomach and intestines, where some active ingredient is broken down before absorption.
Because of this digestive process, the pill requires a much higher dose (25mg) compared to the injection (2.4mg) to achieve comparable effects. Patients must take the pill on an empty stomach with water, waiting at least 30 minutes before eating or taking other medications to maximize absorption.
Weight Loss Results: Comparable Efficacy
Clinical trials show that both the pill and the injection lead to similar weight loss when taken as directed.
- Injectable Semaglutide (STEP-1 Trial): Participants lost an average of 14.4% of body weight.
- Oral Semaglutide (OASIS 4 Trial): Participants lost an average of 13.9% of body weight.
These results suggest that the pill and the injection offer comparable efficacy for weight management, though long-term head-to-head trials are still needed.
Safety and Side Effects
Both formulations of Wegovy share similar side effects, primarily gastrointestinal issues like nausea, diarrhea, vomiting, and constipation. Approximately three-quarters of users experience these symptoms, but only a small percentage (7–10%) discontinue use due to them. Real-world data suggests slightly higher discontinuation rates, potentially due to combined effects of side effects and medication cost.
Who Benefits Most?
The choice between pill and injection depends on individual preferences and circumstances.
- Pill Advantage: Suitable for patients averse to injections or lacking reliable refrigeration. It can be stored at room temperature, making it convenient for travelers.
- Injection Advantage: Offers greater flexibility in administration (no fasting required) and may be preferred by those who struggle with strict daily pill schedules.
Cost and insurance coverage can also influence the decision. The pill may be more affordable for those without comprehensive insurance, though out-of-pocket expenses vary.
In conclusion, the FDA approval of the Wegovy pill expands treatment options for obesity and related conditions. While the pill requires a higher dose and strict administration guidelines, it delivers comparable weight loss results to the injection and offers convenience for certain patients.
