Rhiannon Ingle
The pharmaceutical industry has seen a whole load of major changes in the past few years when it comes to the weight loss drug industry.
And one of the latest updates came yesterday (22 December), when the Food and Drug Administration (FDA) announced it had approved a pill version of Wegovy. Such an update could totally transform how these drugs are administered.
Firstly, it's important to note that Novo Nordisk, the manufacturer behind Ozempic and Wegovy, has highlighted that Ozempic is primarily meant for adults with type 2 diabetes, rather than those looking to lose weight. Wegovy and Mounjaro (the brand name for tirzepatide from Eli Lilly) can be prescribed by the NHS for weight loss.
The current version of many popular weight loss drugs, including Wegovy, requires regular injection, typically administered weekly, but the new version is a once-daily pill that can be taken orally, with no food or drink restrictions.
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The Wegovy pill is the very first oral version of a GLP-1 drug that has been brought to market for weight loss. With a second, from Eli Lilly, also expected to be approved in the coming months.
"This is a meaningful step forward in the field," said Dr Christopher McGowan, a gastroenterologist who runs a weight loss clinic in Cary, North Carolina. "It won’t replace injectables, but it broadens our tool kit in an important way."
"Pills are familiar, nonintimidating and fit more naturally into most people’s routines," McGowan added. "For many patients, a pill isn’t just easier, it’s psychologically more acceptable."
The pharmaceutical company is yet to release the price for the pill, which must be taken daily, but it is expected to be cheaper than the weekly injections.
Last month, Novo Nordisk struck a deal with the Trump administration to sell the lowest dose of the pill for $149 a month for people who pay out of pocket, in exchange for tariff relief.
Similar to the injections, the pill will come in several doses, with patients typically starting at the lowest dose before gradually increasing over several weeks to adjust to any side effects.
Results from a Phase 3 trial published in the New England Journal of Medicine showed that participants taking the highest dose of the Wegovy pill lost an average of 16.6% of their body weight over 64 weeks, compared with 2.2% in the placebo group.
That aligns closely with the injectable Wegovy, which produced about 15% weight reduction after 68 weeks.
Dr Shauna Levy, medical director of the Tulane Weight Loss Center, noted that sticking with the pill routine may be the toughest part, as it must be taken first thing in the morning, on an empty stomach, with no more than 4 ounces of water.
Those in the trial who drifted from the schedule lost less weight, averaging 13.6%.
Questions remain about everyday use, with McGowan calling it a matter of 'real-world performance', adding: "Will patients tolerate the daily dosing and strict timing? Will they stay on long enough to see meaningful results? We don’t know yet."
Side effects of the pill version may feel 'more intense' than the GLP-1 injections because, as McGowan put it, the medication hits the stomach at once and can spark stronger nausea.
"The challenges we see with injectable GLP-1s don’t magically disappear with a tablet," he said.
Weight loss outcomes were broadly similar to the injection, though Levy noted that, in general, oral GLP-1 medicines tend to produce less weight reduction than the newer injectable options.
Novo Nordisk expects the Wegovy pill to be available widely in January, according to a company spokesperson.