As effective as Wegovy injections? Why the new weight-loss pill could be the Key to America’s obesity crisis?

Imagine a future where combatting obesity is as simple as taking a highly effective pill. This concept has long sparked hope among the more than 40% of Americans who are classified as obese, while also drawing criticism from advocates of broader weight acceptance. However, this hope may soon become a reality.

Two recent studies have revealed promising findings about high-dose oral versions of the weight-loss medication Wegovy. These tablets demonstrate comparable efficacy to the popular injections in terms of shedding pounds and enhancing overall health. Furthermore, they appear to be effective for individuals with diabetes, a group that often struggles with weight loss.

With these encouraging results in hand, the pharmaceutical company Novo Nordisk intends to seek approval from the U.S. Food and Drug Administration for the oral pills later this year.

Dr. Daniel Bessesen, an endocrinology specialist at Denver Health who treats patients with obesity, points out that “If you ask people a random question, ‘Would you rather take a pill or an injection?’ People overwhelmingly prefer a pill.”

However, Bessesen emphasizes that the crucial factors are equal effectiveness, accessibility, and affordability of both methods.

“Those are the most important factors for people,” he adds.

While there have been previous weight-loss pills available, none have achieved the significant reductions in weight observed with injected drugs like Wegovy. Consequently, individuals struggling with obesity will be happy to have an oral alternative that is equally effective.

Novo Nordisk is already marketing Rybelsus, an oral version of semaglutide—the same medication found in the diabetes drugs Ozempic and Wegovy—that is approved for diabetes treatment. Rybelsus is available in doses of up to 14 milligrams. However, the recent trials, which adhere to the highest scientific standards, examined the effects of oral semaglutide doses as high as 25 and 50 milligrams. These trials analyzed weight reduction, improvements in blood sugar levels, and other important health indicators.

Overall, the availability of an oral weight-loss option as potent as Wegovy would revolutionize the field, bringing newfound hope to individuals combating obesity. The potential impact on public health and well-being is immense.

In a 16-month study, published in the journal Lancet, involving approximately 1,600 overweight or obese individuals already undergoing treatment for Type 2 diabetes, it was discovered that the high-dose daily pills had a more significant impact on lowering blood sugar levels compared to the standard dose of Rybelsus. Additionally, participants on the higher doses experienced weight loss ranging between 15 and 20 pounds, while those on the lower dose lost about 10 pounds, starting from a baseline weight of 212 pounds.

Another 16-month study, published in the journal Lancet, involving over 660 adults who were overweight or obese and had at least one related disease (excluding diabetes) revealed that the 50-milligram daily pill helped individuals lose an average of approximately 15% of their body weight, equivalent to around 35 pounds. In comparison, those who received a placebo lost about 6 pounds. The study authors noted that these results were notably consistent with the weight loss achieved through weekly injections of the highest dose of Wegovy.

However, there were some side effects associated with the oral semaglutide pills. Around 80% of participants across all dosage levels experienced mild to moderate intestinal issues like nausea, constipation, and diarrhea. In the obesity trial involving the 50-milligram dose, there was evidence of a higher incidence of benign tumors among individuals who took the drug compared to those who took a placebo. Furthermore, approximately 13% of participants who took the drug reported altered skin sensation, such as tingling or increased sensitivity.

Medical experts anticipate that these pills will be well-received, particularly among individuals who desire weight loss but have a fear of needles. Additionally, tablets offer greater portability than injection pens and do not require refrigeration for storage.

However, it’s important to note that the pills may not necessarily be a superior choice for the hundreds of thousands of individuals already using injectable versions such as Ozempic or Wegovy, as stated by Dr. Fatima Cody Stanford, an obesity medicine expert at Massachusetts General Hospital.

“I don’t find significant hesitancy surrounding receiving an injection,” she adds. “A lot of people like the ease of taking a medication once a week.”

Furthermore, Dr. Fatima Cody Stanford highlighted that some patients might actually prefer the shots over the new pills, considering that the pills need to be taken 30 minutes before consuming food or drinks in the morning.

Critics also raise concerns that the availability of a pill could add pressure on individuals who are obese to use it, potentially reinforcing social stigma against those who are unable or unwilling to lose weight.

Tigress Osborn, the chair of the National Association to Advance Fat Acceptance, mentioned “There is no escape from the narrative that your body is wrong and it should change.”

Nevertheless, Novo Nordisk is banking on the popularity of a higher-dose pill to address both diabetes and obesity. Sales of Rybelsus reached approximately $1.63 billion in the previous year, more than double the figure from 2021.

Other pharmaceutical companies are also working on developing oral versions of drugs that are as effective as Eli Lilly and Co.’s Mounjaro, an injectable diabetes drug expected to receive approval for weight loss in the near future. Lilly researchers have reported promising results from mid-stage trials of an oral pill called orforglipron, designed to treat obese or overweight patients with and without diabetes.

Pfizer has also shared mid-stage results for dangulgipron, an oral drug for diabetes that is taken twice daily with food.

Novo Nordisk officials stated that it is too early to determine the cost of the high-dose oral pills or how the company plans to ensure sufficient manufacturing capacity to meet the demand. Despite the increasing popularity, injectable doses of Wegovy will continue to face supply shortages until at least September, according to company officials.

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