The U.S. Food and Drug Administration (FDA) approved for the first time an obesity treatment that is not an injection: A daily pill version of Wegovy, one of the most successful weight-loss drugs in the world. This marks a significant milestone in the treatment of obesity, a chronic disease that affects millions worldwide.
The approval gives Novo Nordisk a clear advantage over competitor Eli Lilly, whose oral weight-loss drug, orforglipron, is still undergoing the approval process. Both medications belong to the GLP-1 family—drugs that mimic the activity of a natural hormone that regulates appetite and the feeling of fullness, and until now have been known mainly in weekly injection versions.
In recent years, weight-loss injections have truly revolutionized obesity treatment, with significant weight reduction and improvements in metabolic markers. However, barriers such as fear of needles, high cost, and limited accessibility have left many patients outside the treatment circle.
Nearly identical results to the injection
According to data from a large clinical trial, patients who took Wegovy in pill form at a daily dose of 25 mg of semaglutide lost an average of 13.6% of their body weight over about 15 months—compared with a loss of only 2.2% in the placebo group. This is a result very similar to the injectable version of Wegovy, which leads to an average weight loss of about 15%.
The active ingredient in the pill is identical to that in Wegovy and Ozempic injections, and even to an earlier oral version—Rybelsus—which was approved back in 2019 for the treatment of diabetes, but at a lower dose.
To enable effective absorption of the drug through the digestive system, a unique formulation was developed that protects the active ingredient in the stomach for about half an hour. As a result, the pill must be taken in the morning, on an empty stomach, with a small sip of water, and one must wait 30 minutes before eating or drinking. Side effects are similar to those of the injections and mainly include nausea and diarrhea.
Convenience, accessibility—and perhaps a lower price as well
Alongside the convenience, the expectation is that the cost will also be lower. Producing medications in pill form is considered significantly cheaper than producing injections. Novo Nordisk announced that an initial dose of the drug will be available in the United States at a price of about 149 dollars per month from some providers—a figure that could significantly expand the circle of patients.
According to a survey conducted in the United States, about 1 in 8 Americans has already used GLP-1 drugs by injection, but many reported that the high cost prevented them from continuing treatment. In Israel, the numbers are lower, but are steadily rising.
“Not a magic pill—but the beginning of a new era”
In Israel as well, the approval is seen as a significant milestone. Dr. Raz Hagoel, director of the medical center for obesity treatment, explains that the very existence of a pill-based treatment may change the landscape of dealing with the disease:
“The FDA approval of Wegovy in pill form opens a door for many patients who until now avoided treatment because of fear of needles. The method of administration is more convenient, and the results are very similar to those of the injections. The fact that another pill-based drug is expected to join soon marks the beginning of a new era in the treatment of obesity.”
However, he emphasizes that this is not a magic solution: “Obesity is a chronic disease, and treatment must be carried out with medical supervision and in combination with a multidisciplinary team, in order to achieve safe and long-term results.”
The big question that remains open is what patients will prefer—a daily pill or a weekly injection. Experts estimate that the very expansion of options is the real news: More personalization, more accessibility—and a greater chance for sustained and effective treatment.