Weight loss drugs have helped millions of Americans shed extra pounds. The only drawback: those pesky injections.
But two new forms of GLP-1 agonists, Wegovy and Foundayo, are available as oral medication.
GLP-1 agonists, when combined with diet and exercise, can help you lose weight. In pill form, these medications may have even broader appeal and easier access than the injectable version. But there’s a difference between the shot and the pill, and the oral option may not be for everyone.
The first pill on the market was oral semaglutide, or Wegovy.
Does that name sound familiar?
“It’s the exact same medication as the injections,” says Diana Plata, MD, weight loss specialist at Rush. “The dosage of oral semaglutide is much higher because less of the oral drug is absorbed into the body through the stomach when compared to how much is absorbed when injected under the skin.”
Lower doses of oral semaglutide have been used to treat diabetes for years under the name Rybelsus, Plata says. But these lower doses are not very effective at inducing weight loss.
“An important thing to know is that this is not a new medication,” Plata says. “People may not want to take something that seems new to them, but we know the safety profile of this medication well.”
Oral semaglutide needs to be taken on an empty stomach, with no other pills, using less than 4 ounces of water. And you can’t eat, drink or take other medication for 30 minutes.
New pill option for weight loss
But there’s another alternative: Foundayo or orforglipron, the newest oral medication for weight loss, doesn’t have these restrictions.
“You can take Foundayo at any time of day, with or without food,” Plata says. “This may make it a more convenient option for patients.”
Both oral semaglutide and Foundayo can lead to weight loss when combined with diet and exercise. But are pills a better option than injectables? It depends.
First, talk to your doctor about whether a weight loss drug is the way to go. It’s an option if you have a body mass index, or BMI, greater than 30, or you have a BMI higher than 27 with at least one obesity-related issue. This may include diabetes or a cardiovascular problem like high blood pressure or cholesterol.
Next, weigh the advantages and disadvantages of each. Yes, the pill means you won’t have to give yourself an injection once a week. But you do have to remember to take a pill every day.
Potential side effects are the same for the shot and the pill. They may include nausea, diarrhea, constipation and other GI issues.
And certain conditions could exclude you from taking any GLP-1. They include a history of certain cancers or a history of pancreatitis or other severe gastrointestinal diseases.
Oral vs. injectable
Are the weight loss effects the same?
Both oral and injectable GLP-1 agonists can, with proper diet and exercise, reduce your weight.
Plata says that for most people, injectables are going to be more effective at weight management.
“The main reason someone would choose the weight loss pill over an injection is a phobia of needles,” Plata says. “There may also be a cost difference, depending on someone’s insurance coverage.
And because the overall weight loss for the pill can be less than injection, it might be a better option for someone with less weight to lose or for someone who is maintaining weight loss.”
Whether you are interested in GLP-1 injections or pills, neither is meant for short-term use.
“One of the biggest misconceptions is that you can take GLP-1s temporarily,” Plata says. “They’re designed for chronic use, to treat what we know to be a chronic disease. This is how patients should approach it.”
