The landscape of medical weight loss just had one major change. On Monday, the Food and Drug Administration (FDA) approved a pill version of Wegovy, Novo Nordisk’s blockbuster GLP-1 weight loss drug, making it the first oral GLP-1 medication approved specifically for weight loss.
Until now, GLP-1 drugs such as semaglutide (found in Ozempic and Wegovy) and tirzepatide (used in Mounjaro and Zepbound) have only been available as injections. While highly effective, injections can be a barrier for many patients. The arrival of a daily pill could change that.
Novo Nordisk expects the Wegovy pill to be widely available in January, according to a company spokesperson. A competing oral GLP-1 pill from Eli Lilly is also expected to gain FDA approval in the coming months.
Why the Wegovy pill matters
GLP-1 drugs were initially developed to treat type 2 diabetes, but they quickly gained attention for their ability to drive significant weight loss. Their popularity has soared in recent years as obesity treatment has shifted toward more effective medical options.
Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in Cary, North Carolina, told NBC News:
This is a meaningful step forward in the field… It won’t replace injectables, but it broadens our tool kit in an important way.
Dr. McGowan emphasized that the form of the medication itself may help more people feel comfortable starting treatment:
Pills are familiar, nonintimidating and fit more naturally into most people’s routines… For many patients, a pill isn’t just easier, it’s psychologically more acceptable.
Novo Nordisk already sells an oral version of semaglutide called Rybelsus for diabetes, but it comes in a lower dose. The newly approved Wegovy pill is formulated specifically for weight loss, and at higher doses.
Cost, coverage, and access questions
Novo Nordisk has not yet released the list price for the Wegovy pill, which must be taken daily, but it is expected to cost less than the weekly injections. Insurance coverage, however, remains uncertain. Many private insurers restrict coverage of injectable weight loss drugs because of their high cost.
Medicare is legally barred from covering medications approved solely for weight loss. However, the Wegovy pill was also approved for lowering heart disease risk, which Medicare does cover — potentially opening the door for broader access.
In November, Novo Nordisk reached an agreement with the Trump administration to sell the lowest dose of the pill for $149 per month for people paying out of pocket, in exchange for tariff relief. Eli Lilly made a similar deal for its own weight loss pill.
How effective is the Wegovy pill?
Clinical trial data suggest the pill works nearly as well as the injectable version — if taken correctly. Phase 3 trial results 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 after 64 weeks. By comparison, those in the placebo group lost just 2.2%. That result is roughly on par with injectable Wegovy, which reduced weight by about 15% after 68 weeks in earlier trials.
However, adherence may be a major challenge. Dr. Shauna Levy, medical director of the Tulane Weight Loss Center, noted that the pill must be taken first thing in the morning, on an empty stomach, with no more than four ounces of water. Participants who failed to follow the strict schedule lost less weight, about 13.6% of their body weight on average.
The key uncertainty is how patients will do outside of clinical trials. The open question is “real-world performance,” Dr. McGowan said. “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 and comparisons to injections
Like injectable GLP-1 drugs, the most common side effects reported with the Wegovy pill were gastrointestinal, including nausea and vomiting. In some cases, those effects may be stronger.
Dr. McGowan explained that side effects from the pill version can feel “more intense” because the medication reaches the stomach all at once. “The challenges we see with injectable GLP-1s don’t magically disappear with a tablet,” he said.
While the Wegovy pill delivers weight loss comparable to injectable Wegovy, newer injectable drugs still lead the field. Lilly’s Zepbound helped patients lose 22.5% of their body weight after 72 weeks in clinical trials, and its next-generation injection, retatrutide, produced average weight loss of 24% after just 48 weeks.
Novo Nordisk says the differences may come down to how the medication is absorbed. Because pills are broken down in the digestive tract, less of the drug reaches the bloodstream compared to injections. To compensate, the Wegovy pill is taken daily and at higher doses.
The pill’s effectiveness is closer to Lilly’s oral drug orforglipron, which led to about 10.5% weight loss after 72 weeks in late-stage trials. These figures, however, are not from direct head-to-head comparisons.
Avoiding past shortages
When injectable Wegovy first launched, it was plagued by prolonged shortages. This time, Novo Nordisk says it has increased pill production ahead of the rollout. Another consideration is that oral medications are often easier to manufacture than injectables, which could help prevent supply issues and improve access.
For now, the Wegovy pill represents a promising new chapter in the rapidly evolving science of weight loss treatment.
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Source: “FDA approves Novo Nordisk’s Wegovy pill, the first and only oral GLP-1 for weight loss in adults,” PR Newswire, 12/22/25
Source: “FDA approves Wegovy weight loss pill from Novo Nordisk,” NBC News, 12/22/25
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