FDA approves first pill for weight loss: 5 things to know

• In December 2025, the U.S. FDA approved an oral pill form of Wegovy for weight loss.
• Until now, Wegovy was only available as a self injection taken once a week.
• The biggest difference between the Wegovy pill and injection is how they are administered and how frequently they are taken.
• While side effects are very similar for both Wegovy formulations, there are some subtle differences to know about.

Until now, Wegovy was only available as a self-injection taken once a week.

Medical News Today spoke with three obesity medicine experts to find out more about the Wegovy pill — why it’s a “game-changer,” how it’s different from the Wegovy injection, and tips for figuring out which form of Wegovy is right for you.

When asked about the importance of the availability of the Wegovy pill Seth Kipnis, MD, FACS, FASMBS, director of bariatric and robotic surgery at Hackensack Meridian Jersey Shore University Medical Center in New Jersey, said that GLP-1 pills represent a pivotal moment in obesity medicine and represents a significant leap forward in patient accessibility and treatment adherence.

“The most obvious and impactful change is the removal of the psychological and physical barrier of self-injection,” Kipnis told MNT. “Needle phobia is a real and significant reason why many potential candidates for GLP-1 therapy refuse treatment.”

The public perception of a ‘pill’

“Daily pill intake is common for many medications, potentially leading to better long-term adherence, which is critical for chronic weight management. Pill form helps normalize the medical treatment of obesity, framing it less as an intensive, specialized intervention and more like the management of other chronic conditions such as hypertension or hyperlipidemia, which are typically treated with oral medications.”
— Seth Kipnis, MD, FACS, FASMBS

Devika Umashanker, MD, system medical director for obesity medicine at Hartford HealthCare, and the Medical and Surgical Weight Loss Hartford HealthCare Digestive Health Institute in Connecticut, told MNT that the recent approval of the Wegovy pill is a game-changer because one of the biggest challenges with once-a-week injectable medications are side effects that can persist for up to a week.

“In contrast, daily medications’ side effects can resolve within 24 hours, minimizing prolonged side effects for patients,” Umashanker explained.

Mir Ali, MD, a board certified general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, added that typically pills are cheaper to manufacture than injections, so that may potentially bring the cost down, whether a user is going through their insurance or not.

“And the big factor still remains that when insurance companies might cover this and what criteria they might have for that,” Ali added.

The most obvious difference between the Wegovy pill and injection is in how the medication is delivered — either orally or subcutaneous injection — and how frequently.

The Wegovy pill is taken once a day on an empty stomach. Pill users are told to wait at least 30 minutes before eating, drinking, or taking any other medications to allow the Wegovy pill time to be absorbed.

“The distinctive difference is the pill provides greater flexibility in how patients choose to take their medication,” Umashanker explained. “In terms of weight loss, the pill form provides a 14% weight loss in 64 weeks. The injectable form provides ~15% weight loss in greater than a year. Both provide approximately the same weight loss.”

As for side effects, Kipnis said that both Wegovy formulations are very similar, with gastrointestinal issues (GI) such as nausea, vomiting, diarrhea, and constipation being the most common for both. However, he did mention there are a few nuances.

“While both cause GI side effects, the daily administration of the pill might lead to more frequent, albeit potentially less intense, GI events as the gut is exposed to the medication every day. The clinical trial data showed high rates of nausea (46.6%) and vomiting (30.9%) for the oral version.”
— Seth Kipnis, MD, FACS, FASMBS

“The pill’s effectiveness is highly dependent on strict adherence to the dosing instructions — empty stomach (and) waiting period),” Kipnis continued. “Failure to follow these rules could lead to reduced efficacy or variable absorption, which is not a concern with the injection.”

“(And) because the pill contains the absorption enhancer SNAC, which is present in human milk, breastfeeding is not recommended during treatment with Wegovy tablets,” he continued.

“This is a specific contraindication for the pill that does not apply to the injection, for which alternative formulations can be used during lactation,” he added.

For readers deciding which form of Wegovy to take — oral pill or self-injection — Umashanker advises having a conversation with a medical provider to determine which type of Wegovy would be best for the patient.

“This conversation can lead to a more individualized approach and provide options for long-term adherence,” she explains. “Before prescribing oral semaglutide, I think it is essential to understand the patient’s experience with pharmacologic treatment for obesity to provide effective care. Understanding what has and has not worked previously, and partnering with the patient to develop a comprehensive care plan is essential.”

Kipnis advises readers to consider the pill if:

• You have a strong aversion to needles or the idea of self-injecting.
• You have a very consistent morning routine and can reliably take a pill on an empty stomach and wait 30 minutes before your coffee or breakfast.
• You prefer the psychological comfort of a daily pill, which feels more like a traditional medication.

Or consider the injection if:

• Your mornings are hectic, and you know you’ll struggle with the strict “empty stomach” rule.
• You prefer the convenience of a “one-and-done” weekly task and not having to think about your medication every day.
• You are comfortable with self-injection or are willing to learn.

Regardless of which form of Wegovy you take, Ali says to be the most successful in losing weight with the help of these medications, the main thing to remember is none of this is magic.

“You still have to make the right food choices, do the right things,” he explains. “We emphasize to our patients to reduce carbohydrates and sugars, and emphasize protein and vegetables in the diet. Protein intake is very important because you want to preserve muscle. You don’t want to lose muscle, and you want to preserve the muscle and burn off the fat.”

“So if you eliminate or reduce as much as possible carbohydrates and sugars, that’s going to direct the body towards burning the fat more and that’s the goal,” Ali added. “These medications are very useful tools to help patients get on the right track, but like any other tool, it has to be used properly.”