The people's voice of reason
The people's voice of reason
Glucagon-like peptide-1 (GLP-1) medications have emerged as powerful tools for weight loss. So far, injectable options like Wegovy (semaglutide) and Zepbound (tirzepatide) have led the way. And their benefits go beyond weight loss alone — as they’ve shown to improve heart health, kidney health, and even sleep apnea.
But injectable medications aren’t right for everyone. That’s where a new wave of oral GLP-1 medications could make a difference. These needle-free alternatives could offer a simpler, more accessible way for people to benefit from GLP-1 therapy.
With the first GLP-1 pills for weight loss on the horizon, GoodRx shares where they could fit in.
Key takeaways:
GLP-1 medications mimic GLP-1, a hormone that helps regulate appetite, blood glucose (blood sugar), and digestion. Most of these medications are designed to mimic GLP-1 alone. Others, like tirzepatide, also mimic GIP (glucose-dependent insulinotropic polypeptide) for additive effects.
Currently, most GLP-1s are injections used to treat Type 2 diabetes. A few, including Wegovy, Zepbound, and Saxenda (liraglutide), are FDA-approved for weight loss. Oral semaglutide (Rybelsus) is the only pill option currently available. But right now, it’s only approved to treat Type 2 diabetes.
So far, GLP-1 injections have been the most effective option for weight loss. But newer GLP-1 pills aim to match, or even improve upon, their results.
Several oral GLP-1 pills are in late-stage development — and they’re getting closer to hitting the market. They work in a similar way as injectable GLP-1s. But they come in a pill, which could be more appealing and convenient for many people.
Oral semaglutide is already approved for Type 2 diabetes at doses up to 14 mg daily. Higher doses (25 mg, 50 mg) have been studied for weight loss and may offer similar results to the Wegovy 2.4 mg dose. But it’s important to note that oral semaglutide isn’t absorbed as well as the injection. You need to take it on an empty stomach first thing in the morning to maximize absorption.
Orforglipron is a non-peptide oral GLP-1 medication. It’s made using a simpler manufacturing process than GLP-1 injections. This could lead to lower prices, easier production, and fewer supply issues. And compared to oral semaglutide, it’s more easily absorbed by the body and doesn't need to be timed around meals.
VK2735 is another medication that mimics both GLP-1 and GIP, like tirzepatide. Early trial results for oral VK2735 show promising weight-loss results with manageable side effects. It’s currently being studied in a phase 2 trial to test different doses. Researchers are also studying an injectable version, which is further along in the clinical development process.
Fatima Cody Stanford, MD, MPH, MPA, an obesity medicine physician-scientist, educator, and policymaker at Massachusetts General Hospital and Harvard Medical School, explained to GoodRx Health how these oral options might fit into different treatment strategies.
Initial weight-loss treatments
Some people may start their GLP-1 journey with a pill, especially if they’re hesitant about injections. A daily oral medication may feel more familiar and easier to manage.
“Self-injection can be a significant barrier for some people, either due to needle phobia, inconvenience, or perceived stigma,” explained Stanford. “Oral options might increase their willingness to initiate and adhere to treatment, potentially broadening the pool of people who can benefit from [GLP-1] therapy.”
Maintenance therapy after weight loss
For people who’ve already lost weight with an injectable GLP-1, switching to a pill may help maintain progress without continuing injections.
“Oral medications could indeed function as an ‘off-ramp’ for those who have reached their treatment goals with injectables and wish to maintain their progress with a less invasive option,” said Stanford. “This transition could help in sustaining motivation and adherence to treatment over the long term.”
This maintenance approach is currently being investigated. The ATTAIN-MAINTAIN trial studies how orforglipron helps people keep weight off after stopping Zepbound. And oral VK2735 may play a similar role with the injectable version.
Step-up or step-down strategies
GLP-1 pills could also support flexible treatment plans, depending on a person’s needs and preferences.
One option is a step-up approach, which may help ease people into treatment. This method may be especially appealing for those hesitant to start with injections right away. As explained by Stanford, “People might begin with oral medications to achieve initial weight loss or glycemic control, and then transition to injections if more intensive treatment is needed.”
On the flip side, a step-down approach can be used to simplify things or lower treatment intensity after reaching goals. In this case, someone might switch from the injections to a pill to reduce side effects, lower cost, or make the routine easier to stick to.
Whether someone is starting or continuing treatment, GLP-1 pills could give people more options to help meet or maintain their long-term body weight goals.
Before GLP-1 pills go mainstream, several questions remain. Stanford noted factors such as effectiveness, adherence, and affordability playing a role in how quickly and broadly GLP-1 pills are adopted once available.
With growing interest in weight-loss treatments, several GLP-1 pills are moving through clinical trials. Here’s where the top candidates currently stand:
Glucagon-like peptide-1 (GLP-1) injections like Wegovy (semaglutide) and Zepbound (tirzepatide) have revolutionized the weight-loss medication market. But oral GLP-1 pills are on the horizon and could soon offer a simpler, more flexible option for weight loss.
Top candidates include orforglipron, oral semaglutide, and VK2735. The FDA could approve orforglipron and oral semaglutide by 2026.
This story was produced by GoodRx and reviewed and distributed by Stacker.
Reader Comments(0)