Oral GLP-1s in the Weight-Loss Market

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 been leading the way. And their benefits go far beyond weight loss alone.

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.

The Wegovy pill is now available, and Foundayo (orforglipron) was recently approved by the FDA, marking an important step forward for oral weight-loss medications. And with additional GLP-1 pills expected in the near future, here’s where they could fit in.

New oral GLP-1 options

GLP-1 pills are no longer just a future concept — they're here. With recent approvals, oral GLP-1s are now an FDA-approved option for weight loss.

• Wegovy: In the OASIS 4 trial, people taking 25 mg oral semaglutide lost an average of about 14% of their starting body weight at 64 weeks. This is similar to the weight loss seen in semaglutide injection trials (2.4 mg dose). But it’s important to note that the oral formulation has poorer absorption than the subcutaneous injection. So it should be taken in the morning on an empty stomach 30 minutes prior to food, drink, or other medications.

• Foundayo: Once-daily oral orforglipron was approved by the FDA on April 1 for weight loss among adults who are considered obese or overweight with at least one related health condition. It’s a small molecule (not peptide) GLP-1 medication that doesn't require timing around meals. In clinical trials, participants lost an average of 8% to 11% of their starting body weight, depending on the dose, after taking Foundayo for 72 weeks.

Another oral medication in late-stage development is GIP/GLP-1 receptor agonist VK2735. Clinical trial data for oral VK2735 show promising weight-loss results. Researchers are also studying an injectable version, which is currently being studied in a phase 3 trial.

How oral GLP-1 medications fit in weight-loss treatment plans

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.

Challenges facing GLP-1 weight-loss pills

Even as 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 will be adopted now that they’re available.

• Can they match injectable GLP-1 results? The Wegovy pill (25 mg) has shown weight-loss results similar to Wegovy (2.4 mg). Results from orforglipron's ATTAIN-1 trial showed that people taking the highest dose (36 mg) lost about 12% of their starting body weight, on average.

• Will they offer the same health benefits? Injectable GLP-1s have benefits beyond weight loss, including protection from adverse cardiovascular and renal outcomes. Oral Wegovy is approved for cardiovascular risk reduction, like its injectable version. It’s likely that other compounds will offer similar benefits, but research is ongoing.

• Will adherence improve with a daily pill? Some people may prefer a daily pill over a weekly injection. But others might struggle with remembering a daily dose. This is especially the case if there are strict instructions to follow when taking it.

• Will they be affordable and covered by insurance? Pills like orforglipron may be easier and cheaper to make. But pricing and insurance coverage remain uncertain.

• Can oral options prevent future shortages? Semaglutide and tirzepatide shortages have largely resolved, but demand remains high. Non-peptide oral GLP-1s are generally easier to produce, which may help relieve pressure on supply chains and support more consistent medication access.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Edited by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Reviewed by:

Farah Naz Khan, MD

Farah Naz Khan, MD, is a board-certified physician at the UW Medicine Diabetes Institute and a clinical assistant professor of metabolism, endocrinology, and nutrition at the University of Washington.

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