Analysts expect the pill to be as effective, safe and tolerable to take as Novo Nordisk's semaglutide – the active ingredient in its popular but costly weight loss injection Wegovy and diabetes drug Ozempic. The Food and Drug Administration approved Wegovy, a higher-dose version of Novo Nordisk's diabetes drug semaglutide, for long-term weight management. Depending on the patient and their other diseases, anti-obesity medications can also help with other weight-related medical problems, such as improving blood pressure or cholesterol levels, improving blood sugar levels in patients with diabetes, and delaying the onset of type 2 diabetes. Want the latest stories on the science of healthy living? After spending two years stuck at a desk as chief science officer of the White House COVID-19 Response Team, Kessler had gained significant weight. He'd gain 20 or 40 pounds in a relatively short time frame, then slowly lose the weight, usually by going on a low-carb, high-protein diet, and exercising. RAND is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. “With the drug now available in pill form and obesity rates falling, broader usage could have further implications for waistlines,” according to the analysis. These new medications are a powerful tool in the Canadian health toolkit, but how they are used requires scrutiny. One of the most interesting parts of the study compared drug-based weight loss to traditional “behavioural” programs (like supervised dieting and exercise). These medications have transformed how we approach weight management, helping many Canadians shed pounds that previously felt permanent. If you feel like you can’t go a day without hearing about weight loss medication like Ozempic or Mounjaro, you’re not alone. Many of the newer drugs coming down the pipeline mimic two or three gut hormones, such as GLP-1, GIP, and glucagon. As scientists learn more about the functions of other gut hormones, they are testing drugs that mimic those as well. “This is new science, and this is coming from someone who has been in this field for over 40 years,” says Robert Kushner, an endocrinologist at Northwestern University’s Feinberg School of Medicine in Chicago, who consults for some of the companies developing these drugs. Orlistat was approved for long-term weight management by the Food and Drug Administration (FDA) in 1999 and the Korea Ministry of Food and Drug Safety in 2000 (Jeon et al., 2023). Therefore, guidelines recommend that obese individuals lose 5% to 10% of their initial body weight within 6 months of starting a weight-loss intervention (Kim et al., 2023). Specifically, weight loss of 5% to 10%, along with improvements in lifestyle, has clinically significant benefits in achieving these goals. Those Medicare negotiated rates will take effect in 2027 — effectively making Novo Nordisk's products the preferred drugs in the program."A lot of people are going to like that," Levy says.At Metro, we’re committed to sharing everyday people’s stories, and you can read more real-life features like this one in our News Updates newsletter.In the semaglutide group, the primary cardiovascular endpoint incidence was 20% lower than in the placebo group, which was a statistically significant effect (Lincoff et al., 2023).List the medications and doses you take on the card.The pill could also help Eli Lilly solidify its dominance in the growing segment as a slate of other drugmakers race to bring a product to the market.Researchers from Oxford University analyzed 37 studies that examined what happened when people stopped taking weight loss drugs. Eli Lilly said those dropout rates were "highly correlated" to patients' starting body mass index and included discontinuations due to "perceived excessive weight loss." One concern with current weight loss drugs is that they can lead to the loss of lean muscle mass. Eli Lilly is betting big on retatrutide as the next pillar of its obesity portfolio after its weight loss injection Zepbound and its upcoming pill. Apovian said Eli Lilly appears to be positioning the drug strategically for people with severe obesity, or a body mass index above 35 or 40. While no specific vitamin or supplement is considered a “treatment” for obesity or overweight, certain ones help support metabolic health. Who should use Wegovy? Wegovy and Zepbound have not been covered by Medicare for weight loss, "and they've only rarely been covered by Medicaid," Trump said in the Oval Office. Emory Healthcare has helped many patients effectively lose weight and transform their lives. However, compounded medications are not regulated. This is frustrating for patients and doctors and can disrupt treatment and progress. The study, called TRIUMPH-4, didn't solely focus on weight loss, meaning that other trials specifically designed for that outcome could produce different or higher results. In a separate note on Thursday, BMO's Seigerman said discontinuation rates "appear to highlight the speed and strength of weight loss was excessive for some patients with lower BMI." But he said, "all in results are impressive." In a note ahead of the findings, BMO Capital Markets analyst Evan Seigerman said his base-case assumption was for the drug to show weight loss of around 20% to 23%, with at least a 50% reduction in knee pain. More than 1 in 8 patients who took the drug were completely free from knee pain by the end of the trial, Eli Lilly said. The pill versions are especially good for “needle phobic” people, Levy says. The lowest doses cost $149 a month for people paying out of pocket, a cheaper alternative to the injectable Wegovy. The once-daily Wegovy pill is already approved and became available in the U.S. in January 2026. Phentermine is one of the most prescribed weight-loss medicines. For example, it can be be used with healthy eating, physical activity and behavior change. Like other weight-loss medicines ordered by providers, phentermine is meant to be only part of a weight-loss plan. Consumers with prescriptions may pick up the new Wegovy pill at pharmacies nationwide or have it delivered through telehealth companies, according to Novo Nordisk.A version of the shot, known generically as tirezepatide, is already sold as Mounjaro to treat Type 2 diabetes.Call your doctor for medical advice about side effects.Besides blood sugar control, however, these medications result in weight loss, an effect that has caught the eye of both the public and drug makers, who have moved to create specific formulations to help patients shed pounds.Phentermine is the oldest and most widely used weight loss medication.Both drugs in this class can increase the risk for heart failure in some individuals and can also cause fluid retention (edema) in the legs and feet. “Weight regain after a period of weight loss is really common, no matter what approach you take,” says Sam West, lead author of the study and a research scientist at the University of Oxford, who specializes in integrated metabolism. “If you’re on blood pressure medication, you get your blood pressure to the level that your doctor says is healthy for you, you come off the medication, your blood pressure is gonna go up,” she stated. While drinking lots of water makes Winfrey’s kidneys “very happy,” Jastreboff said there are other ways to “lessen nausea” while on weight-loss medication. Higher doses of the pill, with 9mg and 25mg, will be expected to pay $299 a month; unless you have insurance that covers it, meaning they will be significantly cheaper. Figure 3 shows the overall prevalence of these side effects among our survey sample, with distinctions made as to whether the side effect was mild or severe.Public and private payers have been trying to wean patients off to save costs.All of the medications discussed here are contraindicated for pregnancy.People trying to lose weight may opt for long-acting monthly shots instead of weekly injections in the future.Higher doses of tirzepatide helped patients with obesity lose roughly 20.9% of their body weight on average in late-stage studies, when analyzing all patients regardless of discontinuations.While Novo's Wegovy lists for $1,350 per month, in March the average net price for the drug was $616 according to an analysis by the Institute for Clinical and Economic Review.Some analysts say orforglipron will also be easier to manufacture at scale than Novo Nordisk's, which is crucial as demand for obesity and diabetes injections outpaces supply.But some health experts say many patients don't need to lose more than 20% of their weight.Prescriptions for GLP-1 drugs have skyrocketed, putting the medications on track to become some of the best-selling of all time.Novo Nordisk has indicated that it plans to launch the 25 mg oral semaglutide in the US in 2026. Do Anti-Obesity Medications Really Work? Despite those results, with a few exceptions, expensive, high-quality trials that can provide conclusive answers still need to be undertaken. Some diets, in particular those with low glycemic load that restrict processed carbohydrates, have shown promise when coupled with intensive behavioral interventions. Most dietary clinical trials are small, low-intensity, and low-quality — a hundred of these can’t produce the knowledge of one good study.” Tirzepatide, the active ingredient in Eli Lilly's Zepbound and diabetes injection Mounjaro, likely won't be eligible for those negotiations until the end of the decade. Eli Lilly expects weight loss in people with diabetes to be "significantly less" than patients with obesity who don't have diabetes, the company's Chief Scientific Officer Daniel Skovronsky said on an earnings call in February. While orforglipron is expected to be as good for weight loss as Wegovy, Zepbound, on average, is more effective at helping patients lose weight than Novo Nordisk's injection, according to real-world data and a head-to-head trial on the drugs. Offering the first oral version of a so-called GLP-1 could help Eli Lilly capture an even greater share of the market for that popular class of weight loss and diabetes drugs. Wegovy is the brand name for a medicine called semaglutide, the same as Novo Nordisks’s blockbuster diabetes drug Ozempic. Yet, as excitement brews, questions about its differences from medications like Ozempic, its ideal candidates and potential side effects may arise. After years of persistent shortages, Canadians can now access Wegovy, an on-label weight loss medication, made by the same manufacturers of Ozempic. That is why treatment for obesity should always be prescribed by qualified healthcare professionals after a thorough assessment of the patient. Ed Sheeran Reveals the 1 Thing That Motivated His 30-Pound Weight Loss Journey People who took the pill in clinical trials also experienced similar side effects as those on injectables, including gastrointestinal issues such as nausea, diarrhea and vomiting, according to Novo Nordisk. The first and only oral GLP-1 for weight loss in adults is now available to consumers. The weight loss it produces is “profound” and might be a good fit for people with a very high BMI, Levy added. Patients are already getting their hands on the first GLP-1 pill for obesity from Danish drugmaker Novo Nordisk — a once-daily drug that shares the same brand name as its popular injection Wegovy. She worked with the patients and their families to refocus on behavioral changes to manage their obesity as they transitioned off of them. New analysis showed 17% of people able to maintain 80% of their weight loss after stopping. But because of cost, for example, negative side effects, or supply shortages, many people are having to transition off of them — while trying not to regain the weight. Weight loss aims to improve obesity-related complications and patients’ health and quality of life. While some experimental drugs are further along than others, all are likely years away from hitting the market, and their competitive potential will depend on future data showing their effectiveness and how well patients tolerate them. Nearly every major pharmaceutical company has bet on obesity drugs, often through deals with smaller developers, including businesses based in China. Nestle shares have dropped almost 5% in the past month, partly on concern people taking medications like Wegovy might consume less food. While you're taking diabetes medications, you should also check with your doctor before starting anything new—even over-the-counter items. According to the Canadian Journal of Health Technologies, treatment with Wegovy is expected to cost approximately C$4,726 per patient per year. “There are side effects that we need to think about and one thing is gastrointestinal side effects. “This is not for people to simply lose a few pounds. “Ozempic comes at a maximum dose of one milligram a week, whereas Wegovy comes in a maximum dose of 2.4 mg per week.” Obesity not only diminishes a person’s quality of life and life expectancy but also escalates the risk of serious chronic illnesses such as heart disease, cancer, stroke, diabetes and non-alcoholic fatty liver disease, Sockalingam said. FDA approves Wegovy pill for weight loss, the first daily oral medication of its kind For example, Merck in December snagged the rights to an early-stage experimental GLP-1 pill from Chinese drugmaker Hansoh Pharma, in a deal worth up to $2 billion. Other experts have said that an ideal competitor would promote weight loss while being easier to tolerate than existing injections. Companies have said that pills could reach patients who don't take injections because they are afraid of needles. But Crable said some employers have actually dropped coverage of GLP-1s for obesity in 2026 due to their high costs. But if they mirror injection costs — often higher than $1,000 per month — employers may be reluctant to add the drug to their formularies, he said. Crable said it is unclear how much the pill will ultimately cost payers such as employers since those prices are not publicly disclosed. Semaglutide treatments can also be used as an alternative to bariatric surgery for some patients who are obese. It's the first drug approved for this purpose since 2014. Wegovy is a once-weekly injection approved by the FDA in 2021 for chronic weight management. Airlines are going premium. Prices are rising. Will cheap tickets be harder to find? Any product falsely representing itself as a Lilly investigational product not yet approved by the FDA, like retatrutide, may expose patients to potentially serious health risks. ‘Everyone seems to have such incredible effects from it, not even a normal type of hunger like you get on the traditional weight loss jabs. Among those who completed the full treatment, the average weight loss increased to 22.7 percent. To use the drug themselves, purchasers would have to reconstitute the powder by combining it with bacteriostatic water and injecting with a syringe, processes that are all explained in detail across multiple social media platforms, like TikTok and YouTube. He prepared it and injected it, following dosing protocols from Lilly’s initial clinical trials. He ordered 10 vials of the drug in powder form, amounting to some 200 mg. Such marketplaces are also used by trans and nonbinary people to source gender-affirming hormones. In Eli Lilly's trial, the highest dose of its pill helped patients lose 12.4% of their body weight on average at 72 weeks. 2026 is likely the year that two new oral weight loss drugs will reach patients in the U.S. As with many medications, some weight loss drugs have been on the market longer, have generic alternatives, and tend to be more affordable. Even as the range of weight loss medications has expanded, some drugs have been withdrawn based on their lack of efficacy as well as safety concerns. Ricks added that Eli Lilly was looking for a less than 12% dropout rate due to side effects, noting that the industry has seen 8% to 12% rates with GLP-1 drugs.Wegovy builds on a trend in which makers of relatively new diabetes drugs test them to treat other conditions common in diabetics.As of early November, when Novo Nordisk and Eli Lilly announced deals with the Trump administration, the starting dose of Zepbound will be available for $299 a month for people buying without using insurance.So the drug companies promised the Trump administration that the pills would be available for $150 a month for people not using their health insurance.But Risinger said he does not necessarily expect the pill to lead to better insurance coverage for obesity medications.You’re looking at potential electrolyte imbalances and issues with bone health to name just two.If all goes according to plan, FDA approval should follow, and marketability by late 2026 or early 2027 could be possible, based on the timelines of other drugs in the category.It doesn’t work for everyone, but when it’s successful, it can help someone shed 15% of their body weight. Bupropion (Wellbutrin), an aminoketone, is considered weight-negative and is prescribed both to assist in weight loss and to treat depression. Desipramine, nortriptyline, and protriptyline have variable effects on weight. Weight-positive medications in the tricyclic antidepressant category include amitriptyline, doxepin, and imipramine. Lilly's oral drug, orforglipron, is still under review. Novo Nordisk also announced that the pill is available through 70,000-plus U.S. pharmacies such as CVS and Costco and via select telehealth providers including Ro, LifeMD and Weight Watchers, NovoCare Pharmacy, GoodRx, and more. Through insurance, patients may pay as little as $25 per month for their prescriptions, but this varies, and plans may not cover the prescription medication. According to the press release, out of pocket, the pill costs around $149 per month or $5 a day for the starting dose of 1.5 mg. It slows down the movement of food through the stomach, curbing appetite, leading to weight loss.” Eli Lilly will soon release key data on its weight loss pill. Here's why it could be a game-changer GLP-1 drugs for diabetes and weight loss have proven to be very effective, but they do have side effects. For practitioners prescribing, patients receiving, and people choosing to purchase these medications privately, it's important to understand the risks of rapid weight regain if treatment ceases - and the value of wraparound behavioural support.' Ultimately, people may see weight return to its pretreatment level within 1.7 years of stopping the drugs and heart health markers return to their pretreatment state within 1.4 years, the study estimated. A new study finds that people who quit weight-loss medications, including GLP-1 drugs, regain weight four times faster than people who stop dieting or exercising With once-daily oral dosing, Wegovy® pill can provide patients with a practical option as part of their daily routine to help people achieve meaningful weight loss. The Wegovy pill is required to be taken 30 minutes before any other medication, food or coffee, according to Novo Nordisk. Consumers with prescriptions may pick up the new Wegovy pill at pharmacies nationwide or have it delivered through telehealth companies, according to Novo Nordisk. Drugmaker Novo Nordisk announced Monday that its daily oral Wegovy pill is now available by prescription. Metsera, a company that was recently bought by Pfizer, is also investigating monthly GLP-1 and amylin analog drugs. Ozempic and Wegovy are known to cause some unpleasant side effects such as nausea, diarrhea and vomiting, but their increasing popularity has led to concerns about more serious outcomes ranging from suicidal thoughts to thyroid cancer. “Treatment decisions should be made together with a healthcare provider who can evaluate the appropriateness of using a GLP-1 based on assessment of a patient's individual medical profile.” Novo Nordisk said it stands behind “the safety and efficacy of all of our GLP-1RA medicines when used consistent with the product labeling and approved indications” and said the study in JAMA has limitations. “And it likely will become the standard of care for treating obesity. That has helped combat the weight bias that’s been so pervasive in our society for so long.” “Traditionally, obesity has been considered a lifestyle choice, which has led to a stigma,” Dr. Dbouk says. They may not contain the same ingredients or formulations as the FDA-approved name-brand versions. Insurance doesn’t always cover them, so they can be out of reach for many people. Still, the slightly lower efficacy of Eli Lilly's pill may not be significant enough to deter patients from taking it. Neither drugmaker has released specific list prices for their pills. The Food and Drug Administration in November said it has awarded a priority review voucher to that pill, which could expedite the review timeline for the drug to a few months. Mounjaro is still only available on private prescription, not through the Pharmaceutical Benefits Scheme (PBS), and its recommended private prescription price begins at $395 per month for the initiation dose. ‘Consistent supply of essential medicines to patients is our company’s highest priority,’ she said. ‘Some people might need a psychologist, other people might need an accredited practising dietitian, other people might need an exercise physiologist, and some people need all of those. ‘Lilly is committed to ongoing replenishment of all doses of the Mounjaro KwikPen presentation.’ Dr Gary Deed, Chair of RACGP Specific Interests Diabetes welcomed the expansion, but added that any agent should be part of a multidisciplinary approach which also includes lifestyle advice. Now that we’ve shown that hormone-based therapies can be so effective, I think it’s changed the world’s perspective that it’s not a losing battle to treat obesity.” Roughly 18% of patients on the highest dose of the drug stopped treatment due to side effects, compared with 4% of those in the placebo group. It's a critical part of the drugmaker's plan to maintain its market share majority over Novo Nordisk in the booming market for weight loss and diabetes drugs. When evaluating only patients who stayed on the drug, the highest dose delivered 28.7% weight loss on average. On Friday, the FDA said this new version of a popular diabetes medicine could be sold as a weight-loss drug. For example, maybe only people with a body mass index over 40 can get a GLP-1 covered, even though obesity is classified as having a BMI of 30 or higher. What about people who are trying to use insurance for these drugs? The higher doses that patients work their way up to will be $300 a month for the Wegovy pill and $400 a month for the Eli Lilly pill. Call your doctor for medical advice about side effects. This list may not describe all possible side effects. Your care team may recommend changes to your treatment plan. When recommended, this medication may be taken. Tirzepatide is similar to semaglutide, which is marketed as Wegovy (for weight management) and Ozempic (for diabetes). As researchers point out, for people who have bariatric surgery, typical weight loss is about 25% to 30% of their weight, one or two years after the surgery. He points to the importance of both clinical trials, and the significance of surpassing the 20% loss in body weight. “Most people who start these drugs will stay on them as long as they can afford them,” he added. This is a medication that is a treatment for a medical condition that’s obesity and how we’re defining it,” he said. The highest dose of Novo Nordisk's Wegovy pill helped patients lose up to 16.6% of their weight on average at 64 weeks in one late-stage study. He told CNBC in December it has not been an issue for the more than a million people who are taking the lower-dose version of the pill for diabetes, marketed as Rybelsus, which entered the market in 2019. Eli Lilly's orforglipron is a small-molecule drug that is absorbed more easily in the body and doesn't require dietary restrictions like Novo Nordisk's pill, which is a peptide medication. Leerink Partners analyst David Risinger said patients with obesity who need to lose a larger percentage of their body weight will likely stick with injections, unless they have a fear of needles. That's higher than results seen with both the Wegovy injection and pill as well as Eli Lilly's oral drug in separate trials. Winfrey revealed that she gained 20 pounds last year after going off of her medication to test if she would retain her weight loss without the drug. According to the Medicines and Healthcare products Regulatory Agency (MHRA), the new dose of 7.2mg is three times higher than the current approved dosage of 2.4mg, but could lead to even more than 20 percent weight loss. So, with demand at an all-time high, the UK's medicine regulator has just approved a much stronger dose of Wegovy, which could support even bigger weight losses. The great thing about these drugs, says Kessler, is that they allow you to relearn how to eat. "They have changed the landscape of weight loss," says Kessler. He says GLP-1 drugs are remarkably effective in countering this pattern. They can activate the same reward centers that addictive drugs do. Then an endocrinologist asked if he'd like to try one of the new class of glucagon-like peptide-1, or GLP-1, drugs that include Wegovy and Mounjaro. In the most recent results from late November, participants lost 10 to 20 percent of their body weight, and nearly a third of those taking the highest dose lost 20 percent or more. With these new drugs, however, “not only do people not feel hungry, but they just don’t have the craving or food thoughts they used to because their brains are not starving.” It was also the most effective drug of its kind when it was approved as Wegovy for obesity in 2021. With the pace of these approvals matched only by demand for them, what hasn’t kept up is access to these medications, primarily due to drug shortages and their cost. The company has said it expects to unveil data from five studies in patients with Type 2 diabetes and two trials in people with obesity in 2025. As NPR has reported, when patients can't afford to stay on obesity medications, they are likely to gain much of the weight back. The medications come at a time when obesity is the most prevalent chronic condition, affecting an estimated 650 million adults globally, and the growing recognition that many people are not able to lose significant amounts of weight through diet and exercise alone. In the SURMOUNT-1 study, people who took the highest dose of tirzepatide, most of whom had a BMI of about 30 or higher but did not have diabetes, lost about 21% of their body weight during the 72 week study. On Thursday, the company released new data to support its aim of fast-track approval, including topline results from another study, called SURMOUNT-2, which shows weight loss of up to 15.7% among people with Type 2 diabetes and obesity. Still, Seigerman said he believes primary care providers who prescribe pills may still encounter issues with pricing and insurance coverage. While some primary care doctors can and do prescribe GLP-1s, others are hesitant due to concerns about side effects and administration since they are injections. The Food and Drug Administration, in most cases, now bars compounding pharmacies from making those unapproved versions because it declared the Zepbound shortage over in December. Those who have a very high body mass index will "best be treated with injectables that offer greater efficacy," Risinger said. Th pill could also tap into new markets in countries that don't have the resources for the cold supply chains needed to store and administer GLP-1 injections, Guggenheim's Fernandez said. Orforglipron's nausea and vomiting rates in the phase two trial were "meaningfully greater" than those among patients who took 2-milligram doses of semaglutide in a phase three trial, Leerink's Risinger said. However, how well patients tolerate Eli Lilly's pill – specifically the rate of gastrointestinal side effects in the trial – will be the "key focus" of the phase three study results, according to Schott. In patients with obesity, that implies weight loss of around 13% to 15%, according to a February note from JPMorgan analyst Chris Schott. He believes orforglipron will be covered by some plans like Zepbound is, but certain employers will likely still fear that some patients are only using obesity drugs for cosmetic purposes. But Risinger said he does not necessarily expect the pill to lead to better insurance coverage for obesity medications. In recent weeks, several media outlets have raised questions about the safety of medicines such as semaglutide and tirzepatide. Novo Nordisk also is developing a pill version that should start final patient studies later this year. That's a new strategy in treating obesity, said Dr. Robert Kushner, a member of Novo Nordisk's medical advisory board who heads Northwestern Medicine's Center for Lifestyle Medicine. Wegovy's most common side effects were nausea, diarrhea and vomiting. Ozempic, known generically as semaglutide, was approved in 2017 by the U.S.Users of similar drugs often struggle to maintain muscle mass, because their appetites are so reduced that taking in enough calories (and protein) becomes a challenge or tedious chore.Those who took tirzepatide lost an average of 5.9% of their body weight after three months; 10.1% after six months; and 15.3% after 12 months.About 1 in 8 adults are now taking a GLP-1 drug for obesity, disease, or both, up 6 percentage points from May 2024, according to KFF poll results released in November.That sets up the drug, which will be marketed as Wegovy in a pill, to launch early next year.Both pills are GLP-1 drugs that work like widely used injectables to mimic a natural hormone that controls appetite and feelings of fullness.As researchers point out, for people who have bariatric surgery, typical weight loss is about 25% to 30% of their weight, one or two years after the surgery.In clinical trials, the average weight loss for people taking Zepbound was about 20%. Based on how these medications work, they commonly cause gastrointestinal side effects including gas and diarrhea. These drugs help the body lower blood glucose levels by blocking the breakdown of starches, such as bread, potatoes, and pasta in the intestine. All sulfonylurea drugs have similar effects on blood glucose levels, but they differ in side effects, how often they are taken, and interactions with other drugs. By increasing the amount of glucose excreted in the urine, people can see improved blood glucose, some weight loss, and small decreases in blood pressure. The most common side effect with these medications is nausea and vomiting, which is more common when starting or increasing the dose. To date, anti-obesity agents with various mechanisms of action have been developed, and mostly reduce energy intake, resulting in weight loss of about 5% to 10% compared to baseline. That refers to how quickly patients start at a lower dose of a drug and ramp up to a higher target dose. But he expects patients to tolerate Eli Lilly's pill better in phase three trials because they are longer in duration than the mid-stage studies and likely involve slower titration. He expects orforglipron to cause slightly worse rates of gastrointestinal side effects in patients with obesity. It's an issue top of mind for doctors, patients and investors because side effects such as nausea and vomiting are a significant reason why some people stop taking the injections. "If it wasn't for the fact that they can be made more cheaply, I wouldn't care" about pills, said Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women's Hospital. "But they could have different views about an oral therapy, which could be considered more like a vitamin so they would be more amenable to taking that." Nedelcovych added that tapering off injections and switching to pills as a maintenance regimen "also doesn't seem to make a ton of sense, when we ask physicians about it." He said that's in part because physician consultants and other experts believe injections, which are more effective and easier to tolerate than pills, will dominate the market for the foreseeable future. In August, Eli Lilly CEO David Ricks told CNBC the company hopes to launch its pill globally "this time next year." “Not everybody responds to GLP-1,” she tells TODAY.com. New treatments that are more powerful, mimic more satiety hormones and can be taken in more ways than weekly injections are in the works. Their success has sparked a frenzy among pharmaceutical companies looking for the next blockbuster weight-loss drug. These drugs are now wildly popular, in shortage as a result, and hugely profitable for the companies making them. Curiously, they also seemed to suppress appetite, and some people taking them lost a modest amount of weight. They bring Eli Lilly's pill, orforglipron, one step closer to potentially becoming a new, needle-free alternative without dietary restrictions in the booming market for weight loss and diabetes drugs called GLP-1s. Some doctors also made note of the number of patients on the highest dose of the pill who discontinued treatment due to side effects or any other reason in the trial. W. Timothy Garvey, M.D., served as lead author in the clinical trial.A new combination drug therapy is showing extraordinary promise in the bout against obesity, helping patients lose an average of 20 percent of their body weight in a major clinical trial. Complex Side Effects Around GLP-1 Drugs Some people experience nausea, diarrhea, constipation, and vomiting. Given what's happened with the spotty insurance coverage of Wegovy, clinicians who treat obesity anticipate similar challenges. "These medicines are the opening to a whole new era of treating metabolic disease," says Dr. Louis Aronne, an obesity specialist at Weill Cornell Medicine, one of the co-authors of the SURMOUNT-1 study. Eli Lilly is seeking FDA approval for tirzepatide for chronic weight management. The latest health and medical news emailed to you every Sunday. With prescription medications, a healthcare professional can weigh all factors affecting the patient’s lifestyle and BMI and monitor progress and side effects. Medicare does not cover weight loss drugs. Studies have also evaluated drugs that target metabolic tissues—such as adipose tissue or muscle—to promote weight loss; however, to date, nothing has carried on into clinical practice.” While GLP-1s have grabbed a lot of headlines, they are only the latest in a long history of evolving weight loss medications. 'These medicines are transforming obesity treatment and can achieve important weight loss. Crucially, weight regain after stopping drugs was faster than after ending behavioural weight loss programmes such as diet and exercise support by approximately 0.3 kg (0.7 pounds) per month - independent of how much weight was initially lost. For newer medicines such as semaglutide and tirzepatide, regain averaged 0.8 kg (~1.8 pounds) per month, with projections indicating return to baseline by approximately 1.5 years - though information on weight change beyond 12 months after these drugs remains limited. Sudhu, who has no connection to Novo Nordisk, plans to switch patients who are obese and have Type 2 diabetes to Wegovy. The drug carries a potential risk for a type of thyroid tumor, so it shouldn't be taken by people with a personal or family history of certain thyroid and endocrine tumors. In a comparison group getting dummy shots, the average weight loss was about 2.5%, or just under 6 pounds. In company-funded studies, participants taking Wegovy had average weight loss of 15%, about 34 pounds (15.3 kilograms). This image provided by Novo Nordisk shows a package of the company's semaglutide medication, named Wegovy. “This is new science, and this is coming from someone who has been in this field for over 40 years,” says Robert Kushner, an endocrinologist at Northwestern University’s Feinberg School of Medicine in Chicago, who consults for some of the companies developing these drugs.Food & Drug Administration (FDA)-approved GLP-1 to do so.The study also estimated the hypothetical trial-product estimand, which estimates treatment effect assuming patients adhere to the treatment as assigned, resulting in a mean change in body weight of –16.6% for oral semaglutide and 2.7% for placebo (95% CI, –16.5% to –11.2%).That's higher than results seen with both the Wegovy injection and pill as well as Eli Lilly's oral drug in separate trials.And because the drug only works as long as you take it, that means people may have to be on Wegovy indefinitely, Elliott said.Eli Lilly's rival pill is expected to have similar pricing for cash-paying patients. On the drug, he says he's no longer preoccupied by food, and can walk past candy bars in the grocery store without grabbing one. For many people, like Meyers, facing that resurfaces familiar anxieties about past failures relying on diet and exercise alone. Now, he can't find Zepbound anywhere, and says friends, family, and people he follows on social media are all in the same boat. But on Zepbound – the newest GLP-1 agonist drug to launch – Meyers lost 35 pounds and loves feeling free from hunger. "I've had success, up and down, but I always regain the weight," says Meyers, a digital strategist at an environmental nonprofit. How is retatrutide different? The tirzepatide solution for injection vial remains in shortage and is expected to stay that way until August next year, with demand for weight loss drugs showing no signs of slowing down. The TGA has approved tirzepatide for the treatment of overweight and obesity for those with comorbidities, via private prescription. But the drug will need to be tested in much bigger trials to assess its effects in larger groups of people. Patients on GLP-1 drugs can also hit a plateau, where weight loss slows or stops. In trial data published last year, retatrutide helped people lose more than 17 percent of their body weight, or 41 pounds, after 24 weeks. Beyond generic interventions like making physical activity more convenient, we must take a more sophisticated approach to investigating the biological effects of diet. They’re huge moneymakers for drug companies, surgeons, and hospitals,” Ludwig said. Such “off-label” use by wealthy celebrities looking not to treat obesity but to drop a few excess pounds is legal but can deplete supplies for those who need it most. Adult obesity rates have risen from 10 percent in 1970 to more than 40 percent today, but financial support for investigating its causes has been relatively meager because few wealthy companies stand to profit if Americans eat better and increase physical activity. As part of the president's "most favored nation" policy, he has announced deals with Pfizer, AstraZeneca and EMD Serono to sell certain drugs directly to patients at a discount, in exchange for exemptions from planned pharmaceutical tariffs. Novo Nordisk's oral version of its obesity injection Wegovy could enter the market by year-end, while Eli Lilly's pill orforglipron could launch next year. Starting doses of upcoming obesity pills from Eli Lilly and Novo Nordisk, pending approvals, will be $149 per month for everyone getting them through Medicare, Medicaid or TrumpRx, a senior administration official who declined to be named told reporters during a briefing Thursday. “The dietary supplement industry is the Wild West, but people have kicked it up another notch by borrowing the name GLP-1,” White tells TODAY.com. Public and private payers have been trying to wean patients off to save costs. Over half of users said their GLP-1s were difficult to afford, and many who had stopped the treatment cited the cost. Thank you for your interest in supporting KFF Health News, the nation’s leading nonprofit newsroom focused on health and health policy. Employers, which can experience high turnover, are also hesitant to cover costly drugs for workers who may leave the company within a few years, Crable added. Novo Nordisk in June said some mass, so-called 503B compounding pharmacies have scaled back production, but accused others — including those tied to Hims & Hers — of continuing to sell the drugs under the "false guise" of personalization. Those decisions legally barred compounding pharmacies from making and selling copycats of those drugs by deadlines that passed earlier this year, except in rare cases where it's medically necessary. Novo Nordisk cut its profit and sales forecast in July, saying compounded drugs had cut into Wegovy's market. Eli Lilly in December released data showing that patients who initially took Wegovy or Zepbound shots maintained the majority of their weight loss after switching to the company's pill. Drugmakers have tried to make a case that patients using injections can switch easily to oral drugs. Grunvald said obesity medicine specialists, who care for only about 5% to 10% of eligible patients, are more likely to continue favoring injections, which appear more effective than pills based on separate clinical trials. GLP-1 drugs now account for more than 7% of all prescriptions in the U.S., according to Truveta Research, a health data company. Oprah Winfrey is among the high-profile GLP-1 users, and credits the medication with finally helping her find lasting weight loss. Evernorth's new weight loss pricing program will begin in the second half of the year, as employers begin to make decisions about coverage for next year's plans. Those Medicare negotiated rates will take effect in 2027 — effectively making Novo Nordisk's products the preferred drugs in the program. Cagrilintide is a long-acting form of amylin, which is normally secreted together with insulin from the pancreas, and for the first time is now being studied in a Phase 3 trial. “It’s no big surprise or mystery why we have such a problem of obesity,” Willett said. The question, they say, isn’t whether they should be used, but how and in what combination with other approaches like bariatric surgery, diet, exercise, and intensive nutritional, behavioral, and family support. That strategy didn’t work for most patients, said Stanford, who did not have a hand in writing the new guidelines. Medi-Cal members under age 21 remain covered for purposes including weight loss, California officials said, citing a federal requirement. “We do see a lot of patients — when they try to get off, unfortunately, then the weight comes back.” “Once they reach their target weight, a lot of people will try to see whether or not they can wean off,” Hong said. Hong understands why Medicaid programs, as well as private providers, want to cut back on covering the drugs, which can cost thousands of dollars per patient per year. But he also noted that the market is "rapidly evolving with competitive assets in development" and an approval for Eli Lilly's pill, orforglipron, "just around the corner." Eli Lilly earlier this year gained the majority share of the market thanks to its blockbuster obesity injection Zepbound, which has shown to be more effective than Novo Nordisk's Wegovy. Incretins refer to treatments that mimic gut hormones such as GLP-1. “I was crying on the bathroom floor.” She stopped the drug. “Nausea, sometimes vomiting, bloating, diarrhea,” Anderson said, ticking off the most common side effects. As many as 20% of patients may experience gastrointestinal problems. (Drug trials have found no impact on dementia, however.) In January 2024, the FDA announced it was evaluating reports of hair loss and suicidal thoughts in patients taking Ozempic, Mounjaro or Wegovy. Beyond working with a doctor to ensure nutritional benchmarks are met, the recommendations include screening for a history of disordered eating and taking into account a person’s whole health before prescribing. And beyond gastrointestinal effects, researchers are investigating concerns about long-term impact, such as gallbladder issues, pancreatitis and potential links to thyroid tumors. With these promising numbers, research is now delving deeper into how to optimize these treatments. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. One problem the drugs can’t address, however, is the nature of the nation’s food environment. Even those cautious about how the new drugs are deployed acknowledge their potency. By minimizing damage to organs from conditions like high blood pressure and diabetes, the body has a much greater chance to recover than it would after decades of trying other strategies. But one thing that airlines weren’t able to control was their passengers’ waistlines, which over the past few decades continued to grow, with the adult obesity rate reaching nearly 40 percent in 2022, according to Gallup. And so, now we’re saying the same thing about obesity.” And people in the audience were like, ‘Oh, just put the bottle down,'” she recalled. Wegovy mimics one gut hormone the body produces after eating, GLP-1; and Zepbound mimics two, GLP-1 and GIP. The most common side effects were nausea and fatigue. This amylin drug from Eli Lilly is injected once a week. A phase 3 trial is scheduled to start in early 2026. The deals are among the most politically significant announcements to date in the Trump administration's push to rein in high U.S. drug costs by tying them to the lowest prices abroad. Starting doses of existing injections like Novo's Wegovy and Lilly's Zepbound will be $350 per month on TrumpRX, but will "trend down" to $245 per month over a two-year period, another senior administration official said during the briefing. The Food and Drug Administration on Thursday said it has awarded priority review vouchers, which expedite the review timelines of Eli Lilly's pill. Emory Healthcare, with 29,500 employees and 11 hospitals, is the most comprehensive academic health system in Georgia. In addition to the complex manufacturing, the small number of obesity drugs on the market has meant less competition, driving up prices for consumers. But the currently approved drugs, synthetic versions of these hormones, are large molecules that are expensive and time-consuming to manufacture, which has meant high prices for consumers and growing drug shortages. The drugs in this class are agonists, or mimics, of natural gut hormones that affect the body’s metabolism and hunger signals in the brain. This competition may finally lead to lower prices and greater supplies of these highly effective drugs, and maybe replace some injectables with pills. Costco is offering the drugs at a price of $499 for four injectable pens, a month's supply, which is about half the price when paying out-of-pocket. It showed a 15 percent loss in body weight at the ADA meeting in June, but the company hasn’t submitted it to the FDA for approval, yet. One in four people taking pemvidutide, for example, dropped out because these side effects were too intense. The other GLP-1 and glucagon combo drug is pemvidutide, being tested for both obesity and fatty liver disease. While medications like semaglutide have already made headlines for their weight-loss benefits, this study suggests combining medications could push those results even further. In January, the nation’s largest association of pediatricians stoked the debate through new clinical practice guidelines that emphasized both drugs and bariatric surgery for treatment of children with obesity and severe obesity. His “back of the envelope” calculation is that the new weight-loss drugs have the potential to add 50 percent to U.S. healthcare costs, which already eat up 20 percent of the gross national product, double that of most other countries. On the other, people don’t improve their diet, don’t increase exercise, and use the drugs to counter unhealthy habits they maintain and that may have contributed to the problem. Demand so outstripped supply in May that drug maker Novo Nordisk, maker of the diabetes drug Ozempic and its weight-loss counterpart Wegovy, announced it was limiting Wegovy supplies for new patients. The weight-loss benefits of these drugs have led to their prescribed use for obesity or overweight treatment. For years, people have been trying all sorts of methods and medications in search of the perfect weight loss solution. West says more assessments of people’s weight and health reversals after they stop treatment conducted outside of the clinical trials would help researchers fully understand what’s happening. For some, these medications have led to profound weight loss and often improvements in heart health. So with continued studies of potential new uses for these drugs, we could see broader and better coverage in 2026 and beyond. That said, the Food and Drug Administration has been approving new uses for GLP-1 drugs over time. Broadly speaking, insurance coverage specifically for weight loss has become more restrictive. The drugs' sticker prices - also called list prices - haven't gone down. In this case, the original brand-name drugs were so popular that there were widespread shortages. Weight loss In results published in February, people taking MariTide in an early-stage trial lost up to more than 14 percent of their body weight in 12 weeks. And data released in March from an early-stage trial showed that people who took Viking’s daily pill version lost around 5 percent of their weight on average in just a month. The existing drugs can cause nausea, headaches, and other unpleasant side effects that lead some people to stop taking them. Researchers are now racing to develop new anti-obesity medications that are more effective, more convenient, or produce fewer side effects than the ones currently on the market. In studies of Zepbound, patients taking the highest dose lost around 21 percent of their body weight. Ozempic has a smaller dose of semaglutide than Wegovy. Ozempic, known generically as semaglutide, was approved in 2017 by the U.S. The loss of too much body fluid may make it dangerous for you to take this medication. Also tell them if you smoke, drink alcohol, or use illegal drugs. It also helps with weight loss by reducing appetite and slowing digestion. That means it is absorbed more easily in the body and doesn't require dietary restrictions like Rybelsus does. The detailed results from the trial will be presented in September at a European medical meeting and published in a peer-reviewed journal. But an oral GLP-1 could be the best fit for those who "prioritize simplicity or convenience or have these logistical challenges with injections," he said. Some physicians are currently hesitant to prescribe injections because they "may not know how to tell patients how to use them," Sheer added. The medication’s cost and side effects will also affect the decision. (Many more take them for other indications.) According to the Kaiser Family Foundation, public awareness has ramped up, with 32% of adults now saying they have heard “a lot” about these drugs. A study from FAIR Health published in May 2025 reports that more than 2% of U.S. adults took a GLP-1 for weight loss in 2024. Next came a dual receptor agonist, Mounjaro, which is indicated for type 2 diabetes, and Zepbound, which is indicated for obesity. Treating obesity is not just a matter of willpower for some people, Anekwe says, and the results underscore what happens when a helpful weight-loss intervention is interrupted. “It goes back to the effects that the GLP-1 medications have on appetite control. What these findings suggest is that, while weight-loss drugs lead to faster results than diet and exercise alone, quitting them also results in weight being regained much faster, regardless of how much was initially lost. They compared the data on those treatments with a previous analysis on behavioral weight-loss interventions that included different dieting programs and exercise regimens. “The fact that people regained weight after stopping medication wasn’t too surprising, but what was striking is just how fast it occurred.” Therefore, tirzepatide is likely to be particularly effective in improving obesity and its related complications; clinical trials of tirzepatide’s effects on obesity and obesity-related complications are ongoing. It is approved for use in adults with obesity (BMI ≥30 kg/m2) or overweight (BMI ≥27 kg/m2) and at least one weight-related condition alongside a reduced calorie diet and increased physical activity. Results from studies that used transgenic GIP-overexpressing mice or that administered GIP to humans show that GIP results in weight loss and improved insulin sensitivity (Hojberg et al., 2009; Kim et al., 2012), suggesting that GIP could be a therapeutic target for obesity. SACRAMENTO, Calif. — Many low-income Californians prescribed wildly popular weight loss drugs lost their coverage for the medications at the start of the new year. Producing pills is generally cheaper than making drugs delivered via injections, so the cost for the new oral medications could be lower. Food and Drug Administration on Monday gave the green light to a pill version of the blockbuster weight-loss drug Wegovy, the first daily oral medication to treat obesity. Find out if weight loss medications can actually help you lose weight However, semaglutide is approved for weight loss under the name Wegovy. This doesn't mean these drugs aren't valuable, but it does support the NHS approach of prioritising people with severe and complex obesity who are most likely to benefit.'