The weight loss drug is now also available in tablet form. This can be a relief for people who are afraid of needles. But a new pill is not a harmless way to change your lifestyle.
The EU Commission has approved Wegovy in tablet form. This is the first oral therapy in Europe with the weight management active ingredient semaglutide, which is not injected but is swallowed. This can be a relief for many obese patients. Is the pill as effective and safe as the injection?
Same active ingredient in Wegovy tablets and syringes.
The most important point: “It is the same active ingredient, taken orally or as an injection,” says Katharina Timper, director of the department of clinical dietetics at the TUM Klinikum Rechts der Isar. Vegovy contains semaglutide. The substance mimics the intestinal hormone glucagon-like peptide-1, which suppresses hunger and appetite and increases the feeling of satiety. If the pill is “taken correctly, there is virtually no difference in terms of effectiveness,” Timper explains.
Research supports this assessment: Obese or overweight adults were able to reduce their weight by an average of about 14 percent after 64 weeks when taking oral semaglutide, according to the study. With the injection, that figure reached 19 percent at 72 weeks.. As usual in such studies, a low-calorie diet and increased exercise were required.
The side effect profile is also comparable, Timper explains, “because the tablet was designed to deliver the same amount of active ingredient into the body.” Gastrointestinal complaints such as nausea, diarrhea, constipation or vomiting are common. Less commonly, bile problems or inflammation of the pancreas may occur.
taking Wegovy-tablet must fit exactly
The big difference between the two dosage forms is in everyday use. “The benefits of the injection are very clear: you only have to worry about it once a week,” says nutritionist Timper. The time of day or previous meal does not matter.
The tablet must be taken every day according to clear rules: in the morning on an empty stomach with a small amount of water, then do not eat, drink or take any other medications for at least 30 minutes. “If you don’t do this, the availability of the active ingredient and therefore the effectiveness will quickly decrease,” Timper says.
This is due to the chemical structure of the drug: if you simply swallow semaglutide, it is broken down in the digestive tract by stomach acid and enzymes and is therefore ineffective. Therefore, the active ingredient in the tablet has been protected with a special excipient that buffers the acid, reduces its breakdown by enzymes and facilitates absorption through the gastric mucosa. Food, drinks or other medications may interfere with this sensitive environment or reduce the absorption of active ingredients.
Who are Wegovy tablets for?
The Vegovoy tablet, like the injection, is intended for obese people, usually with a body mass index (BMI) of 30 or more. The drug may also be an option for people with a BMI of 27 or more if they have underlying weight-related conditions such as high blood pressure, type 2 diabetes or sleep apnea. The tablets are only approved for adults, and the injections are for children 12 years of age and older.
What is new, first of all, is that the “injection” obstacle has been eliminated. “Many people are skeptical about drug injections,” says Jens Aberle, endocrinologist at the University Hospital Hamburg-Eppendorf. “If you ask a person whether they would rather inject a drug or take it as a pill, 90 percent will say not a pill.” There is also a psychological component: for many people, the pill is no longer perceived as a serious illness. This could help people for whom fear of needles has previously been a real barrier.
Cure for a serious illness
At the same time, Aberle warns against a dangerous misunderstanding: the pills may turn out to be “even more accessible” and “they can be taken even in the absence of indications.” But Wegovy, even in pill form, remains a prescription drug for chronic conditions, not a quick way to shed a few pounds.
The drugs act on the complex neuroendocrine system that regulates hunger, satiety, metabolism and body weight. Therefore, Aberle says, it is important to “emphasize again and again that the use of these substances, whether pills or injections, should always be for medical reasons and must be accompanied by a doctor.”
Lots of new ones Anti-obesity drugs in development
Wegovy’s new pill is just one component of a very dynamic area of anti-obesity drug research. Orforgliprone (trade name: Foundayo) was approved in the US in April 2026: it is a GLP-1 tablet that does not require strict application rules because it has a different chemical structure.
Also drawing particular attention is the drug retatrudide: an injectable drug that targets not just one hormone receptor, like Vegovi, or two, like Muñaro, but even three, which the manufacturer says has produced an average weight loss of more than 30 percent over two years at the highest dosage. Approval is expected in 2027.
“This is an extremely dynamic area of research, and there are actually a lot of new drugs in clinical development,” says Aberle, who himself was involved in the orforgliprone study. The Association of Evidence-Based Medicines reports more than 70 other anti-obesity drugs currently under investigation around the world.
“We need to understand who needs what drugs, who benefits most from what drug,” Timper emphasizes. That’s why it’s not just about stronger products, but also active ingredients and combinations that suit different disease profiles, she says: “Tailored obesity therapy is the future.”