Is an ‘Ozempic Pill’ the Future of Weight Loss Medications?

Late-stage study results published June 25 in The Lancet found that participants who took a semaglutide pill lost, on average, 15 percent of their body weight over a 68-week period, compared to 2.4 percent in the placebo group. Thirty-four percent of study participants who took the pill lost 20 percent of their body weight.

A lower-dose semaglutide pill is currently available for the treatment of type 2 diabetes. The higher-dose version under investigation is being studied for both type 2 diabetes and weight loss management. 

Other GLP-1 pills are also in the works. Eli Lilly’s orforglipron helped study participants who were overweight (defined as a BMI of 25 to 29.9) or who had obesity cut up to 14.7 percent of their body weight, on average, after 36 weeks in a phase 2 trial. The results were published June 23 in the New England Journal of Medicine.

And Pfizer’s danuglipron, yet another GLP-1 agonist being researched, was found in a phase 2 clinical trial to help participants with type 2 diabetes lose weight and lower blood sugar levels in the first 16 weeks, according to research published in JAMA Network Open.

Slightly different from the GLP-1 pills but equally as buzzworthy is an investigational medication called retatrutide. In another set of trial results, also reported at the 2023 American Diabetes Association Scientific Sessions, researchers found that study participants with obesity lost more than 24 percent of their starting body weight (an average of 60 pounds) in a 48-week period when taking the highest dose of retatrutide. All of the participants taking the pill lost at least 5 percent of their total body weight in the trial. The phase 2 results were published June 26 in the New England Journal of Medicine.

The study’s authors note that participants taking the medication were continuing to lose weight at the end of the trial, and researchers “speculate that greater weight reductions may be observed in the longer-duration phase 3 trial.”

While some people may prefer a weekly injection, Chetna Bakshi, M.D., a bariatric surgeon at Northwell Health’s Syosset Hospital in New York, says adding a pill to the mix could “offer more options for those patients who are unable to do the injections.” 

It could also be a good option for people who travel often, since the injectable medications have to be refrigerated. “A pill is very easy to take with you, so it definitely allows for more options for patients,” Bakshi says. 

More medications could improve access

Adding new options to the arsenal could help improve access for patients. Both Ozempic and Wegovy are on the Food and Drug Administration’s drug shortage list, and Stanford says she has “struggled to get these medications on a consistent basis” for her patients who have the insurance or the means to pay for them. (A one-month supply costs around $1,000 or more.)

What’s more, there are currently just three GLP-1 drugs approved for the treatment of overweight and obesity — Wegovy, Zepbound (approved by the FDA on Nov. 8 and whose active ingredient is tirzepatide) and an older medication called Saxenda, whose active ingredient is liraglutide — leaving health care providers with “fairly limited options for someone who does not have diabetes,” Bakshi says.

While we wait for more research and potentially more drug approvals to trickle in, both Stanford and Bakshi say it’s important to talk to your health care provider about your weight loss goals and options if you’re struggling to lose weight.

These treatments are not for everyone, Bakshi stresses, and like all medications they can cause side effects, including nausea, vomiting, diarrhea, stomach pain and constipation. Patients with certain conditions, such as a history of medullary thyroid cancer, should not take them, Bakshi adds. “There’s no miracle drug; everything comes with risks, everything comes with complications,” she says.

It’s also important to consider costs. Many insurance companies will cover drugs that have been approved for the treatment of type 2 diabetes in patients who have diabetes. Coverage for approved weight loss medications, however, is trickier. Many insurance plans, including Medicare, won’t cover them. ​​

​Editor's note: The story, first published July 3, 2023, has been updated to reflect the new federal approval of Zepbound for weight loss.