In a major development for weight loss treatment, the FDA has approved Wegovy (semaglutide) tablets 25 mg, making it the first oral GLP-1 medication for obesity in the United States. This pill version offers a needle-free alternative to the injectable Wegovy that has helped millions lose significant weight since 2021.
The Quick Facts
- • FDA approval date: December 22, 2025
- • Drug name: Wegovy (semaglutide) tablets 25 mg
- • Availability: Starting dose available early January 2026
- • Pricing: $149 per month for starting dose with savings offers
- • Average weight loss: 17% in clinical trials (vs 3% for placebo)
Why This Approval Matters
Until now, all GLP-1 medications approved for weight loss in the US required weekly injections. While injectable Wegovy and other medications have been highly effective, many people face barriers:
- Needle aversion — Some people avoid treatment due to fear of injections
- Injection site reactions — Bruising, pain, or irritation at injection sites
- Travel and storage — Injectable pens require refrigeration and careful handling
- Preference for oral medication — Many simply prefer taking a daily pill
The oral version removes these barriers while delivering comparable weight loss results to the injection.
Clinical Trial Results: OASIS 4
The FDA approval was based on the OASIS 4 trial, a 64-week phase 3 study involving 307 adults with obesity or overweight with weight-related conditions (excluding diabetes).
For Those Who Stayed On Treatment
- • 17% average weight loss
- • Only 3% weight loss for placebo
- • 76% achieved ≥5% body weight reduction
- • 31% of placebo group achieved ≥5% loss
Intention-to-Treat Analysis
- • 14% average weight loss
- • 2% weight loss for placebo
- • Accounts for all participants regardless of adherence
The intention-to-treat analysis is considered more realistic since it includes people who stopped the medication early, while the on-treatment analysis shows the results for those who continued.
How the Wegovy Pill Works
Like injectable Wegovy, the oral tablet contains semaglutide, a GLP-1 receptor agonist that:
Reduces Appetite
Acts on brain receptors that control hunger, making you feel fuller with less food
Slows Gastric Emptying
Food stays in your stomach longer, extending the feeling of fullness after meals
Improves Blood Sugar Control
Helps regulate insulin and blood sugar levels, though the pill is approved for weight loss, not diabetes
Dosing and Administration
The oral Wegovy uses a gradual dose escalation approach over 12 weeks:
- Starting dose: 1.5 mg (available early January 2026)
- Maximum approved dose: 25 mg
- Administration: Taken daily, on an empty stomach, with a small amount of water
- Timing: Must wait at least 30 minutes before eating, drinking, or taking other medications
Important Administration Note
Unlike the injectable version which you take once weekly, the oral tablet must be taken daily. The strict timing requirements (empty stomach, 30-minute wait) are critical for proper absorption. Missing these requirements can significantly reduce the medication's effectiveness.
Side Effects
The oral version shares the same side effect profile as injectable Wegovy. The most common side effects include:
- Nausea
- Diarrhea
- Vomiting
- Constipation
- Abdominal pain
- Headache
Serious but rare risks include pancreatitis, gallbladder issues, thyroid tumors, and depression. The medication is contraindicated in patients with a personal or family history of medullary thyroid carcinoma.
Pricing and Availability
Novo Nordisk has announced competitive pricing for the oral Wegovy:
- • Starting dose: $149 per month with savings offers
- • Launch timeline: Early January 2026 for starting dose
- • Supply: Manufactured domestically with robust supply on-hand
- • Insurance coverage: Coverage details still emerging; check with your plan
Who Should Consider the Wegovy Pill?
Good Candidates
- • Adults with BMI ≥30 (obesity)
- • Adults with BMI ≥27 with weight-related conditions (high blood pressure, high cholesterol, etc.)
- • People who are needle-averse
- • Those who prefer daily routine over weekly injections
- • Individuals who can commit to strict daily dosing requirements
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Oral vs Injectable: Which Is Better?
The choice between oral and injectable Wegovy comes down to personal preference:
Oral Wegovy Pros
- ✓No needles required
- ✓No injection site reactions
- ✓Easier to travel with
- ✓May feel more like traditional medication
Oral Wegovy Cons
- ✗Daily dosing (vs weekly injection)
- ✗Strict timing requirements
- ✗Must be taken on empty stomach
- ✗30-minute wait before eating/drinking
The Bottom Line
The FDA approval of oral Wegovy represents a significant expansion of weight loss treatment options. With comparable efficacy to the injection and competitive pricing, it removes a major barrier for people who want GLP-1 therapy but prefer to avoid needles. However, the daily dosing requirement and strict administration guidelines mean it's not necessarily easier than the weekly injection—just different. Talk to your healthcare provider about which option best fits your lifestyle and preferences.