GLP-1 weight loss medications, which includes Wegovy®, Ozempic®, and Zepbound®, are powerful drugs that help people who are obese or overweight to lose weight.
Obesity is a chronic condition that affects about 40 percent of people in the United States, according to the U.S. Centers for Disease Control and Prevention. Until recently, the medication was only available in a weekly injection. But in December 2025, the U.S. Food and Drug Administration approved an oral version of Wegovy.
In this Q&A, Jennifer Lauren Abrams, DO, explains some of the advantages of the pill over the injection, as well as how to switch from the injection to the pill and other questions you should ask your doctor. Dr. Abrams, an endocrinologist, is part of Mount Sinai Doctors-Brooklyn Heights.
Can you tell me about the new GLP-1 weight loss pills?
This new weight loss pill is an oral form of semaglutide, the same medication that is approved for weight loss in the injectable version of Wegovy. Semaglutide is part of a class of drugs known as GLP-1 receptor agonists because they mimic the action of a hormone called GLP-1, which targets the area of the brain that slows digestion and processes hunger. In injection or pill form, semaglutide decreases your appetite overall and makes you feel full sooner, so you eat less. The pills offer an easier and more convenient option that is highly effective, in combination with a healthy diet and regular exercise.
Jennifer Lauren Abrams, DO
Are the pills as effective as the shots?
Yes. A study published in The New England Journal of Medicine showed that patients who received semaglutide pills at the maximum dose had an average weight loss of 13.6 percent from where they started. The clinical trial for the injectable semaglutide showed an average weight loss of 14.9 percent. There is no clinical trial that compares oral and injectable semaglutide , but a separate study looked at the indirect correlation between the two. It showed that the two medications have comparable effects on weight.
What are the advantages of a pill vs. a shot?
The main advantage of the pill is that you can get the benefits of semaglutide without having to take an injection. Many patients either cannot or do not want to use needles. The pills are more convenient—and just as effective. Semaglutide is approved to treat weight loss in patients with obesity or overweight with a weight-related condition such as high blood pressure, and for cardiovascular disease in patients with obesity or overweight; it is not approved to treat diabetes.
Are there any side effects of the pill?
The side effects are the same for the pill and the shot. They are usually minor: headache, nausea, diarrhea, vomiting, constipation, stomach pain, and fatigue. Most people only have side effects for a few days after starting the medication or increasing the dose. If you eat slowly and have smaller meals, you may reduce your risk for side effects. More serious side effects of the drug are very rare. If you have side effects, talk to your health care provider because they may be able to make adjustments.
Can the drug lead to muscle loss?
Both the oral and the injectable semaglutide help with weight loss. The medication does not target fat specifically, so you may experience some muscle loss. For that reason, it is important to do strength training while on the drug, after checking with your doctor to make sure it is safe for you to do so.
How do you get started?
You can only get the semaglutide pill with a doctor’s prescription. You take the pill once a day with water, after fasting. Then do not eat, drink, or take other medications for a half hour. You should not take Wegovy if you are pregnant or planning to become pregnant.
If you are taking the pill, do you have fewer doctor appointments?
The follow-up is usually similar, but you should ask your doctor.
Does the pill dose ramp up as the shot does?
Yes. With both injections and pills, you start at the lowest dose and increase it every 30 days until you reach the highest level you can tolerate. At that point, the drug has the greatest effect on weight loss. But the doses are not the same because the body absorbs the injectable and oral medications differently. The maximum dose for the injection is 2.4 milligrams, and the maximum dose for the pill is 25 milligrams.
When do you reach your ideal weight?
With both pill and shot, we expect to see maximum weight loss after about 12 months after you reach your maximum dosage. Studies have found an average maximum weight loss of 14 to 25 percent, with up to 25 percent of people losing 20 percent of their body weight.
If you start out taking the shot, can you switch to the pill?
Yes. The doses are different, but you can switch between the injectable and the pill. If you are interested in making the switch, you should talk to your health care provider.
What do people need to know about insurance and reimbursement?
That can be a little tricky because the medications are so new. Several commercial insurance plans currently cover the pills, but that could change over time. I recommend you check with your insurance to see if your plan covers it.
How long do you take the GLP-1 medications?
You take GLP-1 medications, pill or injection long term. When patients come off the medication, they typically regain the weight they lost. I tell patients that being overweight or obese is a chronic condition, like high blood pressure or diabetes, which requires long-term management. So, just as with those other conditions, your commitment to nutrition, exercise, and in some cases medication, needs to be long-term.