What if treating obesity could be as easy as popping an effective pill? That's a notion that has long fueled hope for many of the more than 40% of Americans who are considered obese—and fueled criticism by those who advocate for wider weight acceptance. Soon, it may be a reality. High-dose oral versions of the medication in the weight-loss drug Wegovy may work as well as the popular injections when it comes to paring pounds and improving health, according to final results of two studies released Sunday night. The potent tablets also appear to work for people with diabetes, who notoriously struggle to lose weight, per the AP. Drugmaker Novo Nordisk plans to ask the Food and Drug Administration to approve the pills later this year.
Novo Nordisk already sells Rybelsus, which is approved to treat diabetes and is an oral version of semaglutide, the same medication used in the diabetes drugs Ozempic and Wegovy. It comes in doses up to 14 milligrams. But results of two gold-standard trials released at the American Diabetes Association's annual meeting looked at how doses of oral semaglutide as high as 25 milligrams and 50 milligrams worked to reduce weight and improve blood sugar and other health markers. A 16-month study of about 1,600 people who were overweight or obese and already being treated for Type 2 diabetes found the high-dose daily pills lowered blood sugar significantly better than the standard dose of Rybelsus. From a baseline weight of 212 pounds, the higher doses also resulted in weight loss of between 15 and 20 pounds, compared to about 10 pounds on the lower dose.
Another 16-month study of more than 660 adults who had obesity or were overweight with at least one related disease—but not diabetes—found the 50-milligram daily pill helped people lose an average of about 15% of their body weight, or about 35 pounds, versus about 6 pounds with a placebo. That's "notably consistent" with the weight loss spurred by weekly shots of the highest dose of Wegovy, the study authors said. There were side effects: About 80% of participants receiving any size dose of oral semaglutide experienced things like mild to moderate intestinal problems, such as nausea, constipation, and diarrhea. In the 50-milligram obesity trial, there was also evidence of higher rates of benign tumors in people who took the drug versus a placebo. In addition, about 13% of those who took the drug had "altered skin sensation," such as tingling or extra sensitivity.
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The pills aren't necessarily a better option for the hundreds of thousands of people already taking injectable versions, said Dr. Fatima Cody Stanford, an obesity medicine expert at Massachusetts General Hospital. And some worry a pill will put pressure on people who are obese to use it, fueling social stigma, said Tigress Osborn, chair of the National Association to Advance Fat Acceptance. Still, medical experts predict the pills will be popular, especially among people who want to lose weight but are fearful of needles. Plus, tablets would be more portable than injection pens and don't have to be refrigerated. "If you ask people ... 'Would you rather take a pill or an injection?,' people overwhelmingly prefer a pill," said Dr. Daniel Bessesen, chief of endocrinology at Denver Health. Novo Nordisk officials say it's too early to say what the cost of the firm's high-dose oral pills would be. (More obesity stories.)
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