A new option is emerging in the fast-growing weight loss drug market: a GLP-1 pill. The oral medication, designed to mimic the effects of injectable drugs like Ozempic and Wegovy, could expand access to treatment for people managing obesity and Type 2 diabetes.
According to KFF, a national health policy organization, about one in eight U.S. adults currently uses GLP-1 injections for weight loss, diabetes, or other health conditions. These drugs lower blood sugar levels and suppress appetite, making them a popular choice for patients seeking medical weight management. Until recently, GLP-1 medications were available only in injectable form.
“Initially, it came in as an injection because an oral semaglutide would never get absorbed,” said Dr. Srividya Kidambi, who oversees the medical weight loss and bariatric surgery program at the Medical College of Wisconsin, in an interview on WPR’s Morning Edition. She explained that growing interest in GLP-1 drugs is being driven by patients who see friends and family achieve positive results.
“These synthetic versions are designed to last much longer in our body than the hormone our gut releases after meals,” Kidambi said.
Last month, the U.S. Food and Drug Administration approved an oral version of semaglutide, the active ingredient in Wegovy, developed by global pharmaceutical company Novo Nordisk. A competing pill from Eli Lilly is expected to receive approval later this year.
“Both are GLP-1 medications, but Eli Lilly’s is a different type,” Kidambi said. “It’s not a peptide, it’s a small molecule.”
The new pill works by attaching semaglutide to a compound called SNAC (salcaprozate sodium), which creates a unique absorption mechanism. This system alters stomach pH levels to help the drug remain in the stomach long enough for proper absorption.
“It has to be taken in a fasting state in the morning with less than or equal to four ounces of water,” Kidambi said. “Extra water might push the pill out of the stomach, and absorption doesn’t occur.”
While GLP-1 drugs have shown significant benefits, they are not without side effects. According to Harvard Health, common reactions include nausea, vomiting, diarrhea, and constipation. In cases of rapid weight loss, some patients may also develop sunken eyes or sagging skin around the neck and jaw.
Despite these risks, Kidambi called the medications a “game changer” in the fight against obesity, noting that they may also influence healthier eating habits across households.
“Taking the medication might change the way they eat or buy groceries,” she said. “That might also give children the benefit of eating healthy.”
Demand for GLP-1 products has surged in recent years, leading to intermittent supply shortages since 2022, according to the FDA. Kidambi said some of her patients were forced to go months without their weekly injections. Although most supply issues have eased, she said insurance coverage remains the biggest obstacle for patients seeking treatment.
In Wisconsin alone, about 1.6 million adults are living with obesity and more than 400,000 people have diabetes, according to the American Diabetes Association. Kidambi said diabetic patients are more likely to receive insurance approval for GLP-1 drugs because the condition is recognized by Medicare.
“It’s not so clear for patients who have obesity,” she said. “Some insurances cover it and some don’t.”
Patients with obesity may only qualify for coverage if they also have cardiovascular disease or obstructive sleep apnea, she added.
Without insurance, injectable GLP-1 drugs can cost around $1,000 per month. The newly approved pill is significantly cheaper, at about $299 per month. Kidambi said she hopes this signals a broader decline in prices over time.
The financial stakes are high. The global GLP-1 market is projected to grow from $62 billion this year to more than $157 billion by 2035, according to GlobeNewswire.
As for whether pills will replace injections, Kidambi remains skeptical.
“Both have their own role,” she said. “Oral medication has to be taken in a very specific way, and that might be a hindrance for some people compared to taking weekly injections.”
