Wegovy has just had its first weight-loss pill licensed for use in the UK to much fanfare. The GLP-1 medication was previously only available as an injection; the semaglutide tablets are expected to become available via private providers, including supermarkets and pharmacies, within the next few weeks.
Eligible candidates will be adults with a BMI of 30 or more, or adults with a BMI of 27 or more and at least one co-morbidity, such as high blood pressure, type 2 diabetes or cardiovascular disease.
Patients who meet the criteria will still have to pay – the medication won’t be available through the NHS, at least not initially. “We won’t expect that until there’s been a deal reached between [manufacturer] Novo Nordisk and the government, and I expect that to take some time,” says Dr Earim Chaudry, chief medical officer at digital healthcare provider Voy.
There already seems to be a great deal of interest in the Wegovy pill. Voy, the only UK provider currently open for pre-orders, has experienced “massive demand”. “We’ve seen, on our waiting list, tens of thousands of patients who are currently waiting for the treatment,” says Dr Chaudry.
The pill works in much the same way as the jab, providing the same type of hormone – a peptide called semaglutide that mimics GLP-1 to suppress appetite – in oral form. It’s coupled with a molecule called SNAC (salcaprozate sodium), which enables the body to absorb the peptide in an adequate volume.
Unlike the injections, which are administered weekly, the pills are for daily use, taken every morning on an empty stomach. The patient must wait half an hour before they can eat afterwards. There are four dose strengths available – 1.5mg, 4mg, 9mg and 25mg – with new users expected to start on the lowest dose before incrementally increasing over the course of several months.
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The trials of the Wegovy pills have seen similar results to those of the jabs. After 64 weeks, adults taking semaglutide tablets lost an average of 16.6 per cent of their body weight, compared to 2.7 per cent for the control group, who took a placebo pill.
There is some evidence that injections might be slightly more effective: one real-world study found that participants taking Wegovy injections had lost an average of 17.6 per cent of their body weight after 12 months and 20.3 per cent at 18 months. In a separate 72-week medical study, those taking Wegovy jabs, alongside a reduced-calorie diet and increased physical activity, lost an average of 19 per cent of their body weight.
Additional health benefits were observed during the Wegovy pill trial. Participants saw “material uplift in other metabolic markers, like improved blood pressure,” explains Dr Chaudry. “We’ve also seen that people’s physical and functional health has improved, so being able to move and do things they ordinarily couldn’t do.” Eight out of 10 people who had prediabetes were put into a normal sugar state.
Studies have shown that the side effects of Wegovy in either format are experienced at a slightly higher frequency than those of its main weight-loss drug rival, Mounjaro, whose active ingredient is tirzepatide, rather than semaglutide. The most commonly reported side effects are gastrointestinal, including nausea, vomiting and diarrhoea – these were reported by 74 per cent of participants in the Wegovy pill trial. Though these were generally classed as mild to moderate and transient, just under 7 per cent of the oral semaglutide group ended up discontinuing treatment.
It’s unlocking medication for a cohort of patients who didn’t previously feel that the injectable was for them
In terms of overall weight loss, Mounjaro was found to be more effective in one 2025 trial that put tirzepatide (Mounjaro) and semaglutide (Wegovy) head to head. The US researchers found that those on tirzepatide lost 20.2 per cent of their body weight compared to 13.7 per cent for those on semaglutide. Those on tirzepatide also saw their waist sizes shrink by over 5 cm more on average than those on semaglutide.
One of the most compelling arguments for Wegovy in pill form is that it removes certain barriers for prospective users who don’t like the idea of injections, whether because of the continuing stigma around this medication, the hassle of keeping medication in the fridge, or the actual administering of the drug – especially for those who are phobic of needles.
A study conducted by Voy found that 55 per cent of people who were on a weight-loss injectable were hiding it from their partner. “We know that that is linked to stigma and judgement and fear,” says Dr Chaudry. “And we know that no needles, no fridge, nothing visible with the oral pill – that’s going to be fairly game-changing in terms of how comfortable people feel taking this medication.”
Another potential boon of the Wegovy pills being touted is price; many have assumed that the tablets will be cheaper than injections. “I would just slightly temper the enthusiasm around this idea that it’s going to be a cheaper option,” advises Dr Chaudry. “The reality is, this is the same molecule, this is the same technology, and so I’m not convinced that it’s significantly cheaper to produce than the injectables right now.”
However, he does anticipate the cost coming down as manufacturers build more efficiencies into their processes and other rival oral weight-loss products, such as a pill from Eli Lilly with a projected launch later this year, enter the market.
If Voy’s prices are anything to go by, Wegovy in pill form will initially cost more than the jabs; the former is priced at £134 a month for the lowest dose, while the latter is £124 per month.
Amid all the excitement, it’s important to note that this is not the first oral semaglutide product to be available in the UK. In 2020, the same manufacturer, Novo Nordisk, launched a pill called Rybelsus. Though licensed in the UK for managing type 2 diabetes and available through the NHS, it can also be prescribed off-label for weight loss.
“This is a bit of deja vu, really, because we have been here before – it’s not actually new,” says Caroline Balazs, nurse practitioner and founder of SkinnyJab, and one of the UK’s original weight-loss injection pioneers. “There was a lot of hype about it six years ago, and everybody bought the pills, because they thought: ‘Oh great, it’s the pill, it’s easy, we don’t have to worry about keeping things cold, we’re not administering injections!’ And loads and loads of people bought this drug.”
Caroline Balazs, SkinnyJabThese pills can be fantastic for maintenance – but they’re not going to radically change anything
A lot of Balazs’s customers decided quite quickly that it wasn’t for them. “The side effects of nausea were quite prevalent. In some ways, it’s not as easy as the injections because you’ve got to remember to take it every day on an empty stomach. Some people found it less effective, or not effective at all.” According to one study, participants lost 15.1 per cent of their initial body weight over 68 weeks of taking Rybelsus.
A small proportion of Balazs’s clients do still opt for Rybelsus because it’s more convenient for travelling, or because they hate having to inject themselves, but she advises that it’s better for maintenance rather than dramatic weight loss. “These pills, they’ve got a place; they can be fantastic for maintenance – but they’re not going to radically change anything,” she says. “What I don’t want is people stopping their Mounjaro medication, thinking that this is the next big thing, because those people are going to be strongly disappointed.”
Dr Chaudry broadly agrees with this sentiment: “Currently I see the oral medication as sitting alongside the injectables. I would recommend that people who are doing well on injectables continue on that path, because they’re on a stable medication and it’s having a great result for them. If you don’t have any challenges, don’t feel that you have to be on the new oral pill.”
The big difference with the Wegovy pill is the potential to increase the dosage, which could have a bigger impact on weight loss than Rybelsus, even if it doesn’t quite achieve the results seen with Mounjaro. Rybelsus comes in the same initial three doses as oral Wegovy – 1.5mg, 4mg and 9mg – but it doesn’t offer the final, much stronger dose of 25mg. That could be what makes the difference.
Another weight-loss drug, slated for UK release sometime in 2027 or 2028, is going to be a much bigger game-changer than the Wegovy pill, claims Balazs. Retatrutide, a product developed by Eli Lilly that’s currently in phase 3 clinical trials, is what’s known as a “triple agonist”, meaning it stimulates three metabolic pathways simultaneously: GLP-1 receptors, which slow digestion and suppress appetite; GIP receptors, which reduce hunger and improve insulin secretion; and glucagon receptors, which increase energy expenditure and boost fat breakdown. This unique trifecta is expected to deliver radical results.
By comparison, semaglutide (Wegovy, Ozempic and Rybelsus) primarily stimulates one specific receptor (GLP-1), while tirzepatide (Mounjaro) is a dual-receptor agonist, stimulating GLP-1 and GIP receptors.
Ultimately, although Wegovy pills aren’t likely to be a major disruptor in the weight-loss world, they’re still a helpful alternative for people who’ve felt uncomfortable with jabs, enabling them to access potentially life-saving treatment.
“If you are having challenges – maybe you’re in that 55 per cent of people who feel stigmatised about taking the injections, or you’re worried about some element of it – then I think the oral medication is great,” says Dr Chaudry. “It’s really unlocking the medication for a cohort of patients who didn’t previously feel that the injectable was for them.”
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