Oral Semaglutide Pills for Weight Management: What to Know

One GLP-1 receptor agonist drug is now available as a daily pill for weight management. The oral form of semaglutide (Wegovy) works in the same way as the under-the-skin injectable and helps achieve similar levels of weight loss.

While the semaglutide pill is more affordable than the injection, and may be more convenient to take, it’s not right for every patient. Amanda Velazquez, MD, director of Obesity Medicine in the Department of Surgery at Cedars-Sinai, shares what patients should know about this new form of the drug.

The News About the Semaglutide Pill

In December 2025, the Food and Drug Administration approved the oral form of semaglutide, which, like the injection, mimics GLP-1 hormones to reduce appetite, slow digestion, improve blood sugar regulation and more.

Adults with obesity—a body mass index (BMI) of 30 or greater—or those with a BMI of 27 to 29.9 with a weight-related medical condition such as high blood pressure or obstructive sleep apnea, could qualify for the medication. The Cedars-Sinai pharmacy can fill prescriptions for oral semaglutide for Cedars-Sinai patients.

“The oral form of this medication creates more options for patients,” said Velazquez. “Some people may prefer a pill over an injectable, and most importantly, oral medications are more cost-effective to create, so they are less expensive and more accessible.”

The pills are slightly less effective than injectable semaglutide: Studies found that people who took 25 or 50 mg doses of oral semaglutide for 14 months lost about 13% of their body weight. Patients who took injectable semaglutide lost an average of 15%-17% of their body weight in the same amount of time. Side effects are similar—most commonly, nausea, constipation and diarrhea.

Patients should only take semaglutide, in either form, as prescribed by a physician who can help manage side effects, Velazquez said. Clinicians provide guidance and advise patients about lifestyle changes—which are necessary to fully see the benefits of the drug.

“When you start an obesity management medication, it's always in addition to lifestyle therapy,” she said. “This includes nutrition and exercise counseling, stress management, sleep hygiene and overall guidance for overcoming barriers that prevent you from achieving the healthiest form of yourself.”

Is the Semaglutide Pill the Right Fit for You?

Velazquez said the semaglutide pill is best for patients who haven’t had access to injectable obesity management drugs because of cost, or those who fear needles.

One consideration: The drug must be taken first thing in the morning, with no more than half a glass of water, and 30 minutes before any food.

“If patients are not following those directions, it could inhibit proper absorption and affect the efficacy of the medication,” she said.

As with other medications, Velazquez cautions against compounded formulas offered by online pharmacies or medspas, which are not recommended by scientific and professional organizations.

“We can't vouch for their safety, and the dosing may be different because it's not the true medication,” she said.

Can Patients Switch From Injectables to Pills?

Velazquez said most patients who take injectable GLP-1 drugs and experience good results will not benefit from switching to the oral form.  

“For patients who are currently on tirzepatide (Zepbound), which is the most efficacious medication on the market for total body weight loss, switching to an oral semaglutide wouldn't necessarily be recommended,” she said.

Most people lose weight on the pill form of semaglutide, but the injectable version works more consistently for a greater number of people.

“The oral medication is not as effective for some people—about a quarter of patients did not lose 5% or more of their weight,” she said. “People respond differently to obesity treatments, and clinicians should work with each patient to develop an effective weight management plan.”

What’s Next?

New forms and formulations of GLP-1 drugs will continue to be studied in clinical trials and eventually be available to patients. Velazquez said new drugs will use different mechanisms of action, in the same way that medications for high blood pressure can work differently in the body.

“It's an incredible time for obesity management—we're seeing an increase in the tools in the toolbox,” she said. “Medications that will come out in the future will work with varying mechanisms, which is helpful for patients because we need to come at this from different angles.”