GLP-1 pills for weight loss are here. How will they change obesity care

Within three weeks of their launch in the United States on Jan. 5, 2026, the newly approved GLP-1 pills for weight loss had been prescribed to about 170,000 people, outpacing the rate of adoption of other GLP-1 medications.

Previously, GLP-1 medications - which mimic the naturally occurring hormone glucagon-like peptide-1, which regulates blood sugar, digestion, and hunger - had been approved only to treat obesity in the form of weekly, home-administered injections. Even so, an October 2025 Gallup poll reported that 12.4% of respondents to a nationally representative survey were taking this class of medication for weight loss. That's more than 30 million people in 2025.

The approved pills, sold under the brand name Wegovy^®, are created by the Danish company Novo Nordisk, which also manufactures the popular diabetes drug Ozempic^®. Eli Lilly, an American pharmaceutical company, is in the final phases of clinical trials for another GLP-1 weight-loss pill - orforglipron - and is seeking approval for it from the Food and Drug Administration (FDA) this year.

"Having an oral formulation, it may lower the psychological barrier that patients have to starting treatment," says Priya Jaisinghani, MD, an endocrinologist and obesity-medicine specialist at New York University Langone Medical Associates and a clinical assistant professor at NYU's Grossman School of Medicine. "I'm hopeful oral formulations are going to expand evidence-based obesity care and normalize that care. This is a medical therapy, just like for hypertension or diabetes."

This class of medications has proven to be broadly effective at helping people with obesity lose weight and in reducing heart attacks and stroke among people with heart disease. The Gallup poll also found that the percentage of Americans with obesity decreased from 39.9% in 2022 to 37.0% in 2025, a three-percentage-point decrease that represents 7.6 million people.

Still, GLP-1 medications carry side effects, affect people differently, can be prohibitively expensive, and have remaining questions about their long-term effects.

AAMCNews asked experts in obesity medicine and pharmacology to answer common questions about the new pills.

Who is eligible for a prescription?

Adults who have a body mass index (BMI) of at least 30 or who have a BMI between 27 and 30 as well as at least one weight-related health condition, such as heart disease, high cholesterol, or high blood pressure, are eligible for a prescription in consultation with their doctor.

GLP-1 medications have "been life changing for so many people with obesity," says Jody Dushay, MD, an assistant professor of medicine at Harvard Medical School and an endocrinologist at the Beth Israel Deaconess Medical Center in Boston. "In the field of medical weight management, it's been amazing."

However, Dushay worries that the popularity of these medications has influenced people to seek them out even if they don't meet the clinical criteria.

"They were never meant to be used for a small amount of weight loss in a person who is metabolically healthy," she says.

She also emphasizes that current research shows that people who lose weight on these medications are likely to regain the weight if they stop taking them.

"I think a lot of people still want to take them for a short time to lose a little bit of weight," she says. "People really need to understand that this is not how these medications should be used. Rather, they are used to treat high body weight, high BMI, and some comorbidities associated with obesity for the long term."

Are the pills as effective as the injectables?

Based on clinical trial data from Novo Nordisk, people who took the pill along with maintaining a reduced-calorie diet and increased physical activity lost an average of 13% of their body weight over 64 weeks. The injectable Wegovy helps people lose an average of 15% to 16% of their body weight.

Clinically, the results of the injectable and oral formulations are comparable, with the main difference being how the medication enters the bloodstream. The pills contain salcaprozate sodium, which helps protect the active ingredients from stomach acids and allows absorption across the stomach lining, Jaisinghani explains.

Because of this, the instructions for taking the pill are strict. It should be taken daily, on an empty stomach, with 4 ounces of water, and no other food or liquids may be consumed for at least 30 minutes. If a pill is missed, the regime should resume, as usual, the following day.

Dosing guidelines suggest starting at a dose of 1.5 milligrams and gradually increasing to the maintenance dose (the dose found to be most effective in clinical trials) of 25 mg, depending on how the person responds and how strong side effects are.

Jaisinghani says that clinicians have learned from their experience prescribing Rybelsus^®, a GLP-1 pill that was approved for treating diabetes in 2019, that medication adherence can depend a lot on the patient's preferences.

"There's less therapeutic inertia to starting a pill rather than an injection," she says.

The pill may appeal to people who are averse to needles, have dexterity limitations that make self-injecting challenging, or who travel or don't have easy access to refrigeration, which the injectables require.

Jaisinghani thinks that having the pill will give patients more options and may also reduce the stigma often associated with taking medication for weight loss.

How do side effects compare?

Both the injections and pills have similar side effects, including nausea, constipation, vomiting, gallbladder disease, and other gastrointestinal issues. Rarely, the medications may cause thyroid cancer among high-risk patients.

About 5% of people who take the injectable drug either don't respond to it or can't tolerate the side effects and discontinue it, Dushay says.

In the Wegovy-pill clinical trial, 18% of people who received the medication discontinued the treatment, which was less than the 26% rate in the placebo group.

The medications may also have an ominous side effect that's not often reported. In her practice, Dushay has seen some patients develop or exacerbate eating disorders while taking the medications. These patients fear gaining a few pounds, even after having lost a significant amount of weight since starting the medication.

"Sometimes we're haggling over doses," says Dushay, who wrote about this topic in an op-ed for STAT in February. "Completely losing your appetite is not normal. It is essential to eat, to have some sense of hunger, and to enjoy food."

Dushay emphasizes that health is not directly correlated with the number on the scale.

"You can be in very good health and have excess weight," she says. "Excess weight, in and of itself, is not a disease."

When it comes to her patients, she says, she's a stickler for a holistic approach to health, including eating a nutritious diet (not just eating less) and daily physical activity, as essential elements of the weight-loss process.

"It's not just about losing weight," she says. "That's not going to improve cardiopulmonary health or muscle strength."

Because reducing body weight results in loss of muscle as well as fat, experts say that exercise and strength training become all the more important to overall health and functioning.

"There should be more tolerance of the fact that you can be very healthy at a range of weights," Dushay says.

Beware of counterfeits

While the pills may make it easier for people who need obesity care to start medication, they are also easier to counterfeit, says Chun-Su Yuan, MD, PhD, a professor in the Department of Anesthesia and Critical Care at the University of Chicago Pritzker School of Medicine.

"There's a high demand for oral pills," Yuan says. "Counterfeit pills could be a bigger medical problem, since they could have different purity, chemical alteration, and increased side effects."

In early February, the FDA issued a warning about the distribution and use of compounded GLP-1 medications that are not federally approved. Novo Nordisk recently sued the popular American telehealth company Hims & Hers Health for selling "unsafe, knock-off" versions of their GLP-1 medications, according to Novo Nordisk.

Part of the challenge is that the cost of the prescriptions, which is often not covered by insurance, pushes people to seek less expensive alternatives.

Currently, the Wegovy pen (injection) list price is $1,349 per month, though the company recently announced that it will reduce the price to $675 per month, starting in 2027. But what people pay varies depending on insurance coverage. The company also offers a reduced self-pay option, which brings the pen's price down to $349 per month for the maintenance dose. The pill costs slightly less, at $299 per month through the self-pay option.

Eli Lilly's GLP-1 injection for weight loss, Zepbound^®, costs $1,086 per month at list price and as low at $499 per month for self-pay through the company. Hims & Hers advertises its compounded GLP-1 injection for $199 a month and the pill at $69 a month with a membership.

As of July 2025, the FDA has received 605 reports of adverse events related to compounded GLP-1s.

Promising effects beyond weight loss

Researchers are currently studying the effect of GLP-1s on a wide range of conditions beyond diabetes, obesity, and heart disease, including renal, hepatic, neurological, and substance-use disorders.

"There's so much interest, [researchers studying virtually] every disease are looking at GLP-1s," Dushay says. "Although many things have left the gate, very few have crossed the finish line with data that are conclusive."

Anecdotally, she's noticed that her patients with rheumatoid arthritis (RA) report improvement in their joint pain when taking the medications, and studies suggest they could potentially be a promising RA treatment.

Since there are GLP-1 receptors throughout the body, researchers suspect that the hormone may play a role in a variety of biological processes that could influence many diseases.

But Dushay points out that although GLP-1s have been prescribed for 20 years, there has been little precedent for a medication to be used as quickly, as widely, or as long term for so many different ailments. It could take years of study and observation to fully understand the drug's long-term effects, both positive and negative.

"If you do step back and have a wide lens, it seems like this drug is literally a miracle and there's nothing it can't do," she says. "But I have that nagging concern that when something seems to be too good to be true, often that plays out in some way."