People switching from weight loss injections to the Wegovy pill in a trial still lost half a stone, according to a new study. The first study tracking 200 pill-users outside of a clinical trial showed those who switched from injectable GLP-1 medicines to the Wegovy pill continued to lose weight, losing an average 4kg (8.8lbs) in three months, equivalent to a 4% reduction in body weight.
Real-world study findings
The appetite-suppressing jab Wegovy in tablet form is being promoted as a way to keep weight off long term for people who do not want to keep injecting themselves. Jabs have been shown to result in dramatic weight loss of up to a quarter of users' body weight but many people stop taking them due to cost or dislike of needles. This can result in people piling all the weight back on.
George Godfrey, UK director at drugmaker Novo Nordisk, said: “Some people living with obesity may find it more convenient to take an oral therapy alongside making changes to their diet or exercise regime, instead of other forms of treatment. This gives us an early look at what happened when people made that choice in the real-world.
“The results are encouraging. On average patients lost weight, with most taking their medicine consistently. This shows that switching to the Wegovy pill helped people lose weight while simultaneously allowing them a new way to align their weight loss therapeutic journey with their lifestyle.”
How GLP-1 drugs work
GLP-1 drugs slow digestion and reduce appetite by mimicking a hormone called glucagon-like peptide 1 (GLP-1) which regulates hunger and feelings of fullness. They can cause side effects such as vomiting and require personalised support from specialists so that weight loss is maintained. The NHS prescribes the GLP-1 injections Mounjaro and Wegovy for weight loss but Ozempic only for diabetes.
Study co-lead Professor Louis Aronne, of the Weill Cornell Medicine in New York, has previously told the Mirror how overeating the processed, high-calorie food leads to obesity which causes permanent damage to the brain so patients struggle to feel full again, even after losing weight.
Future potential and access
Prof Aronne, who has been researching the human appetite since the 1980s, believes weight loss pills could eventually be given to healthy weight young adults to stop them becoming overweight in the first place – similar to how hypertension drugs are prescribed as a preventative measure.
GLP-1 drugs are still being rationed by the NHS for the most seriously obese and unwell and most users in the UK access them via private prescriptions costing between £100 and £350 a month. The drugs in pill-form have been heralded as a way to eventually make them cheaper and more widely available.
The OCTANE study looked at real-world use of the drug Wegovy, also called semaglutide, and is being presented at the annual Meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy.
Prof Aronne said: "In everyday clinical practice, we see patients who respond well to injectable GLP-1 based therapy but who, for personal or practical reasons, want to try an oral option.
"What the OCTANE data showed is that a switch to oral semaglutide may be a viable path for the right patient, with real weight loss and lifestyle improvements in the first three months. It also showed that oral semaglutide helped many participants achieve a BMI under the clinical threshold of obesity. These are exciting early insights on how Wegovy® pill can individualise obesity care."
How pills are different
Weight loss pills come as a "non-peptide small molecule" allowing it to survive stomach acid and be absorbed by the gut. Weight loss injections are generally made up of a "peptide" which is larger and usually broken down by the stomach - and therefore needs to be injected to work.
The drugs in pill form do not need to be kept in the fridge like injections and do not require fasting, strict water limits or a 30-minute wait to eat. Speaking previously, Dr Aronne said: “It's not a peptide, it's a small molecule. It's easier to manufacture and you don't need to take it with four ounces of water and half an hour before or after a meal. However, it does interact with other medications so, like many treatments, there are benefits to using it and there are other things that need to be adjusted with time."
