At the KAHN CENTER, we teach whole food nutrition, favoring plant based patterns, for optimal health and weight. However, with so many stressors leading to weight gain, optimal weight is not always is not always achieved. More options may be needed and the GLP-1 agonists including injectable semaglutide (Wegovy) has advanced weight management.
Today, the FDA approved an oral version of semiglutide that will be available in 2026.
A study has evaluated its efficacy for weight loss based on the hypothesis that oral semaglutide at a dose of 25 mg may provide an alternative treatment option to injectable semaglutide (2.4 mg) and higher-dose oral semaglutide (50 mg) for persons with overweight or obesity.
In a 71-week, double-blind, randomized, placebo-controlled trial conducted at 22 sites in four countries, persons without diabetes who had a body-mass index (BMI) of 30 or higher or a BMI of 27 or higher with at least one obesity-related complication were enrolled.
The participants were randomly assigned in a 2:1 ratio to receive oral semaglutide (25 mg) or placebo once daily, plus lifestyle interventions. The coprimary end points at week 64 were the percent change in body weight and a reduction of 5% or more in body weight; confirmatory secondary end points included reductions in body weight of 10% or more, 15% or more, and 20% or more.
A total of 205 participants were randomly assigned to receive oral semaglutide, and 102 to receive placebo. The estimated mean change in body weight from baseline to week 64 was -13.6% in the oral semaglutide group and -2.2% in the placebo group.
Participants in the oral semaglutide group were significantly more likely than those in the placebo group to have body-weight reductions of 5% or more, 10% or more, 15% or more, and 20% or more (P<0.001).
Gastrointestinal adverse events were more common with oral semaglutide than with placebo (74.0% vs. 42.2%).
Oral semaglutide at a dose of 25 mg once daily resulted in a greater mean reduction in body weight than placebo in participants with overweight or obesity.
Pricing and insurance coverage for this oral Wegovy is unknown. It is likely to add to the number of persons using this GLP-1 agonist for weight loss.
At the KAHN CENTER, we will continue to teach a whole food, plant diet to patients on these medications to offer a path to wean the medication in the future when weight loss is achieved. We will also teach strength training and cardio exercise to support the healthy weight loss favoring reduced fat over muscle mass.
