GLP-1 medications, renowned for aiding significant weight loss, have become more accessible to those who dislike needles.
Previously, these drugs—known under brands like Ozempic, Wegovy, Mounjaro, or Zepbound—were exclusively injectable. Yet, despite this, a 2024 survey revealed that one in eight American adults had tried a GLP-1 drug via injection.
Now, pharmaceutical companies Eli Lilly and Novo Nordisk have introduced pill versions, offering a simpler alternative for those wary of needles. However, there are some considerations to keep in mind.
Which is more effective: the GLP-1 pills or injections?
For instance, those opting for the Wegovy pill must adhere to specific guidelines. It should be consumed on an empty stomach each morning with just a few sips of water, and one must wait half an hour before consuming anything else, including coffee.
Conversely, Eli Lilly’s new GLP-1 pill, branded as Foundayo, does not impose such dietary restrictions.
Then there’s the matter of efficacy. Early studies show the pills aren’t quite as effective as their injectable counterparts.
One clinical trial of more than 3,000 people compared adults who received the highest dose of orforglipron (the generic name for the Foundayo pill) with people who received a placebo. Over 72 weeks, the people who received the weight loss pill lost about 25 pounds on average, or 11% of their body weight. Those taking the placebo lost less than 5 pounds, or about 2% of their body weight.
Those are real results, but not as impressive as clinical trials for the GLP-1 injectables. Participants who injected Zepbound once a week for 72 weeks lost 50 pounds on average, and those who injected Wegovy lost 33 pounds.
On the other hand, if you’re looking at taking a GLP-1 to treat type 2 diabetes rather than lose weight, the oral versions may be a better fit. One study of 100 people found those taking oral semaglutide had bigger reductions in their blood sugar, even when those taking the injectable version lost more weight. The difference was small, however, the study points out.
Which has worse side effects?
Side effects between the pill and injection may also differ. A study comparing the two last year found “patients receiving oral semaglutide had a significantly higher risk of treatment discontinuation due to side effects.”
In a clinical trial of the injectable Zepbound and Wegovy, 6% to 8% left the trial because of adverse side effects. The most commonly reported effects were gastrointestinal, including nausea, constipation, diarrhea and vomiting.
In a study of the pill form, about 5% to 10% discontinued treatment because of side effects.
Which is cheaper?
With insurance, the cost of both available oral medications starts at $25 per month. Without insurance, the lowest doses are $149 per month, with the price increasing for higher doses.
The injections also start at $25 per month with insurance but are pricier for self-pay patients. Wegovy, for example, has an intro deal for $199 per month for the first two months of its low doses. The highest dose is $399 per month.
Zepbound self-pay prices are $299 to $449 per month, depending on dosage.