Exploring Oral Semaglutide for Obesity
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Oral semaglutide is a tablet version of a drug originally developed to manage type 2 diabetes. It works by mimicking a natural hormone called GLP-1, which helps control blood sugar, reduce appetite, and slow down digestion. Although the injectable version (Wegovy) is officially approved for weight loss, the oral version (Rybelsus) is only approved for diabetes treatment.
However, due to rising obesity rates and limited access to injectable drugs, researchers have started exploring the potential of using oral semaglutide for weight loss in people without diabetes.
The Study: Real-World Use in Obese Adults
A recent study in Slovenia looked at 93 adults with obesity but without diabetes who took oral semaglutide (14 mg daily) for one year. The aim was to see if the drug could help them lose weight and improve their health, even though it wasn’t officially approved for this purpose.
Participants received basic lifestyle advice and were encouraged to join a weight-loss program. However, only 3 people actually did. Most of the weight loss, therefore, can be attributed to the medication.
What Were the Results?
After one year:
- Average weight loss was 5.9 kg (5.7%)
- BMI dropped by 2 points
- Waist size shrank by 5.5 cm
- Nearly half the participants lost at least 5% of their body weight
- Only 4% lost 15% or more, which is the level linked to big health benefits
While these results are encouraging, they also showed that oral semaglutide’s effect varies widely. Some people lost a lot of weight, while others lost little or none.
Side Effects: Mostly Mild
As with any medication, some people experienced side effects. The most common were:
- Nausea (23%)
- Vomiting and diarrhea (12% each)
- Constipation and stomach pain (6%)
Most side effects were mild and went away with time. Only 6 people (6%) stopped taking the drug because they couldn't tolerate it. Importantly, no serious safety concerns were reported.
How Does It Compare to Other Weight Loss Drugs?
When compared to newer drugs like tirzepatide or high-dose injectable semaglutide, the oral version is less effective. Tirzepatide, for example, has shown weight loss of up to 21% in some studies. Injectable semaglutide (Wegovy) also performs better, with average weight loss around 15%.
That said, oral semaglutide is still more effective than older options like orlistat or naltrexone-bupropion, which typically produce 5–8% weight loss.
Who Might Benefit from Oral Semaglutide?
This medication may be useful for:
- People who are unable or unwilling to take injections
- Those who can’t access newer injectable drugs due to shortages or cost
- Individuals who prefer starting with a less intensive weight loss treatment
It’s important to note that oral semaglutide at 14 mg is not officially approved for weight loss, so its use for obesity is considered “off-label.”
Final Thoughts
Oral semaglutide could be a helpful tool for weight management in people without diabetes, especially when other options are limited. It offers modest weight loss and has a generally good safety profile. However, it’s not a magic pill—results vary from person to person, and combining medication with lifestyle changes usually gives the best results.
If you're considering a medication like oral semaglutide for weight loss, talk to your doctor. They can help you decide what’s safe and effective for your specific needs.