We’ve all heard of Ozempic by now. It’s only licensed for use as a diabetes treatment in the UK and US, but it’s widely used ‘off label’ to help people lose weight. So much so, in fact, that its name has become an umbrella term for a revolutionary new class of weight-loss medication.
Injectable drugs such as Ozempic, Wegovy, Mounjaro, Zepbound, Rybelsus and Saxenda can all help people in larger bodies to drop pounds, in some cases up to 20 per cent of their body weight.
But now, the next generation of weight-loss medication is here, and it comes in pill form.
The first of these pills has already arrived in the US. Novo Nordisk (the makers of Ozempic) launched its Wegovy pill there on 5 January 2026 to immediate popularity – more than 18,000 new prescriptions were written for it in its first full week on the shelves.
But it won’t be the only option for long. Eli Lilly’s competitor pill, Orforglipron, is expected to be approved by the US Food and Drug Administration (FDA) in Spring, and a slew of alternative pills is also in production.
(These pills aren’t available in the UK yet, but British regulation is expected to follow in the footsteps of the FDA.)
The pills work in much the same way as the injectables. Known as ‘incretins’, their active ingredients (such as semaglutide in Wegovy or tirzepatide in Mounjaro) mimic naturally occurring satiety hormones to trick your body into feeling full.
Your digestion slows, you eat less and so you lose weight, without a gnawing hunger to trip up your progress.
Now in pill form, the drugs promise the same life-changing transformations – and the same protection from obesity-related diseases – but more cheaply and easily than ever before.
Is it too good to be true? Experts say the pills bring huge positives, as well as serious dangers.
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Could weight-loss pills change the world?
These pills could represent a new era in obesity treatments, where more people than ever before have access to life-changing healthcare.
“Not everyone wants to take an injectable drug,” Dr Simon Cork – a senior lecturer at Anglia Ruskin University, UK, who specialises in the regulation of appetite and body weight – says. “That can be quite off-putting for patients. Taking them in an oral form is generally more acceptable.”
But going sans-syringe doesn’t just benefit the squeamish. At the moment, people taking weight-loss medication are likely to pay hundreds of dollars per month for their injections.
Without the need for needles to administer the drugs or fridges to store them, the pills can be manufactured and distributed more cheaply, enabling millions of people to access weight-loss medication who were previously priced out.
“All in all, the likelihood is these pills will be drastically cheaper than current forms,” says Cork.
That’s already true in the US, where Wegovy pills are being sold for $149 (about £110) per month, compared to $349 (around £250) for Wegovy pens.
In the UK around 95 per cent of incretin users are footing a steep private bill – according to Prof Giles Yeo, a neuroendocrinologist and obesity expert at the University of Cambridge – in part because the drugs are too expensive for the NHS to prescribe to everyone who wants them.
“The likelihood is that these patients are going to have to be on these drugs for life, or certainly for a significant period,” adds Cork. “That cost is a significant barrier – particularly for those who are most at risk of developing obesity, who are from more deprived backgrounds.
“My hope is that these oral medications will democratise access.”
Solving a long-term problem
But, while more people may be able to access them, these drugs are unlikely to be in their most potent forms.
Incretins tend to pack less of a punch as pills. Injectable Wegovy can help patients lose 15 per cent of their body weight after 68 weeks, compared to 13.6 per cent in 64 weeks with Wegovy pills.
The pills really pale in comparison to the newest injectables. Retatrutide – still in production – has been shown to help patients lose a whopping 24 per cent of their body weight, in just 48 weeks.
That disparity is understandable, says Yeo, because getting these drugs into the bloodstream “is always going to be far more challenging in pill form.”
Oral drugs have to pass through additional barriers – the stomach and liver – before they’re absorbed into the blood, so manufacturers have to use more of the active ingredients to get results.
So, weight-loss pills may not rival injections when it comes to rapid results. But they could solve one of the biggest frustrations with these jabs: once people stop taking them, the weight tends to pile back on.
One 2022 study found that, patients who came off their Wegovy injections regained up to two-thirds of the weight they had lost after just one year.
Enter pills. In 2025, Eli Lilly’s ATTAIN-MAINTAIN trial found that its Orforglipron pill helped stabilise participants’ weight after their stopped injectable treatments.
“I get the feeling that a lot of people will end up using these pills as a way to maintain the weight loss,” says Yeo.
Cork agrees. “You could use the injectables to get to an optimal weight and then maintain it on the cheap pills for a long period.”
The dark side of the pill phenomenon
There’s plenty of potential for these pills to make real positive change, but their wider accessibility also brings added danger to vulnerable groups.
“The most dangerous thing that can happen to these drugs is them landing in the wrong hands,” says Yeo. “These drugs don’t have a size limit where they begin or stop working. They’ll work if you’re 300lbs looking to lose 50 – that’s fine. They’ll also work if you’re a 16-year-old girl who weighs 75lbs.
“The moment you get to a pill, it’s easier to black-market, easier to ship, easier to get in the hands of anyone. So, I really do think we need to keep our eyes open. Legislation needs to be robust and I don’t think it is at the moment.”
Cork agrees that we need more checks and balances to prevent these drugs from being misused, but he’s more concerned about their side effects.
Incretins come with myriad symptoms, commonly nausea, vomiting, constipation and diarrhoea. It’s normal for clinical trials to report that three-quarters of their participants experienced digestive upset.
But they can also cause rarer, more serious side effects – like pancreatitis, gallstones, and stomach paralysis. Plus, they can interact with other drugs, such as contraceptives, and make them less effective.
“The risk of pancreatitis is very low – around one per cent,” says Cork . “But when you’ve suddenly got millions of people on these drugs, then one per cent is a lot of people who are at risk, perhaps without the right level of oversight.”
Worrying as these predictions might be, they remain just that – predictions. The true impact of these pills is far from inevitable.
“2026 will be a pivotal year for understanding how effective these pills really are, how widely they’re taken up and how they ultimately end up being used,” says Yeo. “We’ll just have to wait and see what happens.”
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