Oral Semaglutide (Wegovy)
Oral semaglutide (Wegovy) was approved by the U.S. Food and Drug Administration (FDA) in December 2025 as a treatment for weight loss in people with obesity and at least one related health condition.
In clinical trials, oral semaglutide helped participants lose an average of 13.6 percent of their total body weight over about 15 months. For someone with a starting weight of 235 lbs, that translates to about 33 lbs of weight loss.
Oral semaglutide is a prescription medication that’s intended to be used in conjunction with a reduced calorie diet and regular physical activity to help adults with obesity and related health problems lose weight. It’s also used to help lower the risk of major cardiovascular events like heart attack and stroke in adults who are overweight or have obesity and also have heart disease.
Wegovy is the first oral glucagon-like peptide-1 (GLP-1) agonist approved for these purposes.
GLP-1 drugs (including semaglutide) work by mimicking GLP-1, a hormone made by the small intestine, increasing satiety by affecting areas of the brain that process hunger and slowing stomach emptying.
Side Effects and Warnings
The most common side effects of Wegovy include gastrointestinal issues like nausea (the most frequently reported symptom), constipation, diarrhea, stomach pain, and vomiting. Other side effects may include dizziness, fatigue, headache, heartburn, and runny nose or sore throat.
Available in a dose of up to 25 milligrams (mg), the Wegovy pill is taken daily in the morning when you first wake up, on an empty stomach and with no more than 4 ounces (oz) of water. You must then wait 30 minutes before eating, drinking, or taking any other oral medications.
This regimen may be a limiting factor for some: Even once-daily medications can fail if they don’t fit naturally into a person’s routine, says Auda Auda, MD, a board-certified family medicine physician at Baker Health in New York City.
“Oral semaglutide often falls short outside of trials because adherence and side effects become limiting factors,” says Dr. Auda. “It’s the most challenging of these weight loss pills due to its strict fasting and timing requirements.”
Wegovy isn’t recommended for people who have a personal or family history of medullary thyroid cancer. (In rodent studies, Wegovy caused thyroid tumors, but it’s unclear how it may affect the human thyroid.) It’s also not recommended for those who have or have had problems with their pancreas or kidneys, type 2 diabetes and a history of diabetic retinopathy, or mental health issues. It shouldn’t be used by people scheduled for surgery that requires anesthesia, those who are pregnant or planning to become pregnant within two months, or people who are breastfeeding.
If none of these contraindications apply to you and you can adhere to its specific administration instructions, the Wegovy pill may be an option. “Oral semaglutide may work for highly disciplined patients who want to avoid injections,” says Auda.