Should you try oral GLP1?

The oral Wegovy pill has been out for about 3 weeks now, and I am seeing more and more questions about it (including some audience members who have already started on it). I did cover a lot of the basics in this YouTube video, and also had a doctor on to talk more about it on the podcast, but I wanted to address it here as well.

Short answer: Oral Wegovy can be an option for some people, but it’s not automatically an upgrade. Like everything with GLP-1s, the details matter. And just because I PERSONALLY think that oral Wegovy is NOT the best option on the market, it offers a solution for many.

It’s surprising to me that so many took my “meh” attitude about it as a personal attack on their health choices; it’s not. You do you, boo. It is a great option for some, but not for me, and here are the pros and cons you might want to understand about it first. Only you can know what works for you.

Weight loss expectations
For oral Wegovy, the weight loss expectation is about the same as the injection, around 15% of body weight in about 68 weeks. This means if you weigh 250 pounds, you can expect to lose a little less than 40 pounds. This is clinically significant weight loss that will improve your health.

Side effects
Side effects seem to be the same as the injectable. Nausea, appetite suppression, fullness, reflux, and constipation can still happen. In some people, GI side effects may actually feel more noticeable because the medication passes through the digestive tract rather than being absorbed slowly over a week. I have not personally seen people complaining of this yet, so if you are on it, report back.

Medication timing matters (a lot)
One of the biggest drawbacks of oral Wegovy is the timing, and this is the main reason I personally won’t be using it. It requires:

That level of precision works for some people, but for me, it would be stressful and hard to sustain long-term. It just wouldn’t work with my routine. Missed or improperly timed doses can reduce effectiveness.

Pricing and access
Pricing is better than the injectables. Right now, the two lower doses are $149/month, then the price goes up to $299/month at the higher dose. You can check out pricing information here, as it will likely change over the next year as more orals come on the market.

Who might consider an oral GLP-1
Oral options may make sense if you:

A caveat

I have heard people saying online that they are excited about oral because it will be in their system ALL the time, so their hunger will never increase as the week progresses, like it tends to do on the injectable.

I actually think that’s a bad thing, because the hunger that creeps up on day 4-5 is a GREAT time for you to meet your nutrient needs that maybe were lacking earlier in the week. I made a video about why I personally embrace this hunger here.

Why I’m personally waiting
You may have heard about Eli Lilly’s oral GLP-1 in development. One of the most promising aspects is that it does not appear to require strict fasting or timing rules. If that holds true, it could remove one of the biggest barriers to oral GLP-1 use, making it more flexible.

Finally, the ONLY effective oral pill for weight loss on the market is branded Wegovy. There are MANY companies selling various forms of compounded GLP1 in pill, drops, lozenges, patches, etc. NONE OF THESE ARE EFFECTIVE. No one other than Novo Nordisk or Eli Lilly has the right technology to allow the molecule to be absorbed. I am NOT against compounded injectables, as they are actually effective since they don’t have to go through the digestive system.

Bottom line: Speak to your doctor about which format is best for you.

More to come on this as the science evolves.

On the podcast this week, I invited an intuitive eating dietitian to come on. I am actually pretty anti-intuitive eating, especially for people who struggle with obesity. So I thought I would invite someone with a completely different POV. And we actually found quite a bit of common ground. It’s amazing what happens when we actually LISTEN to people we think we disagree with.

I also interviewed my friends over at the Downsized. In case you don’t know them, they are a married couple who lost over 150 pounds on GLP1 and now have a popular YouTube channel where they provide support. I strongly recommend you follow them! (I was also on their channel last week, sharing my story)