Medically Induced Weight Loss, Now in Pill Form

Alright, the FDA under Robert F. Kennedy Jr. is approving some new drugs.

And what a drug the latest one is. On Monday, pharmaceutical giant Novo Nordisk announced that the FDA had approved a pill version of its blockbuster weight-loss medication, Ozempic and Wegovy. (The active ingredient in Ozempic and Wegovy is the same. The former brand is marketed to manage type 2 diabetes, the latter for chronic weight management.)

Previously, patients could only take popular GLP-1 drugs for weight loss via weekly injections that cost hundreds or thousands of dollars per month. The new pill will be taken daily and cost just $149 a month for the starting dose. Sales will begin in early January.

The introduction of oral weight-loss drugs is expected to drastically expand the market because of these drugs’ greater accessibility and lower prices. From the Wall Street Journal:

The Food and Drug Administration approval is a milestone because weekly shots such as Wegovy and Eli Lilly’s Zepbound have dominated the anti-obesity market to date. Yet many people with excess weight don’t take the shots due to cost, spotty insurance coverage and fear of needles.

Drug companies and analysts say pills will tap in to demand from people who don’t want an injection or would prefer the cadence of a daily dose. Pills also offer the prospect of lower prices and better health-insurance coverage than injections, because pills cost less to make.

Novo Nordisk’s stock price jumped 7 percent on the news. Eli Lilly is not far behind, with an oral version of its own signature weight-loss drug awaiting FDA approval.

Analysts estimate that pills will eventually comprise around 25 of the projected $150 billion obesity-drug market in the United States. I would be shocked if the true percentage isn’t much higher than that. Weight loss in a pill bottle sounds to me much more appealing than weight loss in a vial. If the oral versions of GLP-1 drugs are remotely as effective as their injectable counterparts, they should be all the rage. Apparently, they’re pretty close:

In a study of 205 people with excess weight, those taking Novo Nordisk’s pill for 64 weeks lost an average of 16.6% of their body weight.

Eli Lilly’s GLP-1 pill is called orforglipron, and in a study of 3,127 patients its highest dose helped people lose an average of 12.4% of body weight at 72 weeks.

For comparison, in their respective clinical studies, Novo Nordisk’s Wegovy yielded 16 percent weight loss on average after 68 weeks of a patient’s taking injections. Eli Lilly’s Zepbound achieved 16–22.5 percent weight loss on average at 72 weeks, depending on the dosage.

The side effects of these drugs will never be fun, regardless of what form they take: loss of muscle mass, gastrointestinal issues, fatigue. But, in wealthy societies such as the United States, obesity is arguably the single most powerful determinant of poor health. And, unlike the “miracle” weight-loss drugs of yesteryear, GLP-1s actually appear to be effective at reducing obesity at a large scale. The U.S. obesity rate has curved downward in the past few years for the first time in decades, and GLP-1 drugs are by far the biggest reason why.

And it’s only going to get better. The more weight-loss drugs the FDA approves from companies that are vying for market share, the lower prices will fall because of competition. Hopefully, GLP-1s will be affordable enough for most people to buy them directly rather than through insurance. Cuts to cash prices are already underway. Patients and their doctors will soon be able to weigh (no pun intended) the efficacy, cost, and side effects of several treatment options.

No, medically regulating your appetite is not a natural way to lose weight. But all the natural methods simply haven’t worked at scale — we’re rich enough to consume more calories than anyone else for the lowest percentage of income in the world. Obesity rates have marched up despite every diet trend, every nutrition fad, every fitness craze. And really, for Americans, what is more natural than medicating our problems away?

I say, bring on the pills.