Weight-loss injections are dominating the market: Where will GLP-1 pills fit in?

Glucagon-like peptide-1 (GLP-1) medications have emerged as powerful tools for weight loss. So far, injectable options like Wegovy (semaglutide) and Zepbound (tirzepatide) have led the way. And their benefits go beyond weight loss alone — as they’ve shown to improve heart health, kidney health, and even sleep apnea.

But injectable medications aren’t right for everyone. That’s where a new wave of oral GLP-1 medications could make a difference. These needle-free alternatives could offer a simpler, more accessible way for people to benefit from GLP-1 therapy.

With the first GLP-1 pills for weight loss on the horizon, GoodRx shares where they could fit in.

Key takeaways:

• Glucagon-like peptide-1 (GLP-1) injections such as Wegovy (semaglutide) and Zepbound (tirzepatide) are the most effective weight-loss medications available today.
• Oral GLP-1 pills, such as orforglipron, oral semaglutide, and VK2735, are in development. The FDA could approve orforglipron and oral semaglutide by 2026.
• GLP-1 pills may be used as initial treatments or maintenance therapy after injections. They could also be used as part of a flexible step-up or step-down strategy.
• Factors such as effectiveness, adherence, and affordability may influence how quickly and broadly GLP-1 pills are used once available.

What are GLP-1 medications?

GLP-1 medications mimic GLP-1, a hormone that helps regulate appetite, blood glucose (blood sugar), and digestion. Most of these medications are designed to mimic GLP-1 alone. Others, like tirzepatide, also mimic GIP (glucose-dependent insulinotropic polypeptide) for additive effects.

Currently, most GLP-1s are injections used to treat Type 2 diabetes. A few, including Wegovy, Zepbound, and Saxenda (liraglutide), are FDA-approved for weight loss. Oral semaglutide (Rybelsus) is the only pill option currently available. But right now, it’s only approved to treat Type 2 diabetes.

So far, GLP-1 injections have been the most effective option for weight loss. But newer GLP-1 pills aim to match, or even improve upon, their results.

Why GLP-1 pills could be a game-changer

Several oral GLP-1 pills are in late-stage development — and they’re getting closer to hitting the market. They work in a similar way as injectable GLP-1s. But they come in a pill, which could be more appealing and convenient for many people.

Oral semaglutide is already approved for Type 2 diabetes at doses up to 14 mg daily. Higher doses (25 mg, 50 mg) have been studied for weight loss and may offer similar results to the Wegovy 2.4 mg dose. But it’s important to note that oral semaglutide isn’t absorbed as well as the injection. You need to take it on an empty stomach first thing in the morning to maximize absorption.

Orforglipron is a non-peptide oral GLP-1 medication. It’s made using a simpler manufacturing process than GLP-1 injections. This could lead to lower prices, easier production, and fewer supply issues. And compared to oral semaglutide, it’s more easily absorbed by the body and doesn’t need to be timed around meals.

VK2735 is another medication that mimics both GLP-1 and GIP, like tirzepatide. Early trial results for oral VK2735 show promising weight-loss results with manageable side effects. It’s currently being studied in a phase 2 trial to test different doses. Researchers are also studying an injectable version, which is further along in the clinical development process.

How GLP-1 pills may be used for weight loss

Fatima Cody Stanford, MD, MPH, MPA, an obesity medicine physician-scientist, educator, and policymaker at Massachusetts General Hospital and Harvard Medical School, explained to GoodRx Health how these oral options might fit into different treatment strategies.

Initial weight-loss treatments

Some people may start their GLP-1 journey with a pill, especially if they’re hesitant about injections. A daily oral medication may feel more familiar and easier to manage.

“Self-injection can be a significant barrier for some people, either due to needle phobia, inconvenience, or perceived stigma,” explained Stanford. “Oral options might increase their willingness to initiate and adhere to treatment, potentially broadening the pool of people who can benefit from [GLP-1] therapy.”

Maintenance therapy after weight loss

For people who’ve already lost weight with an injectable GLP-1, switching to a pill may help maintain progress without continuing injections.

“Oral medications could indeed function as an ‘off-ramp’ for those who have reached their treatment goals with injectables and wish to maintain their progress with a less invasive option,” said Stanford. “This transition could help in sustaining motivation and adherence to treatment over the long term.”

This maintenance approach is currently being investigated. The ATTAIN-MAINTAIN trial studies how orforglipron helps people keep weight off after stopping Zepbound. And oral VK2735 may play a similar role with the injectable version.

Step-up or step-down strategies

GLP-1 pills could also support flexible treatment plans, depending on a person’s needs and preferences.

One option is a step-up approach, which may help ease people into treatment. This method may be especially appealing for those hesitant to start with injections right away. As explained by Stanford, “People might begin with oral medications to achieve initial weight loss or glycemic control, and then transition to injections if more intensive treatment is needed.”

On the flip side, a step-down approach can be used to simplify things or lower treatment intensity after reaching goals. In this case, someone might switch from the injections to a pill to reduce side effects, lower cost, or make the routine easier to stick to.

Whether someone is starting or continuing treatment, GLP-1 pills could give people more options to help meet or maintain their long-term body weight goals.

Challenges facing GLP-1 weight-loss pills

Before GLP-1 pills go mainstream, several questions remain. Stanford noted factors such as effectiveness, adherence, and affordability playing a role in how quickly and broadly GLP-1 pills are adopted once available.

• Can they match injectable GLP-1 results? Early data is encouraging. Oral semaglutide (25 mg) has shown weight-loss results similar to Wegovy (2.4 mg). Data from orforglipron’s late-stage weight-loss trial is expected in 2025. Positive results from its Type 2 diabetes trial have already been announced.
• Will they offer the same health benefits? Injectable GLP-1s have shown benefits beyond weight loss, including heart protection and sleep apnea improvement. Research has yet to confirm if oral options will offer these same benefits.
• Will adherence improve with a daily pill? Some people may prefer a daily pill over a weekly injection. But others might struggle with remembering a daily dose. This is especially the case if there are strict instructions to follow when taking it.
• Will they be affordable and covered by insurance? Pills like orforglipron may be easier and cheaper to make. But pricing and insurance coverage remain uncertain.
• Can oral options prevent future shortages? Semaglutide and tirzepatide shortages have largely resolved in 2025, but demand remains high. Non-peptide oral GLP-1s are generally easier to produce. This may help relieve pressure on supply chains and support more consistent medication access.

What’s next for oral GLP-1 medications?

With growing interest in weight-loss treatments, several GLP-1 pills are moving through clinical trials. Here’s where the top candidates currently stand:

• Higher-dose semaglutide (oral Wegovy): The FDA has accepted the manufacturer’s application for oral Wegovy. The agency is expected to make a decision in Q4 2025.
• Orforglipron: Phase 3 trial results are expected in 2025. If everything goes as planned, the FDA could approve orforglipron in 2026.
• VK2735: Phase 2 trial results for oral VK2735 are expected in the second half of 2025. The injectable version is advancing to phase 3 trials in 2025.

The bottom line

Glucagon-like peptide-1 (GLP-1) injections like Wegovy (semaglutide) and Zepbound (tirzepatide) have revolutionized the weight-loss medication market. But oral GLP-1 pills are on the horizon and could soon offer a simpler, more flexible option for weight loss.

Top candidates include orforglipron, oral semaglutide, and VK2735. The FDA could approve orforglipron and oral semaglutide by 2026.

This story was produced by GoodRx and reviewed and distributed by Stacker.