Is an oral version of GLP1-RAs (e.g. oral semaglutide) as effective as the injectable version (e.g. Wegovy, Saxenda)?
Key Takeaways:
The 68-week trial of semaglutide, a class of GLP1-RAs, given by injection once per week showed that patients achieved 15% weight loss.
A study showed that patients who took oral semaglutide had a significant weight loss of 17.4% in over 68 weeks.
In addition, oral semaglutide has been found to be as effective or better than the injectable version in treating type 2 diabetes.
Other than their efficacy in weight reduction, the only difference between an oral semaglutide and an injectable semaglutide is the route of administration.
Obesity is a growing epidemic and known to be a major risk factor for several chronic diseases, including diabetes and hypertension. Although healthy lifestyle changes are important for the weight loss journey, there are other factors like genetics that play a significant role in determining a person’s body weight – and this is why some people find it much harder to lose weight than others do.
Due to this, there is great interest in developing non-invasive pharmacotherapeutics to help combat obesity. For years, physicians had little to offer people who were struggling with obesity. With the development of new methods, both surgical and medical options, there are now new alternatives for people who are struggling to lose weight.
Medications for Obesity Treatment
Currently, there are several different medication options for addressing obesity. One of the newest options is a class of medications known as glucagon-like peptide-1 receptor agonists (or GLP-1 receptor agonists, or simply GLP-1 RAs) which includes semaglutide, liraglutide, and dulaglutide.
GLP-1 RAs can help to achieve good blood sugar control in people with diabetes – and these medications can also lead to weight loss. Some GLP-1 RAs are even approved specifically to aid weight loss.
Liraglutide (sold under the brand name Saxenda) is currently approved for weight loss. In addition, semaglutide (under the brand name Wegovy) is the most recently approved medication for weight loss in Singapore. This form of semaglutide was approved in 2021 in the US specifically for weight loss. Other versions of semaglutide available in Singapore are Ozempic (by injection once per week) and Rybelsus (a tablet form taken daily), but both are only approved for the treatment of diabetes.
Injectable GLP-1 RAs vs oral version (e.g. oral semaglutide): Which is more effective?
Injectable GLP-1 RAs
In several clinical studies of Saxenda, which is given as a once a day injection, using the medication consistently resulted in weight loss of 4 to 6 kg. Nearly two-thirds of patients lost at least 5% of their body weight, and nearly one-third lost at least 10%.
With Wegovy, which is given by injection once per week, a 68-week trial showed that patients achieved 15% weight loss.
Oral GLP-1 RAs
Results from a 68-week trial showed that if all people adhered to treatment (from a mean baseline body weight of 105.4 kg), those taking oral semaglutide once a day achieved a weight loss of 17.4%. Across all patients taking oral semaglutide once a day, regardless of adherence, the group achieved a 15.1% weight loss.
Which is more effective?
Both injectable and oral GLP-1 RAs are similarly effective as long as it is the same type of medication, regardless of form.
Table 1. A comparison of the average weight loss of patients taking Saxenda (injectable), Wegovy (injectable) and Wegovy (oral)
| Weight Loss* | |
|---|---|
| Saxenda (liraglutide) once a day injection | 5-10% |
| Wegovy (semaglutide) once a week injection | 15% |
| Wegovy (semaglutide) once a day oral route | 15.1% |
*Sources:
https://www.saxenda.com/about-saxenda/weight-loss-with-saxenda.html
https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=166110
Learn more about sustainable weight loss with FDA approved GLP-1 RA medication.
What is the difference between oral (e.g. oral semaglutide) and injectable (Saxenda and Wegovy) GLP-1 RAs?
The only apparent difference between an oral semaglutide and an injectable semaglutide is the route of administration. However, a study revealed that most patients prefer taking oral weight loss medication to once-weekly subcutaneous injections as it is painless and easier to administer.
Potential side effects: Oral vs injectable GLP-1 RAs
Both oral and injectable GLP-1 RAs can have several potential side effects. If you experience any of these side effects, you should consult your doctor to review your treatment plan.
Some of the potential side effects of semaglutide, liraglutide, and other GLP-1RAs are:
Nausea and Vomiting
Constipation or Bloating
Headache
Heartburn
Abdominal Pain
Burping or Indigestion
Allergic Reaction (such as hives, swelling, or rash)
Oral GLP-1 RAs were also associated with similar side effects of nausea, vomiting, and diarrhea.
How to get the most benefit out of oral and injectable GLP-1 RAs?
GLP-1 RAs such as semaglutide are most effective when it’s used alongside lifestyle changes, such as increased exercise and eating a healthy diet.
However, many people struggle to create and stick to a healthy lifestyle plan. It may be helpful to have the support of a dietitian and/or health coach to assist with this.
Oral or injectable semaglutide are not available over the counter. These can only be obtained by prescription, so you will have to consult a doctor in order to get them. Further, not all clinics in Singapore carry GLP-1 RAs, so if this is a weight loss journey that you’d like to take, you should call the clinic to check before making an appointment.
NOVI offers some of these medications to certain patients – both injectable and oral semaglutide. This requires an appointment with one of our specialist doctors to evaluate whether a GLP-1 RA medication would be a good option for you.
Since we are for holistic and sustainable weight loss, we also believe that medication alone is not the best approach – a healthy lifestyle is also important. Our patients receive personalised nutrition and fitness advice from a dedicated health coach, to help them develop and stick to a healthy lifestyle plan.
NOVI Optimum Plus is our weight loss program centered on safe and proven weight loss medications supported by a healthy lifestyle for weight loss that lasts.
