You’ve likely heard buzz (and seen commercials) about GLP-1 drugs for weight management, like semaglutide (Wegovy) or tirzepatide (Zepbound). Until recently, those medications meant having to give yourself an injection. But the FDA recently approved a pill form of semaglutide (Wegovy), marking the first time a GLP-1 pill was cleared in the U.S. for weight management. But it’s not the first semaglutide pill ever. A pill form of semaglutide, called Rybelsus, has been on the market since 2019 to treat diabetes. And the Wegovy pill isn’t the last. Another oral GLP-1 drug, orforglipron (Foundayo) has just been approved by the FDA for weight management.
"It's good to have more options for patients with obesity," says Melanie Jay, MD, assistant professor of medicine at the NYU Grossman School of Medicine.
Many patients prefer pills to needles, she said. Experts explain how the two forms compare.
First, What’s a GLP-1?
GLP-1 stands for glucagon-like peptide-1, which is a hormone made in your small intestines. The GLP-1 hormone has several functions. It:
- Slows the emptying of your stomach
- Makes your body release glucose more slowly, reducing spikes of blood sugar
- Triggers the release of insulin from your pancreas to reduce the amount of glucose in your blood
- Makes you feel full after eating
- Blocks secretion of the hormone glucagon, which raises your blood sugar level
GLP-1 medicines are created to mimic the natural GLP-1 hormone. The GLP-1 drugs bind to your cells’ GLP receptors to trigger the GLP-1 functions. The higher the dose of GLP-1 medicine, the stronger the effects. The combination of slowing digestion, reducing blood sugar, and decreasing appetite helps weight loss.
GLP-1s were first used for treating type 2 diabetes; the first one was FDA approved in 2005. The GLP-1 medications for diabetes include:
- Dulaglutide (Trulicity)
- Exenatide (Bydureon, Byetta)
- Liraglutide (Victoza)
- Lixisenatide (Adlyxin)
- Semaglutide (Ozempic, Rybelsus)
- Tirzepatide (Mounjaro)
People taking GLP-1s for diabetes had significant weight loss and improvements in cardiovascular factors. That led to approval for using the medications in people with obesity. In 2021, the injectable form of semaglutide (Wegovy) was approved for treating obesity. In 2023, the injectable form of tirzepatide (Zepbound) was approved for treating obesity. In 2025, before the Wegovy pill was approved, the Wegovy injection was approved for treating the liver disease metabolic-associated steatotic hepatitis (MASH).
GLP-1 Pill vs. Shot: What's Different?
Some are daily pills, others are weekly shots.
The GLP-1 pills are tablets you swallow, while the injectable versions are given with a syringe, usually in the upper arm, thigh, or abdomen (the belly area).
With the Wegovy pill, you take one tablet a day — in the morning, 30 minutes before eating — so the medication is absorbed into your empty stomach, helping it reach your bloodstream.
The Foundayo pill is taken once a day, at any time of day, with or without food or water.
With injections, you get the drug once a week; the specific time of day doesn't matter. Medicine enters your fat under your skin and quickly moves into your bloodstream.
The pill's dosage is higher.
The starting daily dose for the Wegovy pill is 1.5 milligrams, which can be ramped up to the maximum dose of 25 milligrams over 90 days. The maximum dose for the injection is 2.4 milligrams, but both forms deliver a similar amount of semaglutide into your bloodstream, according to W. Timothy Garvey, MD, associate director of the University of Alabama at Birmingham Nutrition Obesity Research Center.
When injected, semaglutide is easily absorbed into the bloodstream, he says. But when you swallow the drug, stomach enzymes dissolve some before your gut's mucosal lining can absorb and pass it to your bloodstream.
Another oral semaglutide, Rybelsus, prescribed for type 2 diabetes, contains lower doses, with a maximum dose of 14 milligrams, 44% less than the most potent Wegovy pill.
The newer orforglipron (Foundayo) pill comes in doses of 0.8 mg, 2.5 mg, 5.5 mg, 9 mg, 14.5 mg and 17.2 mg. Dosages can be increased every 30 days until the maximum dose is reached.
The pills are easier to store.
Injectable GLP-1s must be refrigerated. The pills can be kept at room temperature.
Obesity is a stigmatized condition, and people have a lot of judgments about people taking the medications," says Jay. "One of the benefits of the pill is that you don't have to have it in your refrigerator and advertise that you're on the medication."
"It's easier to use and store the oral pill," says Garvey. "You can travel with it and not worry about refrigeration."
The semaglutide pills have less flexibility than the shot if you miss a dose.
If you forget to take the semaglutide (Rybelsus, Wegovy) pill in the morning, you simply skip that dose and resume the next day without doubling up, according to the prescribing instructions. For the weekly shot, you can make up a missed dose if your next scheduled dose is more than two days away. Otherwise, you skip it and proceed with your next scheduled dose.
"Patients really get used to taking something once per week," says Jay. "If you forget [an injection], you can remember to take it 10 hours later that day. I think that will lead to better adherence than [semaglutide] pills, which you have to take every day on an empty stomach and then wait 30 minutes to eat. That can be difficult for people with busy schedules."
The pill may be cheaper.
The cost of Wegovy, whether the pill or injection, may be as low as $25 per month with insurance. If self-paying, some online sites may offer a discounted price for the first month or two.
Pill. Without insurance, the starting cost of the Wegovy pill is $149 a month for the lowest doses (1.5 milligrams and 4 milligrams). The highest doses (9 milligrams and 25 milligrams) cost $299 a month if self-paying.
If self-paying for Foundayo pills, the starting dose also is $149 per month. With insurance, it may also be as low as $25 per month.
Injection. For the first two months, the self-pay discount for the Wegovy pen is $199 per month for the lower doses (0.25 milligrams and 0.5 milligrams). The higher doses (1, 1.7, and 2.4 milligrams) cost $349 per month.
Do GLP-1 Pills Work?
Both the pills and the shot are effective.
Studies of orforglipron (Foundayo) showed significant and sustained weight loss (at least 10% of starting weight) over 72 weeks.
In studies, both forms of semaglutide (Wegovy) show similar weight loss results, particularly among patients who are good at taking it as prescribed. "Both injectable and oral semaglutide achieve over 16% weight loss," says Garvey.
That kind of weight loss can treat and prevent a wide range of obesity-related complications and diseases and improve quality of life, he says.
Side effects are similar between the two forms of Wegovy, as well as Foundayo.
The most common side effects for both injectable and oral forms of semaglutide (Wegovy) include gut issues, such as nausea, vomiting, diarrhea, and constipation, said Hamlet Gasoyan, PhD, assistant professor of medicine at Cleveland Clinic Lerner College of Medicine. Side effects can be managed:
- Eat only when you're hungry.
- Eat smaller portions slowly.
- Stop eating as soon as you start to feel full.
- Avoid greasy, fried foods.
- Prioritize protein and fiber.
- Stay well hydrated.
Managing the side effects makes it more likely you’ll stay on the medication to reap the benefits.
Comparing the GLP-1 Pill and the Shot
The key to success with a GLP-1 medication is to keep taking it. Research shows that when people stop using the medication, they can regain up to two-thirds of lost weight within a year.
"We think of these medications like any other chronic medication, like a blood pressure pill or cholesterol pill," says Jay. "These are things you take to improve health long-term."
The form of GLP-1 that will work best for you is the one that you can stick with taking.
Some people (including patients and caregivers) have visual impairments or physical limitations that make filling a syringe or sticking a needle challenging. "It's often more difficult for older folks to use injectables," says Jonathan H. Watanabe, PharmD, PhD, a professor of clinical pharmacy at the University of California San Francisco School of Pharmacy.
If you're considering oral versus injectable GLP-1 for weight loss, talk to your doctor about what's best for you. "It's a worthwhile discussion for the patient and provider to really think about what is going to help them stay on the medication longer," says Watanabe.
So which will you be more likely to take consistently? That depends on you.
Here are some differences to consider:
| GLP-1 INJECTIONS | GLP-1 PILLS |
| Taken once a week | Taken daily |
| Must be kept in fridge | No refrigeration needed; easier for frequent travel |
| Can be taken at any time of the day, with or without food | Wegovy ust be taken on empty stomach every morning Foundayo can be taken any time of day, with or without food |
| Can eat right away after injection | Must wait 30 minutes after taking Rybelsus or Wegovy before eating |
| May cost more than pill form | May cost less than injectable form |
| More flexibility if you miss a dose (can take within two days to stay on weekly schedule) | Less flexibility if you miss a dose (if Wegovy missed in the morning, must wait until next day) |
| Quickly absorbs into bloodstream | Must dissolve in stomach before being absorbed into blood |
| Some people find it difficult to inject themselves | An option for people who don't like needles or who have skin reactions to injections |
Where Can I Get GLP-1 Meds?
All GLP-1 medications must be prescribed by a doctor. You can fill a prescription for the pill or injectable form of semaglutide (Wegovy) at:
- Most pharmacies
- Pharmacies at big box stores
- Pharmacies at grocery stores
- Online companies
You may see ads for "compounded" GLP-1s, such as Wegovy. Compounded drugs are created from scratch by a pharmacist, usually when a patient cannot be helped by an FDA-approved drug. The pharmacist will mix ingredients to produce a drug.
However, compounded drugs are not verified by the FDA as being safe or effective. Compounded drugs, including compounded semaglutide or tirzepatide, are not FDA approved.
Takeaways
GLP-1s have shown numerous benefits for people who have diabetes, as well as for those who have obesity. Until now, the only GLP-1 medications for treating obesity were injectables: semaglutide (Wegovy) and tirzepatide (Zepbound). Now a pill form of semaglutide (Wegovy) is FDA approved and available for weight management, as is a new GLP-1 pill called orforglipron (Foundayo). If you're considering a GLP-1 for weight loss, talk to your doctor about what form is best for you. You and your doctor can talk about whether the pill or injectable form is going to fit with your daily routine better. Choosing the form of GLP-1 medication that helps you stay on the medication longer — along with adjusting eating habits and exercising — leads to better outcomes.
GLP-1 Pill FAQs
Is there an Ozempic pill?
No, there is not a pill form of Ozempic. Ozempic is the brand name for an injectable form of semaglutide that’s approved for treating type 2 diabetes. It’s similar to Wegovy, but Wegovy is the brand name for an injectable — and now pill — form of semaglutide that’s approved for weight management.
What is the downside to GLP-1 pills?
Some GLP-1 pills (Rybelsus, Wegovy) must be taken first thing in the morning, and then you must wait 30 minutes before eating. If you forget to take your pill, you must wait until the next morning. Since GLP-1s work best when taken consistently, having less wiggle room with a pill if you miss a dose may be a problem. The new GLP-1 called orforglipron (Foundayo) is also a daily pill, but it can be taken at any time of day, with or without food.
Why do people stop taking GLP-1s?
Cost and insurance-related barriers are the most common reasons people stop taking GLP-1s, according to research by Gasoyan's team. Whether the pill improves adherence "will heavily depend on whether insurers cover this new form of semaglutide and also the pricing for direct-to-consumer sales for this medication," says Gasoyan.
