The year 2026 is set to be a major leap forward for pharmacy weight loss programmes, as they are set to become more accessible to people who need them most from a number of directions.
A higher dose of semaglutide, the most commonly used weight loss medication in the UK under the brand name Wegovy, has been approved by the Medicines and Healthcare products Regulatory Authority (MHRA).
At the same time, the Financial Times has reported that generic versions of semaglutide are being developed in preparation for the expiration of its patents in various countries, which whilst it will take until 2031 for it to affect the UK directly, could lead to lowered prices.
However, possibly the biggest news regarding weight loss accessibility is the news that a tablet version of semaglutide has been approved for use in the United States, with the expectation that the MHRA will make an approval decision by the end of 2026.
What is it? How effective is it? Why is a tablet important? And could it make weight loss programmes more accessible?
What Is The Wegovy Pill?
On a basic level, the Wegovy pill is exactly as advertised; it is a dose of semaglutide taken as a tablet rather than a series of weekly injections.
The principle of taking semaglutide as a pill was already proven with Rybelsus, but whilst this is exclusively a medicine for treating type 2 diabetes, the Wegovy pill is significantly stronger in order to match the effects of the highest dose of injectable Wegovy.
How Is The Wegovy Pill Different From Injections?
In many respects, the Wegovy pill is formulated to be similar to the injectable form; whilst it contains 25mg of semaglutide, the complex design of the tablet ensures it can avoid being disintegrated by stomach acid, meaning that it has the same effective dosage as a 2.4mg injection.
This dosage has a very similar average rate of weight loss according to clinical trials, with the 25mg medication offering a typical weight loss of 16.6 per cent of their initial weight, compared to 15 per cent on injectable Wegovy.
For comparison’s sake, that would equate to a 20 stone person losing roughly three stone, five pounds on the tablet compared to three stone on the injection.
A 50mg version of the tablet has also been formulated, which would potentially double this dose if approved.
It works in the exact same way to slow the emptying of the stomach and regulate hunger in the brain, and can have some of the same effects.
However, the biggest differences are in how it is taken.
How Are Wegovy Pills Taken Differently To Injections?
- They must be taken daily, as opposed to weekly injections.
- They must be taken as soon as you wake up.
- They can only be taken with water, and only 120ml of water at that.
- Once they are taken, a person must wait at least 30 minutes before eating anything, drinking anything other than water or taking any other medications.
- The tablet must be swallowed whole; it cannot be crushed or chewed.
All of this is due to the salcaprozate sodium (SNAC) technology used to ensure that the semaglutide can bypass the stomach and remain bioavailable.
Whilst it is effective, it is also very sensitive to food and drink, which can cause it to work less effectively.
Why Is A Weight Loss Tablet So Important?
In general, one of the biggest barriers for wider adoption of GLP-1 receptor agonists such as semaglutide is the injectable nature of the medication, which whilst a highly effective delivery platform, can also lead to a number of extra costs and responsibilities for users.
Despite the relatively restrictive way in which semaglutide tablets need to be taken, and the fact that it is a daily medication rather than a weekly one, it is still more available for a wider group of people than injections.
Injectable vials need to be refrigerated in order to avoid the medication expiring and not working as effectively, you need a sharps bin and a set of sterilised needles, and you also need to inject yourself at a similar time each week, something that can be very uncomfortable for people who are needle-averse.
Part of the reason why Rybelsus was such a revelation is that it was one of the first diabetes medications that did not need to be directly injected, and the same effect may be seen with weight loss pills in terms of how accessible it makes vital treatments.