Only a fraction of the people who could benefit from taking obesity medications are currently doing so. A wider array of affordable, effective treatment options could help more people. Could oral GLP-1s be one of them? Yes, experts say, but there are some caveats.

On the Horizon

More than 42% of the adult population in the US is considered obese, and nearly 31% is overweight. However, only about 2% of adult patients are taking a GLP-1 drug to treat obesity or overweight, according to a June 2025 white paper from FAIR Health, an independent nonprofit organization that gathers data for and manages a large database of privately billed health insurance claims.

Aware of the opportunity at hand, pharmaceutical companies are competing to capture more market share and possibly land the next big obesity drug.

In May, Novo Nordisk announced it had filed a new drug application submission with the US FDA for an oral version of its popular weight-loss drug Wegovy (semaglutide), hoping to get a decision by the end of 2025. If approved, the once-daily 25 mg medication would become the first oral GLP-1 approved specifically for chronic weight management; Novo Nordisk’s Rybelsus (semaglutide) tablets are only approved for treatment of type 2 diabetes.

Then in August, Eli Lilly and Company released results from its phase 3 ATTAIN-2 trial investigating the effectiveness of orforglipron, an investigational oral GLP-1 receptor agonist (RA). The company announced that it had the data needed to initiate global regulatory submissions for the drug.

“I think time will tell us if there is more interest in the medication because of the delivery method,” said Richard Peterson, MD, president of the American Society for Metabolic and Bariatric Surgery.

Oral GLP-1s: A Promising Option for Some

A daily oral GLP-1 could be a good fit for certain people, according to some obesity medicine experts.

“The wider the variety, the more people you’re going to be able to draw into the circle, and the more people you’re going to be able to treat,” said Garth Davis, MD, a bariatric and general surgeon with Houston Methodist in Houston.

For example, more GLP-1s could expand access to more people with obesity who could benefit from a weight-loss drug but aren’t already taking one, said Michelle Rappaport, MD, a bariatric medicine specialist and medical director of Providence Swedish’s Weight Loss Services Program in Seattle.

In addition to newcomers to weight-loss medication, some people don’t need to lose 20% of their body weight to be satisfied with the results. An oral GLP-1 could be a good option for them, as well as a maintenance option for some, she said.

Plus, they could gain the other health benefits of GLP-1s that they can’t get with the oral weight-loss medications that are already on the market. For example, phentermine-topiramate is an affordable weight-loss drug, but the only benefit is weight loss, Rappaport said.

There’s also the convenience factor. Unlike injectable GLP-1s that must be kept cool to maintain their effectiveness, a drug like orforglipron won’t need to be refrigerated.

The Injectable GLP-1 Preference

But some obesity and bariatric medicine doctors doubt there will be a mass exodus of people abandoning their Zepbound and Wegovy in favor of a daily oral GLP.

“My feeling is that people are going to stick with what they know,” said Davis.

Some patients prefer the convenience of a once-weekly injection over taking a daily medication. There’s less opportunity to forget a dose, said Peterson, who is also the chief of Metabolic and Bariatric Surgery at UT Health San Antonio.

While some patients might prefer to take a pill rather than inject themselves, the injectable delivery method doesn’t seem to deter many patients, either, doctors say.

“I have very few patients where the injections are a barrier,” said Rappaport. “It’s a tiny injection. It makes the flu shot look like a steak knife.”

Nicholas Paulk, MD, also rarely encounters patients who are reluctant to try injections. Many patients are so eager to lose weight that injections and needles are not a deterrent. “They’re willing to do anything,” said Paulk, an obesity medicine specialist and bariatric surgeon with Rocky Mountain Associated Physicians in Salt Lake City.

Some people have struggled with their weight for a long time, and a daily pill would just be a reminder of their struggle, said Richa Mittal, MD, founder of Radiant Health Dallas in Texas. A weekly injection, however, allows them to put that aside, so they don’t have to think about it every day.

And more importantly, many people like the results they’ve achieved with the injectable GLP-1s.

The newer-generation injectable GLP-1 drugs are very effective in causing weight loss, especially tirzepatide, which a recent study in The New England Journal of Medicine found to be superior to semaglutide for obesity management in adults. Plus, research suggests they confer additional benefits, such as a reduced risk for cardiovascular disease and numerous obesity-related cancers.

According to clinical trial data released by Lilly, people who took the highest daily dose of 36 mg of orforglipron were able to lose an average of 10.5% of their body weight, or about 22.9 lb. However, some experts point out that those are best-case results.

“In the real world, we may not see the level of weight loss that was seen in the study itself,” said Mittal.

The Cost Factor

It could come down to cost.

“There are a lot of people who could benefit who are not able to be on these medications,” said Mittal. “And a lot of that is due to the cost barrier.”

Insurance doesn’t cover GLP-1s for weight loss for many. Even with direct-to-patient access programs that recently lowered the cost of some injectable GLP-1s to $499 a month, the cost can be too much for some users.

Plus, GLP-1s need to be taken in perpetuity to maintain weight loss and benefits, which can create ongoing financial stress for many users.

A recent JAMA Network Open cohort study of 125,474 patients starting GLP-1 RAs found that “46.5% of patients with and 64.8% without type 2 diabetes discontinued within 1 year; 47.3% of patients with and 36.3% without type 2 diabetes subsequently reinitiated a GLP-1 RA within 1 year.”

The authors wrote, “Weight loss, income, and adverse events were significantly associated with discontinuation, while weight regain was significantly associated with re-initiation.”

Lower prices for GLP-1s could help expand access. If an oral GLP-1 for weight loss were available at a much lower cost, more people might be willing to give it a try, said Mittal.

“Overall, injectable medications at maximal doses still result in more weight loss than maximal dose orforglipron,” said Mittal. “However, based on cost, the oral medications will definitely be a viable option.”

Additionally, a lower-cost oral version might drive down the cost of the injectables, she said.

However, without a major cost differential, Rappaport doesn’t think a lot of people who already take an injectable GLP-1 will switch to an oral formulation.

“I’m sure some people will come in who would not have otherwise,” she said. “But I don’t think it’s going to shake things up that much.”

The Bottom Line

Experts agreed that there’s room for a wide variety of obesity medications.

Patients could also consider bariatric surgery, said Karan Chhabra, MD, assistant professor in the Department of Surgery and the Department of Population Health at the NYU Grossman School of Medicine in New York City. He is the coauthor of a study recently presented at the American Society for Metabolic and Bariatric Surgery’s 2025 Annual Scientific Meeting that showed that patients who underwent bariatric surgery experienced significantly more weight loss after 2 years than patients who received weekly injections of semaglutide or tirzepatide.

Expanded access to GLP-1s for chronic weight management could help many people, but only time will tell what the specific impact of oral GLP-1 medications will be.

“There will be some people who just want to do a daily pill,” said Davis. “I am sure there are some people out there. But I don’t think this is the end of injectables.”

“I don’t think it’s going to be one or the other,” said Chhabra. “I think it’s going to be ‘both/and.’”