As of 2025, the obesity treatment landscape continues to evolve. Injectable GLP-1 receptor agonists have set new clinical benchmarks, achieving 15–20% average weight reduction and improving cardiometabolic outcomes in adults with obesity. Yet real-world use often lags, hampered by injection hesitancy, supply constraints, and insurance variability.
Emerging research suggests the next frontier may lie with oral GLP-1–based therapies. In phase 3 studies, these agents have delivered weight reductions of 14–15%, closely mirroring injectables. Meanwhile, early-phase data on dual and triple agonists targeting GLP-1, glucagon, and amylin pathways show promising results, with up to 24% reductions reported in select populations. Gastrointestinal effects remain the most common treatment-related events and are typically mild and transient.
As these therapies near clinical integration, clinicians must consider how oral options will complement current care models—aligning with behavioral interventions, supporting adherence, and broadening access. Framing obesity as a chronic, manageable disease remains key, with new therapies positioned as tools for long-term metabolic health.
Pharmacologic therapy—oral or injectable—should enhance, not replace, nutritional, behavioral, and physical activity strategies. As HCPs, your role is pivotal in ensuring optimal treatment pairing and fostering durable outcomes.
Which of your patients might be best suited for oral anti-obesity therapy once available? What strategies have been most effective in supporting adherence and tracking response over time?
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Sorin Herscovici, MANCHESTER VA MEDICAL CENTER2dMost likely when transitioning to maintenance chronic therapy as well as for patients who need to lose only 5-10 % of body weight -
Sachin Panchal6dThat’s great alternative for patients with phobia of needle and wants to use oral GLP
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MATTHEW MILLIGAN6dI am still very concerned about rebound weight gain. I love seeing a patient lose weight, reduce risk, etc-however, when the pt changes insurance and no longer can afford her meds, watch out. I really want to see prices drop and competition improve in this market. Most of my patients who could really use these meds are still excluded.
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Terry Cheung6dOral GLP-1 is questionable at this point I've tried prescribing Rybelsus in the past and found it intolerable by the few patients I've tried it on. However as new GLP-1 products are expected to be available in 2026 I will re-explore these oral GLP-1s once it becomes available. Patients do come in asking for a GLP-1 many times and initiate the conversation and those are the ones that continue to adhere to therapy over time. usually I do monthly monitoring to make sure they're staying on track and titrate their dosing as needed.
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SHABNAM SACHDEVA6dI would use oral GLP1s as maintenance therapy for patients who have achieved weight loss with injectables but want an oral option as maintenance therapy. Oral GLPs are also a good option for needle phobic patients who want to lose weight, Oral Semaglutide 25 mg has shown about 16 % weight loss in clinical trials whereas Orforglipron has about 13 % weight loss at maximum dose. With the approval of medication like Cagrisema, Retatrutude and Maritide , I believe most patients would still prefer an injectable option as the weightt loss and frequency of administration is far superior with the injectables
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Muhammad Nawaz6dDefinitely great time top practice Bariatric medicine and an addition of oral GLP-1 indicated for Obesity will be definitely welcome . Rybelsus is already around for some time as on Oral GLP-1 agonist for Diabetes so familiarity with this oral molecule is there and so lot of experience as well so novelty is not there ! There is a subset of patient who are needle phobic but it is very small percentage and most of the time it is overcome when they come across the small size of the needle and ease of the available injectable ! With the oral therapy compliance will become an isssue as compared to the weekly injectable and doubt that pts who are comfortable using them and seen good response will switch over to oral as such also doubt that cost will be any less that could be a motivating factor ! Imagine this is the Lilly orforglipron that is coming out and is $499 for month cash price for all doses will be interesting to see the coverage and patient acceptability am sure Novo will come out an oral one for weight loss indicated soon too ! i would still prefer an injectable one for weight loss to prescribe given pretty good expereince and results
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DONNA SILLMAN6dPatients who are needle phobic would benefit from an oral version. The cost will have to be weighed with injectable now being sold at lower rates. We have patients scheduled every 3 months for weight checks and prescriptions renewals. We track weight loss and how this has positively impacted patients and their ADL
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BRETT NILE6dpatients who are afraid of injections or are hesitant to use the injections for fear of long term side effects are perfect for the oral version. Also, if the oral version is cheaper then the injection, cash pay patients. The strategies that have been most effective are coaching at appointments and following the weight gain. Often celebrating the weight loss with them will be the best way to motivate. We track weight at every visit, and I always remind them of the original and goal weight. Try to aim for 1-2 pounds a week