Bodies come in all shapes and sizes, but this doesn’t mean that those seeking weight-loss medication want a one-size-fits-all approach. Whether you’re wanting to lose weight to feel better, look better, move better, or a bit of all three, it’s important to reach a healthy weight and habits that best suit your lifestyle.
As interest in weight-loss medications continues to grow, so does interest in other options, specifically with oral alternatives. In this article, we’ll break down what’s currently available for oral GLP-1s and some of the challenges surrounding this type of weight-loss medication.
What is the difference between injectable and oral GLP-1s?
The most common GLP-1 medications, like Wegovy® and Ozempic®, come in injectable form, requiring weekly injections. Oral GLP-1s, on the other hand, come in liquid or tablet form and are taken daily. With the exception of Rybelsus® (more on that below), these are compounded by pharmacies, usually using a semaglutide base.
Why brand-name oral GLP-1 options are limited
Currently, only one FDA-approved oral GLP-1 choice exists: Rybelsus® by Novo Nordisk. However, it has only been approved for type 2 diabetes, not weight loss, and comes in 3 mg, 7 mg, and 14 mg doses, with its max dose still lower than the Wegovy® injectable version.
While there are efforts being made to get a higher dose approved by the FDA, there are strict absorption requirements, as medication must be taken on an empty stomach with limited water and no food for 30 minutes.
Pharmaceutical barriers
No oral GLP-1 formulation for weight loss has received FDA approval, as oral delivery of GLP-1 is scientifically challenging due to peptide breakdown in the stomach. (Rybelsus® uses a special absorption enhancer (SNAC) to work, which is proprietary.)
In addition, production costs are high, and meeting strict FDA requirements is a lengthy process.
Compounded oral GLP-1s are on the rise
Despite these barriers, demand for these medications has risen, and healthcare providers are prescribing compounded oral semaglutide versions for patients they feel would benefit from an oral version. While the FDA has deemed that the GLP-1 medication shortage is over—for now—many patients and providers still prefer compounded oral GLP-1s* due to convenience and lack of needles. Oral GLP-1 alternatives are also available via telehealth and online clinics, making access easier.
Liquid drops or lozenges?
The most popular oral GLP-1 options—liquid drops and lozenges (tablets)—may be slightly less potent than injectable GLP-1s, which means side effects may be fewer, making them a more attractive option for some patients.
Liquid drops:
- Taken once a day
- Absorbed under the tongue to bypass digestion and enter the bloodstream quickly
- Side effects may include mild nausea or dry mouth, but in general, they are very well tolerated
Lozenges
- Taken once or twice a day, depending on response and goals
- Dissolve slowly under the tongue, allowing semaglutide to be absorbed through the oral mucosa
Liquid drops and lozenges may be a good oral GLP-1 alternative prescribed by licensed providers for those looking to avoid needles, those transitioning down from injectables, or those just starting their weight-loss journey. Visit tryshed.com to learn more.
What’s next for oral GLP-1s?
Novo Nordisk® is reportedly testing higher-dose oral semaglutide for obesity treatment with ongoing clinical trials. If approved, it would be the first FDA-approved oral GLP-1 for weight loss.
Several companies, including Lilly®, are investing in oral GLP-1 candidates with improved bioavailability and fewer dietary restrictions. Oral tirzepatide is in early-stage trials.
Until an FDA-approved GLP-1 for weight loss is approved, compounded oral alternatives may be available if prescribed by a licensed healthcare professional through. Check with your provider to see what options are available to you.
In conclusion
The weight-loss market is ever changing, so work closely with a licensed provider before starting any new medication, and be cautious of non-accredited online sellers. Shed only works with licensed providers to provide quality, consistent care for Shed members.
*Compounded medications are not FDA-approved. They are prepared by a licensed pharmacy based on a provider’s prescription.
