Oral semaglutide weight loss vs injections: are tablets just as good?

Ready to take the next step? See if you're eligible for expert-led weight loss support.

Have you heard about semaglutide tablets? Let's compare Wegovy injections and oral semaglutide in terms of weight loss.

There's no denying that weight loss drugs like Wegovy (semaglutide) have changed the game for a lot of people when it comes to losing weight.

However, Wegovy is a once-weekly injectable drug – and some people thoroughly dislike injecting themselves. Others completely avoid Wegovy out of fear of the injections.

Is there another way? Kind of.

Semaglutide exists in pill form under the brand name Rybelsus. Right now, however, Rybelsus is only licensed in the UK for type 2 diabetes, not for weight loss.

What is Rybelsus?

Rybelsus is an oral form of semaglutide designed to be taken as a daily pill to help adults with type 2 diabetes control their blood sugar. It works in the same way as injectable semaglutide (Wegovy and Ozempic) – by mimicking the GLP-1 hormone. This slows digestion, reduces appetite and helps regulate blood sugar.

In diabetes trials, people using oral semaglutide did lose weight, but not as much as people do with injectable semaglutide.

The OASIS 1 and OASIS 4 trials: higher-dose oral semaglutide weight loss

OASIS 1

In 2023, Novo Nordisk announced results from the OASIS 1 trial. This trial tested a higher 50mg daily dose of oral semaglutide in people living with obesity but not type 2 diabetes.

After 68 weeks, participants taking oral semaglutide lost on average 15.1% of their body weight, whether they adhered to the treatment or not. That's compared to the placebo group, who lost 2.4%. Those who took the medication consistently lost 17.4%.

OASIS 4

In November 2025, Novo Nordisk reported similar results from its OASIS 4 trial. In this study, participants took a 25mg dose of oral semaglutide and experienced 16.6% weight loss on average.

The trial also showed improvements in blood pressure, blood sugar and heart health. However, it's worth noting that participants in the OASIS 4 trial had prediabetes (a forerunner to type 2 diabetes).

That means they were more at risk than the general population. Being more at risk might mean that they see greater benefits more quickly than people living with obesity but not prediabetes.

What these results show

Taken together, these results suggest that oral semaglutide could be just as effective as injections. They're close to the results seen in the STEP 1 trial, where participants lost 15% of their starting weight on average with injectable semaglutide.

However, a much higher dose of semaglutide is needed to achieve similar results (25mg to 50mg orally; up to 2.4mg with injections).

So, can you use Rybelsus for weight loss?

At the moment, no. Rybelsus is currently only licensed for type 2 diabetes management in the UK. Using it for weight loss would be considered 'off-label' and is not recommended – especially since effective, approved options like Wegovy are available.

However, when announcing its OASIS 4 results, Novo Nordisk indicated that it expects to launch its higher-dose oral semaglutide treatment in the US in 2026. That's dependent on the US Food and Drug Administration approving the new drug.

If the drug is approved in the US and sold next year, it might not be long before we also see it in the UK. But again, we'll have to wait to see what UK regulators say before we know for certain.

Until the higher-dose version of oral semaglutide is approved, Wegovy remains the only safe and licensed semaglutide treatment for obesity.

Tablets vs injections: what's the difference?

Convenience: some people would be happy to take a daily pill, while others may prefer the simplicity of a once-weekly injection.
Absorption: pills are absorbed through the gut, which can affect how much medication reaches the bloodstream compared to injections.
Availability: semaglutide injections are licensed and available now for weight loss. Semaglutide pills are not.

How SemaPen can help

At SemaPen, we provide safe, regulated access to licensed medications like injectable Wegovyand Mounjaro to help you on your weight loss journey.

Our specially designed, medically supervised weight loss programmes include:

Expert support: regular check-ins with obesity specialists keep you motivated and on track
Smart scales: a simple way for you and your care team to track your progress
The SemaPen app: full of helpful tools to help you lose weight safely and effectively

If high-dose oral semaglutide weight loss treatments are approved in 2026, we'll be ready to support our patients with the safest and most effective options. For now, we're sticking with our safe and proven treatment programmes: Wegovy, Mounjaro and meal replacement diet plans.

Want to see what a SemaPen weight loss programme can do for you? Complete our online medical assessment or contact our specialist team with questions today.

Sources

1. Wilding, J.P.H. et al. (2021) "Once-weekly semaglutide in adults with overweight or obesity" The New England Journal of Medicine, 384(11) https://doi.org/10.1056/NEJMoa2032183

2. Husain, M. et al. (2019) "Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes" The New England Journal of Medicine, 381(9) https://doi.org/10.1056/NEJMoa1901118

3. Knop, F.K. et al. (2023) "Oral semaglutide 50 mg taken once per day in adults with overweight or obesity (OASIS 1): a randomised, double-blind, placebo-controlled, phase 3 trial" The Lancet, 402(10403) https://doi.org/10.1016/S0140-6736(23)01185-6

4. Gronholt-Pedersen, J. (2025) "Novo Nordisk's Obesity Pill Shows Cardiovascular Benefits, Comparable Efficacy to Injection", Medscape, 5 November. Retrieved from https://www.medscape.com/s/viewarticle/novo-nordisks-obesity-pill-shows-cardiovascular-benefits-2025a1000uil

This article was reviewed and approved by Lujain Alhassan, Bariatric Nutritionist, on 17 November 2025.

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