A new year brings a new therapeutic milestone for weight management: Following its recent U.S. Food and Drug Administration approval, the 25 mg oral semaglutide tablet (brand name: Wegovy), a once-daily pill became available in the United States in early January 2026 for chronic weight management and for reducing the risk of major adverse cardiovascular events in adults living with obesity or overweight and established cardiovascular disease.
According to results from the OASIS (Oral Semaglutide Treatment Effect in People with Obesity) 4 clinical trial recently published in the New England Journal of Medicine, a daily 25 mg dose leads to significant weight reduction and improved physical function. The study positions this mid-dose oral option as a potent alternative for patients who prefer the convenience of a pill over standard weekly injections or higher-dose oral formulations.
“The reasons patients may prefer oral administration over the subcutaneous route are most often needle aversion and local skin reactions,” the authors write. They further noted that oral pills do not require refrigeration, a factor that could “widen the reach of obesity care in many regions of the world where lack of refrigeration is a barrier to access.”
The 71-week, double-blind, randomized trial enrolled 307 participants without diabetes across four countries. Eligible participants had a BMI of 30 or higher, or a BMI of 27 with at least one obesity-related complication, such as hypertension, dyslipidemia, or obstructive sleep apnea. Results revealed that participants taking 25 mg of oral semaglutide achieved an estimated mean weight loss of 13.6% from baseline, compared to just 2.2% in the placebo group. This offers a strategic “middle-ground” therapeutic window for patients who may not require the maximum 50 mg dose but seek more robust results than those offered by lower-dose oral options.
“Oral pills do not require refrigeration, a factor that could “widen the reach of obesity care in many regions of the world where lack of refrigeration is a barrier to access.”
Beyond primary weight loss, the study measured several confirmatory secondary endpoints, including waist circumference reduction and improvements in systolic blood pressure. Participants in the semaglutide group were significantly more likely to reach major milestones than those on placebo, achieving weight reductions of 10%, 15%, and even 20% or more. Furthermore, patients reported a marked improvement in their physical function scores via the IWQOL-Lite-CT assessment. These scores indicate that the weight loss translated into tangible improvements in mobility and quality of daily life.
“The weight loss and improvements in metabolic markers seen with oral semaglutide is significant and will positively impact the field of obesity medicine and metabolic conditions,” said Sean Wharton. primary author and head of the Wharton Weight Management Clinic in Burlington, Canada. As a GLP-1 receptor agonist, oral semaglutide works by mimicking a natural hormone that regulates appetite and caloric intake. While highly effective, the 25 mg dose was associated with a higher frequency of side effects than the placebo. Gastrointestinal adverse events — primarily nausea and diarrhea — were reported by 74.0% of the semaglutide group, compared to 42.2% of the placebo group. These findings remain consistent with the established safety profile of the GLP-1 class.
Loading ...