Wegovy pills demonstrate comparable effectiveness to their injectable counterparts in aiding weight loss, but may not provide the same heart health benefits, according to a new analysis of existing data. The review suggests that while most obesity medications, including Wegovy and Mounjaro, lead to weight reduction, their impact on improving quality of life is often minimal.
The study, published in the British Medical Journal (BMJ), examined 19 obesity drugs across 262 trials involving nearly 100,000 participants, with follow-up periods ranging from 12 to 172 weeks. Researchers found that the most significant weight loss after one year, compared to lifestyle changes alone, was achieved with Mounjaro (tirzepatide) at 14.9 percent, closely followed by CagriSema at 14.8 percent.
Wegovy pills (oral semaglutide) resulted in 10.9 percent weight loss, while orforglipron pills showed 9.9 percent. Injectable Wegovy (semaglutide) led to 9.8 percent weight loss, and phentermine-topiramate pills achieved 8.1 percent.
Mounjaro also led to the greatest reduction in body fat, at 25.7 percent, but was associated with the largest decrease in lean body mass, such as muscle, at 8.3 percent. Emerging drugs like retatrutide, ecnoglutide, and mazdutide showed substantial weight loss effects but were supported by evidence of low or very low certainty.
Cardiovascular and Other Health Impacts
Injectable Wegovy was the only medication linked to a statistically significant lower risk of all-cause mortality (19 percent), heart attack (28 percent), and heart failure (57 percent). Mounjaro also demonstrated a reduction in heart failure risk by 51 percent. However, no drug definitively reduced the risk of kidney failure or showed clinically important improvements in quality of life, according to the researchers, who included experts from China, Norway, and Canada.
This analysis comes as private waiting lists for Wegovy pills in the UK are reportedly nearing 100,000, following the medication's approval in the country last month. The oral version of the once-weekly Wegovy injection is currently available only through private healthcare providers, with some offering the first month of treatment for approximately £60 as they compete for market share. Pharmacy officials have reported 'unprecedented' demand for the tablets.
Discussions regarding the potential availability of the oral treatment on the National Health Service (NHS) are anticipated soon, though no specific timeline has been announced. The BMJ authors noted that the relatively short follow-up periods in most clinical trials limit conclusions about long-term safety, quality of life, and effects on heart and kidney health. They emphasized that treatment decisions for obesity should be individualized, considering expected benefits, potential harms, treatment burden, costs, availability, and patient preferences.
In an accompanying editorial, medical professionals from the Cleveland Clinic in Ohio stated that the increasing number of new obesity drugs is a positive development for clinicians and the over one billion people worldwide living with obesity or overweight. They described the new study as an important step in providing comparative information to guide patient-clinician discussions on obesity drugs in the rapidly evolving treatment landscape.