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Is an ‘Ozempic Pill’ the Future of Weight Loss Medications?

When it comes to treating obesity, researchers are working to expand the pool of options


spinner image anti-diabetic medication Ozempic is pictured in a pharmacy
Florian Gaertner / Getty Images

The type 2 diabetes medications Ozempic and Mounjaro and their close relatives prescribed for weight loss, Wegovy and the newly approved Zepbound, have taken the world by storm for their ability to help people shed excess pounds.

But these injectable drugs might not be the last word on weight loss medications. Researchers are working to expand the pool of options in the same medication class — what’s known as GLP-1 agonists. Among them: a daily pill.

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Obesity medicine physician scientist Fatima Cody Stanford, M.D., says she’s “thrilled to see the level of investigation that’s being put forth” with regard to the latest research.

“We've seen this broaden as more and more people are beginning to recognize obesity for the complex, chronic, multifactorial, relapsing disease that it is, and I’m really excited to see that,” says Stanford, who works at Massachusetts General Hospital in Boston and is an associate professor of medicine at Harvard Medical School.

More than 40 percent of Americans have obesity — defined as a body mass index (BMI) of 30 or greater based on height and weight — according to the Centers for Disease Control and Prevention, putting them at increased risk for other chronic illnesses such as heart disease, stroke and type 2 diabetes. Research shows that losing 5 to 10 percent of your total body weight can help to improve these conditions.

So far, the more popular GLP-1 medications on the market are helping people lose, on average, 12 to 18 percent of their total weight, and some new drugs under investigation are achieving results beyond that. (Some of the current medications are approved specifically for weight loss, while others are approved for the treatment of type 2 diabetes but are being prescribed off-label by doctors for weight loss.)

Here’s what to keep an eye on in the weight loss treatment pipeline.

A weight loss pill

A few medications in clinical trials made news at the 2023 American Diabetes Association Scientific Sessions, one being a daily semaglutide pill from the same company that makes Ozempic and Wegovy. (Semaglutide, a GLP-1 agonist, is the active ingredient in Ozempic and Wegovy, both of which are given as weekly injections.)

Late-stage study results published June 25 in The Lancet found that participants who took a semaglutide pill lost, on average, 15 percent of their body weight over a 68-week period, compared to 2.4 percent in the placebo group. Thirty-four percent of study participants who took the pill lost 20 percent of their body weight.

A lower-dose semaglutide pill is currently available for the treatment of type 2 diabetes. The higher-dose version under investigation is being studied for both type 2 diabetes and weight loss management. 

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Other GLP-1 pills are also in the works. Eli Lilly’s orforglipron helped study participants who were overweight (defined as a BMI of 25 to 29.9) or who had obesity cut up to 14.7 percent of their body weight, on average, after 36 weeks in a phase 2 trial. The results were published June 23 in the New England Journal of Medicine.

And Pfizer’s danuglipron, yet another GLP-1 agonist being researched, was found in a phase 2 clinical trial to help participants with type 2 diabetes lose weight and lower blood sugar levels in the first 16 weeks, according to research published in JAMA Network Open.

Slightly different from the GLP-1 pills but equally as buzzworthy is an investigational medication called retatrutide. In another set of trial results, also reported at the 2023 American Diabetes Association Scientific Sessions, researchers found that study participants with obesity lost more than 24 percent of their starting body weight (an average of 60 pounds) in a 48-week period when taking the highest dose of retatrutide. All of the participants taking the pill lost at least 5 percent of their total body weight in the trial. The phase 2 results were published June 26 in the New England Journal of Medicine.

The study’s authors note that participants taking the medication were continuing to lose weight at the end of the trial, and researchers “speculate that greater weight reductions may be observed in the longer-duration phase 3 trial.”

While some people may prefer a weekly injection, Chetna Bakshi, M.D., a bariatric surgeon at Northwell Health’s Syosset Hospital in New York, says adding a pill to the mix could “offer more options for those patients who are unable to do the injections.” 

It could also be a good option for people who travel often, since the injectable medications have to be refrigerated. “A pill is very easy to take with you, so it definitely allows for more options for patients,” Bakshi says. 

More medications could improve access

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Adding new options to the arsenal could help improve access for patients. Both Ozempic and Wegovy are on the Food and Drug Administration’s drug shortage list, and Stanford says she has “struggled to get these medications on a consistent basis” for her patients who have the insurance or the means to pay for them. (A one-month supply costs around $1,000 or more.)

What’s more, there are currently just three GLP-1 drugs approved for the treatment of overweight and obesity — Wegovy, Zepbound (approved by the FDA on Nov. 8 and whose active ingredient is tirzepatide) and an older medication called Saxenda, whose active ingredient is liraglutide — leaving health care providers with “fairly limited options for someone who does not have diabetes,” Bakshi says.

While we wait for more research and potentially more drug approvals to trickle in, both Stanford and Bakshi say it’s important to talk to your health care provider about your weight loss goals and options if you’re struggling to lose weight.

These treatments are not for everyone, Bakshi stresses, and like all medications they can cause side effects, including nausea, vomiting, diarrhea, stomach pain and constipation. Patients with certain conditions, such as a history of medullary thyroid cancer, should not take them, Bakshi adds. “There’s no miracle drug; everything comes with risks, everything comes with complications,” she says.

It’s also important to consider costs. Many insurance companies will cover drugs that have been approved for the treatment of type 2 diabetes in patients who have diabetes. Coverage for approved weight loss medications, however, is trickier. Many insurance plans, including Medicare, won’t cover them. ​​

​Editor's note: The story, first published July 3, 2023, has been updated to reflect the new federal approval of Zepbound for weight loss.

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