Is Wegovy Available as a Pill?
No, Wegovy (semaglutide 2.4 mg) is not FDA-approved as an oral pill for weight loss—it is only available as a once-weekly subcutaneous injection. 1
Key Formulation Facts
Injectable semaglutide 2.4 mg (Wegovy) is the only FDA-approved formulation of semaglutide for chronic weight management in adults with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) with at least one weight-related comorbidity. 1, 2 This formulation was approved in June 2021 and must be administered as a once-weekly subcutaneous injection. 3, 4
Oral semaglutide (Rybelsus) is FDA-approved only for type 2 diabetes treatment at doses up to 14 mg daily—it is not approved for obesity management. 1 The American College of Gastroenterology explicitly states that oral semaglutide lacks sufficient evidence for weight management and is "less potent" than injectable formulations for this indication. 1
Why Injectable Semaglutide is Superior for Weight Loss
Injectable semaglutide 2.4 mg weekly achieves 14.9–16.0% total body weight loss at 68 weeks, with 64.9% of patients achieving ≥10% weight loss. 1, 5, 6 In contrast, oral semaglutide produces only "modest weight loss" that is significantly less than injectable formulations. 1
Real-world data from 8,177 patients using Wegovy with the WeGoTogether support program demonstrated mean weight loss of -17.6% at 12 months and -20.4% at 24 months, with 50.5% of patients achieving ≥20% weight loss at 24 months. 3 These outcomes far exceed what oral semaglutide can deliver.
Clinical Implications
If a patient strongly prefers to avoid injections, oral semaglutide may be considered for type 2 diabetes management (where it achieves HbA1c reductions of approximately 1.4%), but it should not be prescribed for weight loss as a primary goal. 1 For patients requiring maximum weight loss or those with established cardiovascular disease, injectable semaglutide 2.4 mg remains the evidence-based choice, with proven cardiovascular benefits including a 20% reduction in cardiovascular death, nonfatal MI, or nonfatal stroke. 1
Administration Protocol
Wegovy is administered as a once-weekly subcutaneous injection with gradual dose escalation: starting at 0.25 mg weekly for 4 weeks, then increasing to 0.5 mg, 1.0 mg, 1.7 mg, and finally reaching the maintenance dose of 2.4 mg weekly at week 16. 1, 2 This slow titration minimizes gastrointestinal adverse effects, which occur in approximately 53% of patients but are typically mild-to-moderate and transient. 1, 7
Critical Contraindications
Wegovy is absolutely contraindicated in patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN 2). 1, 2, 6 It should also be avoided in pregnancy or breastfeeding. 1