Wegovy Oral Dosing
Wegovy (semaglutide) does not have an oral formulation approved for weight management—it is only available as a once-weekly subcutaneous injection. 1
Why There Is No "Oral Wegovy"
Injectable semaglutide 2.4 mg (Wegovy) is FDA-approved exclusively as a subcutaneous injection for chronic weight management in adults with BMI ≥30 kg/m² or BMI ≥27 kg/m² with at least one weight-related comorbidity. 1, 2
Oral semaglutide (Rybelsus) is FDA-approved only for type 2 diabetes treatment at doses of 3 mg, 7 mg, or 14 mg daily—it is not approved for obesity management. 1
Oral semaglutide is significantly less potent for weight loss than injectable formulations, with the American College of Gastroenterology noting that oral semaglutide produces modest weight loss but is insufficient for obesity management compared to injectable semaglutide 2.4 mg, which achieves 14.9% total body weight loss at 68 weeks. 1
Emerging Oral Semaglutide Data (Not Yet FDA-Approved for Weight Loss)
A 2025 trial (OASIS 4) evaluated oral semaglutide 25 mg daily (a higher dose than the diabetes formulation) in adults with overweight or obesity without diabetes, achieving a mean weight loss of -13.6% at 64 weeks versus -2.2% with placebo. 3
This 25 mg oral dose is investigational and not yet FDA-approved for weight management—it remains in clinical development and is not commercially available. 3
Gastrointestinal adverse events occurred in 74.0% of participants taking oral semaglutide 25 mg versus 42.2% with placebo, indicating a higher side-effect burden than injectable formulations. 3
Current FDA-Approved Semaglutide Formulations
| Formulation | Brand Name | Indication | Dosing | Route |
|---|---|---|---|---|
| Semaglutide 2.4 mg | Wegovy | Chronic weight management | Once weekly | Subcutaneous injection [1] |
| Semaglutide 1.0 mg | Ozempic | Type 2 diabetes | Once weekly | Subcutaneous injection [1] |
| Oral semaglutide 3–14 mg | Rybelsus | Type 2 diabetes | Once daily | Oral tablet [1] |
Clinical Implications
If a patient requests "oral Wegovy," clarify that no oral formulation exists for weight management—the only FDA-approved semaglutide for obesity is the injectable 2.4 mg weekly dose. 1
Oral semaglutide (Rybelsus) at diabetes doses (3–14 mg daily) should not be prescribed off-label for weight loss, as it lacks efficacy data and FDA approval for this indication. 1
For patients who strongly prefer to avoid injections, consider alternative oral anti-obesity medications (e.g., naltrexone-bupropion, phentermine-topiramate), though these are less effective than injectable semaglutide 2.4 mg. 1
Injectable semaglutide 2.4 mg remains the gold standard for pharmacologic weight management, achieving 14.9–17.4% weight loss at 68 weeks with 64.9% of patients reaching ≥10% weight loss. 1, 4
Common Pitfall to Avoid
- Do not confuse oral semaglutide (Rybelsus) for diabetes with injectable semaglutide (Wegovy) for weight loss—they are distinct formulations with different FDA indications, doses, and efficacy profiles. 1