From the Guidelines
Injectable semaglutide is more effective for weight loss compared to oral semaglutide, with a higher mean weight loss percentage. The efficacy of injectable semaglutide for weight loss has been established in the STEP trials, which reported a mean weight loss of 14.9% and 16.0% at 68 weeks, compared to 2.4% and 5.7% for placebo, respectively 1. In contrast, oral semaglutide achieved a mean weight loss of 15.1% vs 2.4% for placebo in a clinical trial, although it is not yet FDA approved for obesity alone 1.
Key differences in dosing regimens:
- Injectable semaglutide is dosed once weekly, with an initial dose of 0.25mg, titrated to 1.0mg weekly over 4 weeks
- Oral semaglutide is initiated at 3mg daily, increased to 7mg daily after 1 week, and then to 14mg daily after an additional week, if tolerated
Important considerations:
- Long-term use of semaglutide is necessary to maintain weight loss, as significant weight regain occurs after cessation of treatment 1
- Both injectable and oral semaglutide have been shown to decrease the risk of cardiovascular events in adults with overweight or obesity without diabetes 1
From the Research
Efficacy of Injectable and Oral Semaglutide for Weight Loss
- The studies 2, 3, 4, 5, 6 demonstrate that semaglutide, a GLP-1 receptor agonist, is effective for weight loss in adults with obesity or overweight.
- The SUSTAIN and PIONEER clinical trials studied the use of 1.0 mg, once-weekly, subcutaneous and oral semaglutide, respectively, on participants with type 2 diabetes, and showed superior efficacy compared with placebo and other antidiabetic medications in weight reduction 2.
- The STEP trial examined the effects of 2.4 mg, once-weekly, subcutaneous semaglutide on patients with obesity and demonstrated significant weight loss compared to placebo 3, 5, 6.
Dosing Regimens of Injectable and Oral Semaglutide
- The dosing regimen for injectable semaglutide is 2.4 mg, once-weekly, subcutaneously, as studied in the STEP clinical trials 3, 5, 6.
- The dosing regimen for oral semaglutide is 1.0 mg, once-weekly, as studied in the PIONEER clinical trials 2.
- The studies do not provide a direct comparison of the efficacy and dosing regimens of injectable and oral semaglutide for weight loss.
Weight Loss Outcomes with Semaglutide
- The studies report that semaglutide 2.4 mg injection produces a mean weight loss of 14.9% to 17.4% of initial body weight at week 68 4, 6.
- The weight loss outcomes with oral semaglutide are not directly compared to those with injectable semaglutide in the provided studies.
- The studies suggest that semaglutide is a highly effective treatment for weight loss, with significant improvements in cardiometabolic and psychosocial indices 4, 5, 6.