Move over GLP-1 injectables; Novo Nordisk — creator of Ozempic and Wegovy — and Eli Lilly — producer of Zepbound — are racing to develop a pill version of their drugs to help people shed pounds.
“There's a lot of hype and anticipation for this new pill version, which would be a daily pill as opposed to the weekly or monthly injections that they currently have,” says Kirsten Hokeness, Ph.D., Bryant University’s School of Health and Behavioral Sciences director.
Hokeness notes that both companies have gone for FDA approval and will likely get their rubber stamps around the first of the year. Because the pills are expected to be cheaper to manufacture and can be mass produced on a larger scale, the cost for consumers could be more affordable and increase accessibility for users.
GLP-1 agonists help manage Type 2 diabetes, with some medications also helping to manage obesity. Wegovy and Zepbound are FDA-approved for weight loss while Ozempic is FDA-approved for treating Type 2 diabetes but has been used off-label for treating weight loss; on average, people can lose 10 percent to 20 percent of their body weight from these medications. GLP-1 agonists are relatively new, according to the Cleveland Clinic, and researchers are still learning about their other potential uses and benefits.
As the market for GLP-1 drugs continues to rise, Hokeness emphasizes that the real conversation isn’t just about the pill — it’s about how weight loss is approached personally and within the healthcare industry:
Weight loss: A multi-faceted approach
The price tag for GLP-1 medication remains high — even though supply has started to meet demand. For instance, when Wegovy was first released in 2021, the monthly price tag was more than $1,000. Today, through various incentives, prices hover around $500.
With such a high expense, Hokeness notes that it’s worth considering if the medications are worth their price. People who are taking GLP-1 medication for weight loss tend to rapidly shed weight and abruptly stop medication use — due in part to affordability. Because of this action, individuals gain weight back quickly.
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To counter this issue, Hokeness explains that studies should be conducted on how to wean people off the medication in a healthier manner, and people need to be educated on how to keep weight off.
“An injectable or pill is not going to suddenly make you healthy,” she says. “It's a multifaceted approach: recognizing and understanding that the pill in combination with behavioral changes, lifestyle changes, and wellness interventions are all critically important.”
Reported side effects
Media outlets such as Today, Healthline, and Allure have been reporting on the side effects of rapid weight loss, including popular, nonmedically dubbed terms ‘Ozempic butt’ and ‘Ozempic face.’ Hokeness explains that individuals are not only losing fat during weight loss, but muscle mass — which can result in sagging skin.
“When the body is nutrient-deprived, it starts going after your muscles because it needs to feed itself. If people aren't pairing weight loss with resistance training to keep building muscle, that’s what happens,” she says.
‘Ozempic teeth’ is another side effect being reported from different GLP-1 medications and involves gum issues and tooth decay. Experts believe these issues could be due to nutrient deprivation or from nausea and vomiting — another GLP-1 medication side effect.
“Exposure to stomach acids in your mouth can cause enamel to degrade and cause discolorations,” Hokeness says, noting that it can also cause dry mouth, which means there is not enough saliva to keep the mouth moist and limit bacteria growth.
Insurance’s role and broader impacts
Hokeness notes that the conversation around insurance companies’ roles in covering GLP-1 medications continues to evolve. Some companies strictly cover the drugs for Type 2 diabetes while others may support weight loss up to a certain point. For instance, individuals may have a starting BMI that qualifies them for coverage, but once they hit a point where their BMI no longer qualifies them, they’re cut from coverage.
“Those are all things that could be traumatic to the patient and have an impact on the long-term success of these drugs,” Hokeness says, adding that cost depends on the company a person is enrolled with, underlying conditions, and individual parameters.
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With studies in the works that look at the impacts of GLP-1s on the body for weight loss, Hokeness says the drugs have been great in their impact on metabolic and cardiovascular diseases, which has been extensively studied. If researchers and scientists can get these medications to work really well, she notes that it will be interesting to see the downstream impact on healthcare costs.
When thinking about whether to take the medication for weight loss, Hokeness says it comes down to talking with your provider.
“Every person who's going to think about this has their own story,” Hokeness says. “It's an honest conversation between your healthcare provider and yourself in terms of is this the right option for you.”