Weight loss without resorting to injections is already a possibility in Spain. The new oral presentation of semaglutide, marketed by Novo Nordisk, reached pharmacies on November 1 and broadens the treatment options for people with obesity or overweight linked to health problems.
It is the first GLP-1 receptor agonist in pill form that has been approved specifically for weight control. The medication acts on appetite, increases the feeling of fullness, and helps reduce food intake.
Its arrival represents another step forward in obesity treatment, especially for those who have difficulties or averse to injections. But is it as effective as the injections? Does it have the same side effects? Can anyone who wants to lose weight take it?
To answer these questions, we spoke with Dr. Federico Relimpio Astolfi, a specialist in Endocrinology and Nutrition at the Rocío Vázquez Clinic in Seville.
The pill that avoids injections: does it work as well as injections?
One of the main attractions of this medicine is its oral form. Compared with injectable treatments, semaglutide in tablet form offers an option for patients who have a strong aversion to needles.
“It is an option for patients who have an insurmountable aversion to injectable treatment, that is, to needles”, explains Dr. Relimpio.
However, being more convenient does not mean it is more effective. According to the specialist, the available studies show that injectable treatments achieve greater weight loss than the oral presentation.
The difference is particularly notable when comparing it with tirzepatide, another drug used to treat obesity. Therefore, the pill does not arrive to replace injections, but rather to expand the range of available options and adapt to the needs of each patient.
Nausea, vomiting and other side effects
Although the route of administration is different, oral semaglutide is not free of adverse effects. The most frequent relate to the digestive system.
Among the discomforts that may appear are nausea, vomiting, diarrhea, constipation, abdominal pain, belching, flatulence, and the worsening of a prior gastroesophageal reflux.
“These effects usually manifest especially at the beginning of treatment and, in many cases, lessen as the therapy continues”, notes the endocrinologist. Still, the response can vary greatly from one person to another.
There is another aspect not to overlook: a significant weight loss can necessitate adjusting the doses of other medicines, such as insulin, thyroid hormones, or treatments for high blood pressure.
For this reason, medical follow-up is not optional.
It is essential to monitor both weight progression and the potential health effects and how the rest of the patient’s treatments are affected.
Can anyone who wants to lose weight take it?
The arrival of a weight-loss pill may give the impression that shedding pounds is now easier than ever. But the specialist stresses that this is not a drug to take on one’s own initiative.
Oral semaglutide is indicated for certain patients with obesity or overweight associated with health problems. It should be used under medical prescription and accompanied by a nutritionally appropriate diet and an exercise plan.
In Spain, the treatment is not funded by the National Health System, so its cost must be borne by the patient.
Dr. Relimpio also warns about the risk of trivializing these drugs by presenting them as tablets. “No, it is not something trivial. Altering a patient’s body composition in the short, medium, and long term are significant issues”, he asserts.
The end of injections for weight loss?
Are we witnessing the beginning of the end for injections to shed pounds? The endocrinologist believes there are not yet enough scientific data to support that idea.
In fact, in the coming years new oral medications will arrive, such as orforglipron, which is in an advanced stage of development and shows promising results in weight control and blood glucose management.
The arrival of oral semaglutide therefore opens another avenue in obesity treatment. It is an alternative for those who do not want or cannot use needles, but it still carries one essential condition: it must be used with medical guidance and never as a quick fix to lose weight.
