Bottom line
The Wegovy pill, approved January 2026, is the first oral GLP-1 for obesity. Efficacy is slightly below the injection (~15% vs ~16% at 72 weeks) — within noise for any individual patient. Price ceiling is lower, no needles, but the daily fasting window matters.
Quick comparison
| | Injection | Pill | |---|---|---| | Dosing | Weekly | Daily | | Avg weight loss | 15-17% | 15% | | Cash price | $349/mo | $149-$299/mo |
Where the pill wins
No needles, lower price floor, discreet, no cold chain.
Where the injection wins
Once-weekly dosing, consistent absorption, better-established insurance coverage.
Who should switch
Cash-pay patients, anyone with injection fatigue, patients who travel frequently.
Who should stay
Anyone with good injection coverage, people who struggle with daily medication adherence, anyone who eats breakfast immediately.
Watch orforglipron
A cheaper oral GLP-1 with no fasting window is expected FDA-approved in 2026.