For the past few years, the newest obesity medicines have come with a needle attached. Patients on Wegovy and Zepbound inject themselves once a week, and many assumed that routine would last as long as treatment did. Data released today suggests otherwise. People who moved from those injections to a daily Wegovy pill did not just hold on to their progress. They kept losing weight.
The findings come from Novo Nordisk A/S (NYSE: NVO, CPH: NOVO-B.CO), the Danish maker of Wegovy, and were presented at the European Association for the Study of Diabetes annual meeting in Milan, Italy. The analysis, called OCTANE, used anonymized records from Ro, a privately held U.S. telehealth company that prescribes weight loss drugs online. It is the first study from their research partnership.
The group was small: 194 adults with obesity or excess weight, about 56% of them women. Half had started on Novo’s Wegovy injection. The rest began on Zepbound, a rival shot from Eli Lilly (NYSE: LLY). Everyone switched to the Wegovy pill and stayed on it for three months.
Over those three months, the average patient lost 4.1% of their body weight, or about 8.8 pounds, from a starting point of roughly 221.6 pounds. About 2 in 5 lost at least 5%. The share of patients with a body mass index of 30 or higher, the threshold for obesity, fell from 87.1% to 65.5%.
The scale told only part of the story. Among patients who shared feedback, about 82% noticed at least one improvement on the pill. Close to 70% said their clothes fit better, and about 51% said they were eating more healthily. Roughly 75% were satisfied with the switch.
Martin Holst Lange, Novo’s chief scientific officer, said the company has rethought what patients want. A year ago, it believed most people seeking obesity treatment were fine with injections. Now, he said, “we clearly see a preference for orals,” pointing to frequent travelers who would rather not keep their injections refrigerated. Pills now account for about a third of U.S. obesity prescriptions, and Novo says it captures more than 80% of new oral prescriptions.
These results deserve a careful reading. Real-world studies track what happens in everyday care, but they cannot prove the drug caused the outcome. Data came from routine telehealth visits, so timing and completeness varied, and much of it was self-reported. Only patients who stayed on the pill for three months were counted, which leaves out anyone who stopped early. Novo itself cautioned that the results may not apply to the broader population.
Ro sees this kind of research as a way to fill gaps that clinical trials leave open. Its co-founder and CEO, Zachariah Reitano, said medicine is good at showing whether a treatment works on average but poor at showing what works for a particular person. He wants to understand why some patients respond better than others and how best to keep weight off long term.
Novo also used the Milan meeting to share new results for CagriSema, an experimental injection that combines semaglutide, the active ingredient in Wegovy, with cagrilintide, a drug that targets a hormone called amylin. In a yearlong brain imaging study, CagriSema changed how the brain reacted to tempting, high-calorie foods and reduced “food noise,” the persistent thoughts about eating many people with obesity describe. Compared with placebo, CagriSema cut body weight by an estimated 22.4% after 52 weeks.
Separate studies in adults with Type 2 diabetes found CagriSema reduced fat around the abdominal organs, including the liver and pancreas, and early findings suggest bone health held steady despite substantial weight loss. The drug is still investigational. Novo expects to launch it early next year, with standalone cagrilintide and a higher-dose CagriSema to follow in 2028.
For patients, the takeaway is that a weekly shot may not have to be permanent. For Novo, the pill and CagriSema are central to holding its ground against Eli Lilly in a crowded, fast-moving market. Larger controlled studies will be needed to confirm what this early look suggests.
The bigger shift may be in how people think about obesity treatment. If a daily tablet can carry patients forward after injections, the choice between shot and pill becomes a matter of lifestyle, not results. That is Novo’s bet against Eli Lilly, and larger controlled studies will decide whether it pays off.
