Novo's Wegovy Pill Delivers Further Weight Loss for Injection Switchers

Patients who switched from obesity injections to Novo Nordisk's new Wegovy pill lost roughly 4% more of their body weight — an additional 8.8 pounds on average — in the three months after the change, according to an analysis of real-world data the company presented Wednesday.

The figure is based on an average starting weight of around 221 pounds before taking the pill, Novo said. It is among the first real-world evidence of weight loss outcomes among patients moving from blockbuster injections — Novo's Wegovy shot and Eli Lilly's rival Zepbound — to the new oral treatment.

The results carry commercial weight for Novo. They suggest the Wegovy pill may improve upon the initial weight loss people achieve on injections rather than simply maintain it. They also suggest patients may not need weekly shots like Wegovy and Zepbound forever, and can instead opt for more convenient treatments.

The Data

Novo's analysis drew on data from Ro's telehealth platform covering 194 patients with obesity or who were overweight, around 56% of them female. Half started on the Wegovy injection; the rest initially took Zepbound.

Beyond the headline weight loss, 2 in 5 participants achieved 5% or more weight loss three months after switching to the pill. The share of people with a body mass index at or above 30 — the threshold that shifts a person from overweight into obesity — decreased by more than 21% after the switch to oral Wegovy.

Among patients with available data, around 82% reported at least one improvement during treatment with the pill. That includes almost 70% who reported better-fitting clothes and around 51% who said they pursued healthier eating. Around 75% of patients said they were satisfied with the switch, according to Novo.

Novo's chief scientific officer, Martin Holst Lange, framed the pill's interchangeability with the injection as a distinct advantage. "We have the unique benefit that, in the market, the subcutaneous Wegovy can now be interchanged with a tablet of Wegovy, and the patient can expect the same tolerability profile, the same safety profile, and actually a little bit more weight loss, which is what a lot of them want," he said in an interview.

Lange said the market picture has shifted quickly. "I think we are seeing a shift where we, maybe just a year ago, we actually thought that the vast majority of patients who wanted treatment for obesity were happy with a subcutaneous treatment," he said. "We see that picture differently now. We clearly see a preference for orals." He pointed to frequent travelers who do not want to worry about refrigerating their injections.

Caveats

Real-world studies evaluate associations and cannot determine causality. Novo itself flagged the study's limitations: variable timing and completeness of data collected during routine telehealth care, self-reported data subject to bias, and results "not being generalizable to the broader population."

CagriSema Findings

The figures are one of several new datasets Novo unveiled this week on its obesity and diabetes pipeline at the European Association for the Study of Diabetes in Milan, Italy.

Also on Wednesday, Novo said its experimental next-generation obesity drug CagriSema reduced "food noise" — persistent thoughts about food — and showed benefits in organ and bone health. The results come from a yearlong functional magnetic resonance imaging study, a noninvasive method to measure brain activity during specific tasks.

Novo said CagriSema changed how the brain reacted to tempting, high-calorie foods in areas linked to cravings, pleasure and self-control in people with obesity or who were overweight. "The signal in the brain changes in a way that actually is associated with improved quality of life," Lange said.

The company added that CagriSema reduced harmful fat around abdominal organs, including the liver and pancreas, in adults with Type 2 diabetes. Early findings also suggest patients' bone health was maintained despite substantial weight loss.

CagriSema combines Novo's semaglutide — the active ingredient in Wegovy — with cagrilintide, a drug that targets amylin. It is expected to launch early next year, followed by standalone cagrilintide and a higher-dose version of CagriSema in 2028.

Novo said the findings suggest CagriSema may address underlying factors of obesity and diabetes in the brain and multiple organs and tissues, rather than only affecting weight and blood sugar — a positioning that could sharpen its edge as competition with Lilly intensifies.