{"id":124403,"date":"2025-05-23T05:13:11","date_gmt":"2025-05-23T05:13:11","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/124403\/"},"modified":"2025-05-23T05:13:11","modified_gmt":"2025-05-23T05:13:11","slug":"forget-needles-fat-jab-pills-are-here-how-much-weight-you-could-lose-how-they-work-and-the-new-side-effects-special-report-by-antonia-hoyle","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/124403\/","title":{"rendered":"Forget needles, fat-jab PILLS are here: How much weight you could lose, how they work and the new side-effects. Special report by ANTONIA HOYLE"},"content":{"rendered":"

A weight-loss injection pen sits in Melanie Hinton\u2019s fridge amid the eggs and vegetables she\u2019s trying to train her brain to enjoy. She knows Saxenda, the brand she was prescribed, could help shift the fat that has crept on thanks to a double whammy of menopause<\/a> and biscuit addiction.<\/p>\n

And, at 12st 10lb and 5ft, she\u2019s desperate for a solution where slimming clubs and willpower have failed.<\/p>\n

\u2018My confidence has gone. I feel depressed. I have osteoarthritis<\/a> and degenerative disc disease and the excess weight is limiting my mobility,\u2019 says Melanie, 56, a married mother of two from Leicester.<\/p>\n

But a month ago, when she injected herself with the medication, which contains the drug liraglutide and like the better-known semaglutide mimics the action of the GLP-1 hormone to reduce appetite, she felt so sick she couldn\u2019t get out of bed for 24 hours. While nausea is a side-effect that supposedly passes, she\u2019s too scared to try again.<\/p>\n

\u2018Putting a needle in myself makes me feel weak,\u2019 she says. \u2018If I could get the same results from a pill, it would make a massive difference. In tablet form, I\u2019d get it down.\u2019<\/p>\n

She won\u2019t have to wait long. At least a dozen oral versions of the weight-loss jabs that have revolutionised our attitude to dieting in just two years are being created, with a couple already on the cusp of completion.<\/p>\n

With research suggesting they can cut cravings in a similar way to injectables such as Wegovy and Mounjaro, these pills look set to upend the weight-loss landscape all over again \u2013 and perhaps to an even greater extent.<\/p>\n

After all, what could be more convenient than popping a pill, with no fridges, forward thinking or punctured skin required? In tablet form, GLP-1 drugs will not only be more appealing to people like Melanie, but potentially cheaper and certainly easier to roll out on a mass scale to the billions who are overweight or obese worldwide.<\/p>\n

\"When <\/p>\n

When Melanie Hinton injected herself with Saxenda, she felt so ill she couldn’t get out of bed for 24 hours. If it came in a pill form, Melanie would be able to take the weight-loss drug<\/p>\n

Indeed, this week Sir Tony Blair\u2019s think-tank suggested the NHS send injectables through the post, to speed up delivery and get those whose health is affected by obesity off benefits and back to work. Imagine how much easier that would be with a blister pack of pills compared to bulky, temperature-sensitive jabs.<\/p>\n

Already the markets are poised. Whether weight-loss pills expand an industry already estimated to reach \u00a375 billion in sales by 2030, or, as some experts believe, come to dominate it, they will certainly offer a windfall to the pharmaceutical giants creating them.<\/p>\n

Little wonder, then, there is a race to get them to the public first, with every step closer sending the stakes higher.<\/p>\n

Last month, when Eli Lilly became the first company to successfully complete a phase 3 trial for a small-molecule weight-loss pill (more of which later), its share price rocketed by 13 per cent.<\/p>\n

\u2018The company that has the best effects is at such an advantage that everyone is trying to take a share of the market,\u2019 says Professor Elisabet Jerlhag Holm, an addiction researcher at the University of Gothenberg, who studies the efficacy of these drugs.<\/p>\n

So who are the behemoths battling it out? Which will get there first? And how will our lives change as a result?<\/p>\n

On paper, Novo Nordisk, the Danish company that started the weight-loss jab movement with Ozempic, the injection licensed for diabetes in the UK back in 2019, is winning. Last month it was the first to submit a GLP-1 weight-loss pill for approval to America\u2019s Food and Drug Administration (FDA), which is expected to make a decision on the drug\u2019s viability by the end of the year, meaning it could be on the market as early as 2026.<\/p>\n

In phase 3 trials \u2013 the final stage in the clinical trial process \u2013 the pill, an oral version of Wegovy (the weight-loss version of Ozempic, licensed in the UK in 2023) led to an average weight loss of 15 per cent over 68 weeks \u2013 a similar amount to injectable Wegovy.<\/p>\n

\"\u2018The <\/p>\n

\u2018The company that has the best effects is at such an advantage that everyone is trying to take a share of the market,\u2019 says Professor Elisabet Jerlhag Holm<\/p>\n

Novo Nordisk arguably had the edge because it has already developed the first GLP-1 pill shown to cause weight loss \u2013 Rybelsus, licensed for diabetes since 2019.<\/p>\n

Sarah Coombs, 77, a diabetic, has been taking it for eight months. She is one of 20,000 participants on a five-year trial run by Oxford University, testing the effects of Rybelsus on heart health, after being put forward by her GP. Within a week of taking the \u2018small, oval, bitter\u2019 pill last September, her appetite drastically diminished.<\/p>\n

\u2018That constant hum in the background \u2014 what will I eat next? \u2014 was gone. If I eat too much fat, I feel queasy. I\u2019ve cut my portions down. I just can\u2019t eat as much,\u2019 says the grandmother from East Stour, Dorset, who had tried various ways to lose weight, from juicing retreats to egg-based diets, with little success. \u2018The simplicity of the pill has made me feel safe,\u2019 says Sarah, who has shrunk from 11st 5lb to 10st 5lb.<\/p>\n

So far, so promising. However, both Rybelsus and oral Wegovy\u2019s active ingredient, semaglutide, is a peptide (a short chain of amino acids) too big to be efficiently absorbed from the gut into the bloodstream \u2013 so a pill needs to contain a greater amount than its injectable version which of course bypasses the gut altogether. Sarah is taking a 14mg dose, while oral Wegovy contains a whopping 25mg, compared to just 2.4mg in highest dose of the Wegovy jab.<\/p>\n

What\u2019s known as a \u2018gastrointestinal permeation enhancer\u2019 also has to be added to the pills to ease penetration, explains Prof Jerlhag Holm. The one in Rybelsus, for example, is called salcaprozate. Even then, \u2018gastrointestinal absorption can break down medications, resulting in disappointing results\u2019, adds Lee Brown, a health care analyst at investor research firm Third Bridge.<\/p>\n

It can also mean more significant gastrointestinal side-effects, according to Dr Jorge Moreno, an obesity specialist and assistant professor of medicine at the Yale School of Medicine.<\/p>\n

Certainly, Sarah\u2019s nausea has worsened since her dose was increased from 7mg to 14mg: \u2018I have some days where I feel rotten.\u2019 She has experienced hair loss \u2013 a reported side-effect of semaglutide. \u2018It could be my age, but I don\u2019t want it to get doubly thin because I\u2019m taking a funny pill. I also get more heartburn now.\u2019<\/p>\n

Plus, she has to take her Rybelsus tablet on an empty stomach, then wait 30 minutes before eating \u2013 and the same will go for oral Wegovy \u2013 which rather takes the edge off the convenience factor.<\/p>\n

\"Sarah <\/p>\n

Sarah Coombs has been taking Rybelsus for eight months on a five-year trial from Oxford University<\/p>\n

The active ingredients in other weight-loss injections, such as liraglutide in Novo Nordisk\u2019s Saxenda and tirzepatide in American company Eli Lilly\u2019s Mounjaro, are also peptides, and so also likely to be problematic in pill form.<\/p>\n

Which explains why \u2018small molecule\u2019 weight-loss pills that have the same impact on GLP-1 receptors as injectables and can be absorbed through the gut are the holy grail of tablet solutions.<\/p>\n

Effectively this is a brand new formulation of a GLP-1 drug.<\/p>\n

Eli Lilly\u2019s is called orforglipron – and it\u2019s also the reason why, even though it hasn\u2019t yet been submitted for approval, the company still has the edge over its competitors.<\/p>\n

Although results were only reported last month for its trial on people with diabetes \u2013 it is expected to report on its trial on obese participants \u2018later this year\u2019 \u2013 participants lost an average of 16lb in 40 weeks taking the once-daily pill.<\/p>\n

Orforglipron \u2018can be taken any time of the day without restrictions on food and water intake\u2019, says Patrik Jonsson, executive vice president and president at Lilly Cardiometabolic Health.<\/p>\n

The company expects to submit orforglipron for approval by the end of this year. In the UK drugs are given the green light by The Medicines and Healthcare products Regulatory Agency, which takes an average of six months to approve a drug, unless it has already been approved by other authorities such as the FDA or European Medicines Agency in which case it can be fast tracked in as little as two months \u2013 meaning as soon as next summer, popping an orforglipron pill could be as much a part of our daily routine as brushing our teeth or walking the dog.<\/p>\n

Eli Lilly\u2019s CEO David Ricks could be forgiven for feeling smug as he told Time magazine last month that if orforglipron \u2013 developed by the Japanese pharmaceutical company Chugai and effectively bought for commercial purposes by Lilly in 2018 \u2013 proves successful, \u2018it will go down as probably the best business development deal in the history of pharma\u2019.<\/p>\n

\"David <\/p>\n

David Ricks is the CEO of Eli Lilly, which last month became the first company to successfully complete a phase 3 trial for a small-molecule weight-loss pill<\/p>\n

Yet the race is not won yet. The approval process for any new drug is notoriously difficult, and a medication that has taken years and cost a fortune to get to this stage (Lilly\u2019s average cost to discover and develop a new drug is \u00a31.9 billion) can still be failed by authorities for something as innocuous as its manufacturing process.<\/p>\n

Or an unexpected side-effect could floor it at the final hurdle. Last month Pfizer announced it was discontinuing development of its small molecule weight-loss drug danuglipron after one \u2018asymptomatic\u2019 subject in a 1,400-participant strong phase 3 trial experienced \u2018potential drug-induced liver injury\u2019.<\/p>\n

If a company has similar promising drugs in its pipeline, it can bounce back better from a trial failure, but when data doesn\u2019t live up to the hype, heads roll. Last week, after disappointing results, Novo Nordisk\u2019s CEO Lars Fruergaard Jorgensen, left the company, a departure euphemistically described as the result of \u2018market challenges\u2019.<\/p>\n

The ubiquity of Ozempic and Wegovy long made Novo the market leader, but they target one receptor that influences appetite (GLP-1), unlike Lilly\u2019s newer Mounjaro, which targets two (GLP-1 and GIP) and which now seems more popular. According to a trial (admittedly funded by Lilly) presented to European Congress on Obesity this month, Mounjaro led to 20 per cent weight reduction after 72 weeks of treatment, pipping Wegovy\u2019s 14 per cent. \u2018Confidence is greater with Eli Lilly,\u2019 says Sheena Berry, healthcare analyst at Quilter Cheviot, who attributes Jorgensen\u2019s departure to Novo\u2019s share price performance as well as the \u2018market challenges\u2019.<\/p>\n

In a cut-throat industry, one company\u2019s triumph is another\u2019s despair. \u2018If a rival company releases better results (say, greater weight loss or fewer side-effects) then other companies\u2019 stocks can fall, even if their own trials were OK,\u2019 says Pernia Rogers, financial analyst and founder of finance company Your Finance Travel Buddy. Last June, for example, Eli Lilly announced that its latest injectable weight-loss drug, retatrutide, achieved a 24 per cent weight loss in trials. In December 2024 Novo Nordisk revealed that its new injectable weight-loss drug, CagriSema, achieved a very slightly lower weight loss, at 22.7 per cent. \u2018The poor comparative performance saw a drop in stock price of 20 per cent \u2013 a wipeout of \u00a376 billion in (Nova\u2019s) market value,\u2019 says Rogers.<\/p>\n

Unsurprisingly, pharma companies are cagey about discussing their drugs before trials are completed. But Astra Zeneca, whose small molecule GLP-1 drug, AZD5004, is in phase 2 trials, did allow me to speak to its senior vice president Mikhail Kosiborod, a lead scientist in its development.<\/p>\n

Last year early trial data found 5.8 per cent weight loss in participants with diabetes after four weeks on the drug, but Kosiborod is \u2018certainly not\u2019 prepared to speculate on how his drug compares to his rivals at this stage in the research. \u2018We\u2019ll have to wait and see once we have the data.\u2019<\/p>\n

There is, he believes \u2018a remarkable simplicity and convenience of having a once-daily pill\u2019, adding that \u2018a pill that doesn\u2019t need to be refrigerated and can be easily distributed to hundreds of countries is incredibly powerful\u2019.<\/p>\n

\"Astra <\/p>\n

Astra Zeneca senior vice-president\u00a0Mikhail Kosiborod believes there is a\u00a0\u2018a remarkable simplicity and convenience of having a once-daily pill\u2019<\/p>\n

Plus, a small molecule medication can be combined with other medicines for serious conditions like heart failure. \u2018Our approach is to focus not just on weight loss but to provide maximum value to the patients by reducing complications, and we believe by combining AZD5004 with other treatments in our portfolio we can deliver that.\u2019<\/p>\n

Astra Zeneca, whose HQ is in Cambridge, has a \u2018long legacy\u2019 in developing small molecule drugs and is a \u2018truly global company\u2019 he says. \u2018Our ability to mass produce treatments to address the needs of potentially hundreds of millions of patients is super important. That\u2019s what we bring to the table.\u2019<\/p>\n

Smaller companies such as Structure Therapeutics and Terns Pharmaceuticals \u2013 based in the US \u2013 are also developing GLP-1 pills, while manufacturer Syntis Bio, another American company, is trialling a weight-loss pill called SYNT-101 that stops food from being absorbed.<\/p>\n

Many doctors think pills will serve as a way of maintaining or boosting weight loss once initial weight has been lost through injections, says Lee Brown: \u2018Alternatively, they see the market breaking down with higher BMI patients using injections and lower BMI patients using orals.\u2019<\/p>\n

Certainly, they are a less drastic prospect for those without a huge amount to lose, like Sarah Coombs. She\u2019s not overweight enough to qualify for an Ozempic prescription from her doctor, yet felt \u2018disappointed and a bit ashamed\u2019 as her weight crept on.<\/p>\n

Whether pills will become as integral a part of a dieter\u2019s tool kit as cottage cheese and chicken breasts remains to be seen, but after years of fighting her weight and health, Sarah is delighted to have shed pounds on the oral semaglutide trial. \u2018My waistbands feel looser \u2013 and I may fit into my favourite summer dress again.\u2019<\/p>\n

Additional reporting by Rosie Beveridge<\/p>\n","protected":false},"excerpt":{"rendered":"A weight-loss injection pen sits in Melanie Hinton\u2019s fridge amid the eggs and vegetables she\u2019s trying to train…\n","protected":false},"author":2,"featured_media":124404,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4315],"tags":[92,368,105,4326,370,16,15],"class_list":{"0":"post-124403","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-dailymail","9":"tag-femail","10":"tag-health","11":"tag-medication","12":"tag-ozempic","13":"tag-uk","14":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114555440711351035","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/124403","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=124403"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/124403\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/124404"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=124403"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=124403"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=124403"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}