Landscape with Zigzag Path

Pills and Pokes, Different People, Different Paths

“Are you sure you want an Ozempic pill?” In the Atlantic, Yasmin Tayag poses this question. Back in June people were bubbling with enthusiasm at the prospect of an oral small molecule – orforglipron – that might work as well as injectable semaglutide. But Tayag offers caution that we share. One size, one approach, for the treatment of obesity seldom fits all. Different people choose different paths – many may actually prefer the poke of a needle over a less convenient regimen with a tablet.

The truth is that we are far from having – indeed may never have – a single therapy for obesity that satisfies the needs of a majority of the people living with this condition.


Obesity medicine physician Sean Wharton expressed the excitement that many felt when he presented data on orforglipron this past summer at the Scientific Sessions of the American Diabetes Association:

“In my opinion, this is a medical advancement not just another study … because this is a non-injectable, it’s a nonpeptide. It’s hard to make injections. It’s hard to make oral peptides for the world. Obesity is on every continent, in every country, and there’s no access to care.

“Making a chemical, nonpeptide, small molecule drug that you can make a billion of relatively quickly and warehouse them can help people access care that they need. That’s what I think is the game changer. This is a world-changing molecule.”

Hang On a Minute

Whether oral medicines will replace injectables for obesity care is far from certain, Tayag concludes:

“There is so much competition in the obesity-drug space that future medications may take more unexpected forms. Amgen is studying a once-monthly injection; Novo Nordisk is developing a hydrogel form of semaglutide that would need to be taken only three times a year. If the future of obesity drugs will come down to what patients prefer, then the more options, the better.”

She is right on the mark. Different people have different needs and will pursue different paths in looking for ways to cope with obesity. Competition to provide more options is a good thing.

Click here for Tayag’s insightful reporting and here for further perspective on the increasing competition to provide better options for obesity.

Landscape with Zigzag Path, woodcut by Jacoba van Heemskerck / WikiArt

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December 17, 2023