OW2025: Which of These Orals Will Become the GP GLP-1?
At ObesityWeek in Atlanta, people are speculating about innovations that health professionals in general practice can embrace widely. We’re getting a good look at two candidates to become the GP GLP-1. Providing real obesity care and prescribing these medicines for more than a small portion of patients who need them is far from the norm. Both Novo Nordisk and Eli Lilly seem to think they have good candidates to widen the reach – daily tablets that can deliver the benefits of an injectable GLP-1 without the needles.
From Novo, we heard about the potential effect of oral 25 mg semaglutide on cardiovascular risk factors in patients with overweight and obesity. Lilly presented detailed data on the ATTAIN-2 study in people with obesity and type 2 diabetes.
The enthusiasm and the need are high for something that can reach more of the patients who want access to these advanced obesity medicines.
“Wegovy in a Pill”
Novo is calling their oral offering “Wegovy in a pill,” presumably to plant the idea that it has all the benefits of their Wegovy brand, but without the necessity of injections. It’s under review at FDA and might receive an approval by the end of the year.
Domenica Rubino presented the results of an exploratory analysis of the OASIS 4 study. She found improvements in both glycemic parameters and cardiovascular risk factors. They were greater in the patients who lost more than 15% of their body weight. She tells us:
“It’s exciting to see these new results from the cardiometabolic post hoc analysis, which showed that while benefits were most pronounced in people who achieved greater than 15% weight loss, clear improvements in glycemic parameters and CV risk factors were observed in patients taking oral semaglutide 25 mg, regardless of how much weight was lost, based on the groups observed.”
Orforglipron in Diabetes and Obesity
In a series of five presentations, we heard the detailed results of the pivotal trial that completed the package of data needed for submission of orforglipron to FDA. Deborah Horn presented the efficacy data from the ATTAIN-2 study in patients with both overweight or obesity and type 2 diabetes. Typically, these patients lose less weight than those who don’t have diabetes. Anticipating the possibility of FDA approval, Horn said:
“What gets me really excited is it’s another option in our toolbox that lands us in double-digit weight loss for individuals struggling with obesity and diabetes.”
A GLP-1 for General Practice?
Neither of these oral medicines offer stunning breakthroughs in clinical outcomes. But what they do offer is the possibility of a GLP-1 for the mass market – something a GP might embrace more fully than they have the injectable forms of these medicines.
We note that Rybelsus, an oral form of semaglutide, has been available since 2019 and has yet to set the world on fire with widespread adoption. Clinicians note limitations related to taking it on a totally empty stomach. It’s also a large peptide molecule that is relatively expensive to produce.
On the other hand, orforglipron is a small molecule, cheaper to produce, and has no restrictions on taking it with food. As the next year unfolds we will watch to see if either of these new options gets approval and uptake in the marketplace.
Click here for reporting on the ATTAIN-2 analysis and here for the reporting on the OASIS 4 study.
Visit with a GP, photograph © Obesity Action Coalition / OAC Stop Weight Bias Image Gallery
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November 6, 2025
