Experimental obesity pills from Novo Nordisk and Eli Lilly await FDA approval, offering daily oral alternatives to weekly injections at potentially lower prices starting at $149 monthly
Millions of people use injectable drugs like Wegovy to reach healthier weights, but weekly injections don’t work for everybody’s lifestyle or budget. That’s why experimental pills that could achieve similar results are drawing significant attention from patients and healthcare providers.
The medicines haven’t yet won FDA approval, but the first one could receive authorization before year end. Tracy Zvenyach, director of policy strategy and alliances at the nonprofit Obesity Action Coalition, noted that the patient community has gone without adequate treatment for so long that new innovations to treat this chronic disease are welcome and exciting.
Two competing pills target different approaches
Novo Nordisk’s obesity pill is expected to gain approval first. It contains the same ingredient, semaglutide, that powers Wegovy, Ozempic and Rybelsus, the company’s Type 2 diabetes pill approved in 2019. The difference between this new pill and Rybelsus lies in dosage, with more semaglutide packed into the obesity formulation.
Main competitor Eli Lilly, which makes Zepbound and Mounjaro, is working on an obesity pill too. Instead of using tirzepatide, the same ingredient in its blockbuster injectables, the company developed a new compound called orforglipron specifically for its oral obesity medication.
Daily dosing replaces weekly injections
The pills require daily administration rather than the once weekly schedule of injectable versions. For Novo Nordisk, creating a semaglutide pill that wouldn’t immediately break down in the stomach before absorption proved challenging. Scientists added an ingredient called sodium N hydroxybenzoyl amino caprylate, mercifully shortened to SNAC, to protect the pill for 30 minutes during absorption.
Andrea Traina, one of Novo Nordisk’s obesity directors, explained the process works like dropping an Alka Seltzer tablet in water. The immediate fizzy reaction creates a foamy environment directly around the tablet in the stomach. That foam prevents stomach enzymes from breaking the tablet down, slightly lowers stomach acidity and makes cells under the pill more permeable so semaglutide can absorb into the bloodstream more easily. The pill must be taken on an empty stomach.
Eli Lilly’s orforglipron proved less vulnerable to stomach breakdown. Dr. Max Denning, one of Eli Lilly’s senior medical directors, noted it has no food or water restrictions. Patients can take it orally and it absorbs effectively without additional absorption enhancers or administration restrictions.
Effectiveness varies between formulations
A study published in September in the New England Journal of Medicine showed a 25 mg semaglutide pill led to 16.6% average weight reduction over 64 weeks, roughly matching Wegovy’s performance. Eli Lilly’s orforglipron produced 12.4% average weight loss at its highest dose over 72 weeks, making it less effective than injections currently on the market.
The drugs produce similar side effects to injectables, including nausea and diarrhea. Both companies continue researching next generation compounds that could prove even more effective.
Lower costs could expand access
Pills typically cost less than injectables, raising patient hopes they’ll prove more affordable than brand name injected medicines with list prices exceeding $1,000 monthly. Dr. Richard Siegel, co-director of the Diabetes and Lipid Center at Tufts Medical Center, emphasized that easier manufacturing should translate to lower ultimate costs, addressing one of the biggest problems in this treatment arena.
According to a recent KFF poll, one in eight people currently takes an injectable drug in this class. While most have at least some insurance coverage, more than half reported difficulty affording the medications.
Since early 2025, drugmakers made these medicines available at discounts to patients not using health insurance. As of early November, when Novo Nordisk and Eli Lilly announced Trump administration deals, Zepbound’s starting dose became available for $299 monthly for people buying without insurance, while Wegovy dropped to $349 monthly.
Neither company announced official list prices for experimental pills, but their administration agreements specify that approved oral obesity medicines will sell directly to consumers for $149 monthly without insurance. Better insurance coverage could drive copays significantly lower than that amount.
Approval timeline and future developments
Novo Nordisk’s obesity pill is expected to win approval before year end. Eli Lilly plans to submit orforglipron for FDA approval this year. The drug won a priority review voucher from the agency, potentially meaning decisions within months rather than standard timelines.