Oral Semaglutide for Weight Loss: The Questions Behind the Headlines Ref: 338
Date: Thu 02 Jul 2026, 09:24 
Author: MALCOLM VANDENBURGI am just watching a segment on BBC Breakfast about the oral use of semaglutide for weight loss. There was an interview with an NHS GP about her use of it. She correctly said that although approved by MHRA who consider efficacy, and risk/benefit ratio, it is yet to be approved by NICE who consider cost effectiveness.
There were no questions related to the higher dosage due to its poor bioavailability and the adverse event profile alteration due to this, and the local effect on on gut wall and local gut function.
It is my personal belief that there should be consideration of this, and a discussion and conversation as to whether the weight loss associated with semaglutide is as much related to its adverse symptoms reducing appetite as well as due to direct the reduction in appetite caused by its effect on GLP- 1 agonist effect on appetite. They also referred to it by the trade name Wegovy and not the different marketed name of the tablet Rybelus.
Semaglutide is also called Ozempic in the dosage form used for diabetes. Confused, you bet. Mounjaro is not approved in a tablet formulation although I do believe it is advertised illegally in the UK in a unapproved formulation with all the problems with this. Eli Lilly do have a different oral medication for weight loss called orforglipron which only mimics GLP-1 and not GLP plus GLP-1 like Mounjaro... more confused of course.
Malcolm Vandenburg MBBS FFPM FRCP.
Specialist in General Medicine, Pharmaceutical Physician and Forensic Clinical Pharmacologist.
https://www.malcolmvandenburg.co.uk/
+44 7850 049134