Wegovy tablets: the first oral semaglutide for weight loss explained

The Wegovy pill: an explanation of the first oral semaglutide for weight loss

Short answer: The Wegovy pill is 25 mg of oral semaglutide, the first GLP-1 tablet specifically approved for weight loss (FDA, December 2025). It is not yet available in the Netherlands; for the time being, injections or Rybelsus are used here, which, like Ozempic, are also used off-label for weight loss.

For the first time, there is a semaglutide tablet developed specifically for weight loss. Until now, semaglutide for weight loss has only been available as a weekly injection, and the oral version was reserved for diabetes patients.

The Wegovy pill changes all that. In this blog, you can read exactly what the pill is, how it works, how effective it has been shown to be, and when it is expected to become available in the Netherlands.

What is the Wegovy pill?

The Wegovy pill contains 25 mg of oral semaglutide, the same active ingredient as the well-known Wegovy injection. It is the first oral GLP-1 receptor agonist to be specifically approved for weight management by the US FDA on 22 December 2025. This marks a milestone: a GLP-1 medicine taken as a tablet rather than by injection.

It is important to distinguish this from a medicine that is already available in the Netherlands. Rybelsus, the oral semaglutide tablet, is authorised for type 2 diabetes and contains a maximum of 14 mg of semaglutide. Like Ozempic, Rybelsus is also prescribed off-label for weight loss. The Wegovy tablet is specifically authorised for weight loss and has a higher dose of 25 mg.

It contains the same active ingredient, but is a different product with a different authorisation and dosage. They are therefore not interchangeable.

How does the Wegovy tablet work?

The Wegovy tablet mimics the body’s own gut hormone GLP-1 and thereby suppresses your appetite. Semaglutide delays gastric emptying, suppresses the feeling of hunger via centres in the hypothalamus and prolongs the feeling of fullness. The mechanism of action is identical to that of the injection, as it is the same molecule. It is only the method of administration that differs.

A GLP-1 in tablet form is technically challenging, as this protein is normally broken down in the stomach before it can take effect. The tablet therefore contains an absorption-enhancing agent, SNAC. Laboratory studies of SNAC show that the substance helps guide semaglutide through the stomach wall. Absorption therefore remains relatively low and depends heavily on the stomach being empty, which explains the strict rules for taking the pill.

How effective is the Wegovy pill?

The Wegovy tablet resulted in weight loss of approximately 16.6 per cent with good adherence to treatment. This was shown in the OASIS 4 trial, a phase 3 trial of oral semaglutide 25 mg in adults who were overweight or obese. This result is comparable to that of the Wegovy injection at 2.4 mg per week. An earlier Phase 3 study (OASIS 1) also showed significant weight loss at a higher dose, confirming that oral semaglutide can be effective.

However, it is important to be realistic. The outcome depends largely on consistent use and a combination of lifestyle changes, including diet and exercise. The figures from the studies are averages, not guarantees.

Would you like to understand how semaglutide (Ozempic) aids weight loss? You will then see that the medicine is an aid that works best in combination with lasting behavioural changes.

How do you take the Wegovy tablet?

The Wegovy tablet must be taken on an empty stomach with a small sip of water, and you must then wait at least 30 minutes before eating, drinking or taking any other medication. You must swallow the tablet whole and use no more than half a glass of water, as more water actually reduces absorption. According to Farmacotherapeutisch Kompas, oral semaglutide requires this strict on-an-empty-stomach regimen to work reliably.

This requirement is also its biggest drawback compared to Foundayo, another oral weight-loss medication that has no intake restrictions. If you find it difficult to stick to a fixed morning routine, this may feel like a burden. For those who do not wish to use injections, the practical advantage of a tablet may well outweigh this. You should therefore also read about how to use Wegovy safely for weight loss before starting GLP-1 treatment.

What are the side effects of the Wegovy pill?

The side effects of the Wegovy pill are similar to those of injectable semaglutide and are generally mild. Nausea is the most commonly reported side effect, particularly during the build-up phase, and occurs in around a quarter of users. In addition, diarrhoea, vomiting, constipation, abdominal pain and loss of appetite may occur. These symptoms usually subside as soon as the body gets used to the medicine.

Rare but serious side effects include gallstones, pancreatitis and dehydration resulting from persistent gastrointestinal discomfort. Caution should also be exercised in cases of a history of pancreatitis and during pregnancy, in which case treatment must be discontinued in good time. If your symptoms persist or are severe, you should always contact a doctor.

Is the Wegovy pill already available in the Netherlands?

No, the Wegovy pill is not yet available in the Netherlands or the rest of the EU. Approval is currently limited to the US. Novo Nordisk has submitted an application for approval of oral semaglutide 25 mg for the treatment of obesity to the European Medicines Agency (EMA) in the second half of 2025. The medicine is expected to become available in Europe in 2026 or 2027 at the earliest, but an exact date and details regarding reimbursement have not yet been finalised.

However, there are other options currently available in the Netherlands. As well as Rybelsus (off-label for weight loss), you can choose injectable medicines such as Wegovy (semaglutide injection for weight loss), Ozempic and Mounjaro. You can find an overview of these in our guide to weight-loss medicines. Whether GLP-1 therapy is suitable for you depends on your situation and your BMI.

Wegovy tablet or injection: what’s the difference?

The main difference between the Wegovy tablet and the injection lies in the method of administration and ease of use. The tablet is taken daily and may be easier for those who do not wish to give themselves an injection, but it must be taken on an empty stomach. The injection is self-administered once a week, and there are no dietary restrictions.

Foundayo is a third alternative that does not contain semaglutide and has no intake restrictions. The table below compares the key features.

Which form is best suited varies from person to person. If you’re unsure whether you’re eligible, find out when you’re eligible for GLP-1 medication.

Stay up to date on the latest weight-loss medication with Goodweigh

Goodweigh closely follows developments in oral GLP-1 medication and already offers guidance on the available, approved medicines. As soon as the Wegovy pill becomes available in the Netherlands, a Dutch doctor will assess whether it is a suitable option for you. Would you like to know which treatment is best for you right now? Then start an online initial consultation and discover your options.

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