Oral semaglutide caught on quickly after obesity approval

Clinical takeaway: Oral semaglutide was quickly adopted following its approval for obesity, with more than half of initiators having no prior GLP-1 receptor agonist use. Early prescribing patterns suggest uptake reflected both initiation among new GLP-1 users and switching from existing GLP-1 therapies.

GLP-1 receptor agonists have transformed obesity management, but until recently were available only as injectable therapies. Oral semaglutide became the first oral GLP-1 receptor agonist approved for chronic weight management, introducing a noninjectable treatment option for adults with obesity.

Researchers analyzed electronic health record data from 47.9 million US adults eligible for obesity management medications and without type 2 diabetes. Among this population, 148,792 adults initiated oral semaglutide between December 22, 2025, and March 15, 2026. Within 3 months of launch, prescribing rates of oral semaglutide approached those of injectable semaglutide and briefly exceeded them. Tirzepatide, however, remained the most commonly initiated obesity management medication throughout the study period.

Notably, 53% of oral semaglutide initiators had not received a GLP-1 receptor agonist in the previous year, suggesting that early uptake reflected both treatment expansion to new users and switching from existing GLP-1 therapies.

Compared with patients initiating injectable semaglutide or tirzepatide, oral semaglutide users tended to be older, were more likely to be female, had slightly lower BMI values, and higher Medicare coverage. Among oral semaglutide initiators, 87.6% received Wegovy and 12.4% received Rybelsus.

Source: Lei Y, et al. (2026 Oct 7) JAMA Network Open. Early Adoption and Diffusion of Oral Semaglutide in US Adults With Obesity