Future of Weight Loss Treatment: Oral Options on the Horizon
The landscape of weight loss treatments is shifting, with promising developments in oral medications. Recent research teams and pharmaceutical companies are actively working on GLP-1-based drugs that are designed to be taken as pills instead of injections.
This month, two research teams reported on their Phase II trial findings for oral GLP-1 candidates, identified as aleniglipron and elecoglipron. Both seem to offer weight loss results similar to current treatments. There are also additional pill-based candidates advancing through development.
Understanding Small Molecule GLP-1s
GLP-1, a peptide hormone, plays a role in managing hunger. GLP-1 drugs, officially known as receptor agonists, simulate this hormone to help individuals lose weight by, among other things, curbing food cravings.
Currently, GLP-1s and analogous weight loss medications usually require weekly subcutaneous injections, and creating effective pill forms has historically been challenging. Large peptide molecules, like semaglutide—the key active ingredient in Ozempic and Wegovy—are broken down by stomach acid, meaning that when ingested as a pill, very little makes it into the bloodstream.
Recently, companies have found ways around this problem. For example, the oral Wegovy pill, which received approval in late 2025, incorporates an absorption enhancer, SNAC (salcaprozate sodium), that shields the drug from stomach acid, allowing more semaglutide to enter the system. Other firms have introduced small molecule mimics, such as Eli Lilly’s ofolifeigron, which debuted as Foundayo in April.
Numerous other companies are now following Eli Lilly’s lead, developing their own small molecule weight loss medications.
AstraZeneca is among these companies, working on the drug elecoglipron. Recent data from two randomized, placebo-controlled Phase II studies was presented last week, showing that individuals taking elecoglipron daily lost as much as 11.8% of their body weight over 36 weeks.
Structure Therapeutics is also in the mix with aleniglipron, which produced results that are similarly impressive. A Phase II trial recently published in Nature Medicine revealed that participants taking aleniglipron daily lost up to 12.1% of their body weight in the same timeframe.
These positive outcomes have encouraged the companies to advance to Phase III trials, which may be essential for obtaining regulatory approval.
“No safety concerns were identified; we detected no new safety signals. The dose appears to be effective, and we plan to slow down dose escalation in the Phase III trial to improve tolerability,” stated Robert Kushner, a professor emeritus of medicine at Northwestern University and co-author of the Nature paper on aleniglipron.
Looking Ahead at Weight Loss Pills
Several additional GLP-1-based pill candidates are in development, including Roche’s CT-996, Ascletis’ ASC30, and Viking Therapeutics’ VK2735, which is being developed for both traditional subcutaneous injection and oral tablet formats.
However, there’s no certainty that any of these oral medications will gain regulatory approval. Even if they do succeed, they will enter a competitive market dominated by major players like Eli Lilly and Novo Nordisk, which produce semaglutide. Some injectable options currently available have their own benefits, such as Eli Lilly’s forthcoming retatrutide, which has demonstrated remarkable trial results of up to 30% weight loss.
Still, increased competition in the pharmaceutical industry often translates to lower prices for consumers. Moreover, many may prefer the simplicity of taking a GLP-1 pill over injections, especially given the successful launch of oral Wegovy this year. So, there’s a chance we may soon see a wider selection of effective weight loss options available for individuals to choose from.
