UK Approves First GLP-1 Weight Loss Tablet as Semaglutide Landscape Shifts

On 11 June 2026, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) approved the first GLP-1 receptor agonist tablet for weight loss and weight management: oral semaglutide, sold as Wegovy and made by Novo Nordisk. The tablet is approved for adults with obesity (BMI of 30 or above) or overweight (BMI between 27 and 30) with at least one weight-related comorbidity, to be taken alongside a reduced-calorie diet and increased physical activity.

The starting dose is 1.5 mg once daily, increasing to 4 mg, 9 mg and 25 mg, with a minimum duration of one month at each dose level. Patients currently treated privately with a 2.4 mg semaglutide injection once weekly can transition directly to the 25 mg tablet once daily. The tablet should be taken whole on an empty stomach after fasting for at least 8 hours, and no food or drink should be consumed for at least 30 minutes afterwards, as eating or drinking less than 30 minutes after taking the tablet lowers its absorption. The most common side effects are gastrointestinal disorders including nausea, diarrhoea, constipation and vomiting. The tablet is not currently available via the NHS; as with all new treatments, decisions on NHS use will follow established processes, including an evaluation by the National Institute for Health and Care Excellence (NICE).

Separately, a report published in Obesity Pillars detailed three cases of patients developing anhedonia — an inability to feel pleasure — after taking the GLP-1 medication tirzepatide for obesity. The symptoms emerged after the patients reached the maximum prescribed dosage of 15 mg per week, and included a loss of interest in hobbies and feeling unmotivated to do healthy things like exercise. The report's authors wrote: “Clinicians should consider monitoring for changes in motivation and reward perception during treatment, particularly at higher doses.” Two of the women reported feeling much better after lowering their dosage; one required an add-on treatment of bupropion, an antidepressant known to help with anhedonia by boosting dopamine levels. The authors noted that this effect is distinct from depression, and that several studies have suggested GLP-1 therapy is linked to reduced symptoms of depression overall.

The rise of GLP-1 drugs is also reshaping obesity treatment. Across a study population of 11.7 million adults with obesity, overweight or diabetes, GLP-1 receptor agonist prescriptions increased by 140.4% between 2022 and 2024, while metabolic bariatric surgery decreased by 34.1%. A JAMA Surgery research letter found that from Q3 2022 to Q3 2025, bariatric surgery procedures fell 46.4% among eligible patients, with sleeve gastrectomy down 50.1% and Roux-en-Y gastric bypass down 44.3%. A Loyola University Chicago study presented at the ASMBS 2026 annual meeting reported that annual procedures dropped below 200,000 for the first time since the 2020 pandemic collapse, with 2024 procedures at approximately 177,000. Surgery patients were significantly more medically complex than those prescribed GLP-1s: among metabolic bariatric surgery patients, 17.9% had four or more comorbidities, versus 6.9% for GLP-1 patients.

Despite this growth, over 90% of the eligible study population received neither treatment, and in Q3 2025, 75.8% of surgery-eligible patients were completely untreated. Cost and access remain major barriers: semaglutide (Wegovy/Ozempic) runs roughly $1,000 to $1,500 per month out of pocket, and tirzepatide (Zepbound/Mounjaro) is in the same range. Insurance coverage is patchy, with many employers and state plans excluding anti-obesity medications entirely.

In the UK, an estimated 1.5 to 2 million adults currently use weight-loss injections, and nearly four million Brits are estimated to have taken the drugs since they arrived in the UK. Clinical trials show that while most people lose at least five per cent of their body weight, around one in ten lose less than five per cent, which is not considered “clinically meaningful”. People with type 2 diabetes tend to lose less weight on the drugs — around four to ten per cent of their body weight compared to six to 17 per cent among non-diabetics.

As with all medications, users may experience side effects, including digestive issues such as nausea, stomach pain, diarrhoea or vomiting, as well as gallstones and, in rare cases, pancreatitis. Some studies suggest a measurable risk of nutrient deficiencies — particularly vitamins D, B12, A and C — within the first 12 months of taking the medication. Rapid weight loss can also cause a loss of skeletal muscle: studies have suggested that 20–40% of total weight lost could be lean mass. The NHS currently prescribes weight-loss jabs for a maximum of two years, and weight typically returns after the medication is stopped. Oral semaglutide is appealing as a cheaper non-injectable option, but rapid weight regain and muscle loss remain hurdles once treatment stops.