GLP-1 pills vs. Shots: Which is easier, cheaper, and more effective for weight loss?

Medically reviewed by Lindsay Cook, PharmD

• GLP-1 medications are now available as pills and injections, providing more options for weight loss treatment.

• The two forms work similarly and have comparable results, but differ in dosage, absorption, and regimens.

• Experts say the best choice comes down to personal preference and how well you tolerate each option.

After years of being available only as shots, some GLP-1 medications are now available as pills. In January, drugmaker Novo Nordisk released an oral version of Wegovy, a semaglutide weight-loss drug, taken once a day and available by prescription. Here’s a comparison of GLP-1 pills and shots—especially those that use the active ingredient semaglutide.

How do they work?

Both semaglutide pills and shots activate glucagon-like peptide-1 (GLP-1) receptors, which help regulate blood sugar and appetite. The drug slows digestion, makes you feel fuller for longer, and tells your brain that you’re full, reducing hunger.

The main difference is how your body absorbs them: While shots inject medicine directly into your bloodstream, pills have to go through your digestive system, explained Su-Nui Escobar, DCN, RDN, founder of Nutrition for Weight Loss.

“When semaglutide is taken as a pill, it has to pass through the digestive system before it can be absorbed,” Escobar said. health. That’s why pills come in higher doses — 25 milligrams (mg) for shots than 2.4 mg — and are taken daily, as opposed to a weekly shot.

The tablets also come with a special regimen to ensure they are absorbed properly and reduce the chance of side effects. You should take it in the morning on an empty stomach and wait at least 30 minutes before eating or drinking. Meanwhile, GLP-1 injections can be taken at any time of the day and do not require an empty stomach.

Which one is more effective?

With the same active ingredients, semaglutide pills and injections have similar results for weight loss, with a potential slight edge to the shots.

In the 2025 trial, patients who took the tablets lost an average of 13.6% of their body weight over 64 weeks. Participants in a 2021 study of injections lost an average of 14.9% of their body weight after 68 weeks.

Which one is less expensive?

With insurance, copays for oral and injectable semaglutide are the same — as little as $25 a month.

Without the cover, the pills are slightly less expensive. For new users, Vigovi tablets cost $149 per month, compared to $199 for injections. As the dose increases, the price of the pills increases to $299 per month for the 25-mg maintenance dose, and the price of the shots increases to $349 for the standard 2.4-mg dose.

Which one is safe?

Both drugs slow digestion, which can cause gastrointestinal (GI) side effects, including nausea, diarrhea, and vomiting. Patients may also experience headaches, fatigue, dizziness, and heartburn.

Sonya Gibson, MD, an endocrinologist with Allara Health, notes that semaglutide tablets may cause stomach problems because they have to be digested. Since the injections pass through the digestive tract, they may be easier to tolerate.

More serious risks, such as pancreatitis or stomach ulcers, are rare and similar in both species, Gibson said. health. Escobar added that people with a history of certain types of thyroid cancer should not take both drugs.

Who might benefit the most?

With similar effectiveness, costs, and safety risks, the decision between semaglutide pills and shots will come down to your personal preferences.

If giving yourself weekly shots seems daunting, the daily pill may be an easier option for you. Gibson also noted that the pill may be better for people looking to lose moderate weight.

The pills may also be better for frequent travelers, Gibson said, because the pills are easier to carry and don’t require refrigeration like shots. Plus, if you pay out of pocket, you’ll save about $50 a month on pills.

On the other hand, injecting once a week may be easier for some people than following a strict pill regimen every day, Escobar said. The shots may also be better for people looking to lose weight, Gibson added, because of their slower, more predictable absorption.

“Ultimately, the best choice depends on patient preference, medical history, insurance coverage, and treatment goals,” Gibson said.

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