Weight loss pills Wegovy explained: How they work and the risks, according to UAE doctors

Weight loss just got easier to swallow. The FDA has approved Wegovy in pill form, creating a daily alternative to weekly injections with comparable results, even as availability in the UAE remains pending.

To break down what this really means—and what patients need to know—we spoke with Dr Yousef Said, Medical Director at GluCare.Health by meta[bolic], and Dr Ali El Houni, Consultant Endocrinologist at Medcare Royal Speciality Hospital. Here’s the science, the guidance, and the practical insights you should consider before thinking of pills as a weight-loss solution.

Think of it this way: The pill and the injection are two ways to deliver the same powerful weight-loss tool. Both contain semaglutide, a medication that reduces appetite, boosts feelings of fullness, and helps control blood sugar, as Dr. Said explains.

He adds: “The real difference is not what the drug does, but how it enters the body. The injection is absorbed steadily under the skin, while the pill has to be absorbed through the stomach and intestine. That means the pill must be taken very precisely, on an empty stomach and exactly as instructed, to work well.”

Both formats help manage chronic weight. But the daily pill requires careful adherence—getting it right really matters.

A landmark Phase 3 trial, OASIS 4, published in The New England Journal of Medicine in Denmark, tested the once‑daily oral semaglutide 25 mg pill for adults with obesity or overweight who had at least one weight‑related health condition. Over 64 weeks, participants taking the pill alongside lifestyle support lost an average of 16.6 per cent of their body weight, compared with about 2.7 per cent for those on placebo, among those who adhered closely to the treatment. The study demonstrated that the oral version of semaglutide can achieve substantial, clinically meaningful weight loss, comparable to results seen with the injectable form of Wegovy.

Roughly one in three people in the semaglutide group lost 20 per cent or more of their weight — far more than placebo — and the results were comparable to what has been seen with weekly injectable Wegovy. Even when considering all participants regardless of perfect adherence, the pill still produced significant weight loss versus placebo. The trial also showed improvements in physical function and cardiometabolic risk markers, reinforcing the potential benefits of oral semaglutide as a weight‑management option

 As the clinical studies suggest that, when taken correctly, the pill delivers weight-loss results comparable to the weekly injection. “People can lose a significant amount of weight over time, often in the range of 15 percent of their body weight over about a year,” says Dr. Said.

 Moreover, as he asserts, some people do better with a weekly injection, others prefer a daily pill. The option that a patient can stick to long term is usually the one that delivers the best results.

 Dr. El Houni echoes this, noting, “At the maximum maintenance doses approved for weight loss, the efficacy is very similar as compared to the injection.”

 Both the pill and the injection share similar side effects, but the pill can hit the stomach a bit harder at first. “The most common ones are nausea, bloating, constipation, diarrhea, and sometimes heartburn. These effects usually appear early, especially when the dose is increased, and tend to improve as the body adapts,” says Dr. Said.

 Wegovy is not for everyone. “It should not be used during pregnancy, and people with certain rare thyroid cancers should avoid it,” he warns. Severe or persistent abdominal pain, ongoing vomiting, or signs of dehydration should prompt immediate medical attention.

Another critical concern is muscle loss. “After the age of 50, the rate of sarcopenia—progressive age-related muscle loss—is 1–2 per cent per year, but a weight loss attempt using GLPs without proper lifestyle modifications can cause muscle loss of up to 20 per cent, accelerating up to 20 years of sarcopenia in just a single weight loss cycle theoretically-speaking,” Dr. Said explains.

For the unversed, sarcopenia is the age-related, progressive loss of skeletal muscle mass, strength, and function. It can lead to weakness, falls, and reduced mobility. While often seen in older adults, it is also linked to inactivity, poor nutrition, and chronic diseases like diabetes or cancer. It can be managed by exercise and adequate protein intake.

For this reason, careful monitoring using body composition analysis, ultrasound, or DEXA scans is essential. As the doctors emphasise: BMI alone isn’t enough. What matters is keeping track of fat, muscle, and lean mass to make sure weight loss is healthy.

As these risks can be significant, ongoing supervision is just as important as understanding them.

 In the UAE, metabolic disorders are common among patients seeking weight-loss treatments, explain the doctors. “Before starting Wegovy, we assess overall metabolic health, including weight trends, blood sugar levels, liver and kidney function, and existing medications,” Dr. Said explains.

In the first few months, it’s important to keep an eye on your weight, how your body is handling the treatment, hydration, and any side effects. Regular check-ins with your doctor make sure your weight loss is steady, safe, and doesn’t come at the expense of muscle or overall health.

Wearables and tracking tools can monitor sleep, stress, activity, and blood sugar, helping you and your doctor make real-time tweaks to your diet, exercise, and medication—making weight loss safer and more effective.

With careful monitoring in place, the pill could be especially appealing to certain groups, such as younger or tech-savvy patients, and those uncomfortable with injections. “It’s more convenient for people who travel frequently, as it does not need temperature control, unlike the injections,” notes Dr. Said.

 However, both doctors stress that Wegovy is a medical treatment for a chronic condition, not a shortcut. “Used correctly, it can support healthier habits, but it doesn’t replace them,” Dr. Said says.

There’s a danger of relying solely on medication. “Medication should never replace healthy eating, physical activity, or good sleep. Wegovy is not doing the work for you—it is helping you do the work better,” says Dr. Said.

 Patients should combine medical treatment with structured lifestyle support. Moreover, weight loss isn’t just about taking a pill—it’s about what you eat, how you move, and how you care for your body. For best results, patients should focus on protein, fibre, staying hydrated, and incorporating strength training.

“The medication helps control appetite, but what patients choose to eat, how they move, and how consistently they follow up with their doctor ultimately determines long-term success,” Dr. Said emphasises.

Muscle preservation is key. “Previous studies have linked Semaglutide-related weight loss with lean mass reductions of up to 6.9 kg over 6–12 months. In contrast, findings published in Diabetes Technology and Obesity Medicine show better muscle preservation within UAE patients, with an average skeletal muscle loss of just 1.1 kg at six months when Semaglutide is used within a structured care model, suggesting favorable lean mass preservation," he adds.

 Both doctors agree: Wegovy in pill form is a powerful new option for weight management—but it’s not magic. Success still depends on proper prescribing, ongoing care, and lifestyle support. When used responsibly, it can help patients lose weight safely, protect muscle, and improve long-term metabolic health.

As Dr. El Houni explains: “Clinical trials show that patients taking Wegovy, along with lifestyle changes, lose significantly more weight than those on a placebo; many lose 10% to 15% or more of their initial body weight.”

With careful medical guidance, the pill could be a game-changer for people who have struggled for years—but supervision by a healthcare professional is essential.