Wegovy tablets: how they work, the science, and dose titration

The Wegovy tablet is the UK's first GLP-1 weight loss medication you take by mouth rather than by injection, approved by the MHRA in June 2026. For anyone who'd prefer to avoid injections altogether, or who's simply curious how a tablet can do the same job, here's how it works, what the trial evidence shows, and what starting treatment looks like.

How the tablet works

The Wegovy tablet contains the same active ingredient as the Wegovy injection, semaglutide, formulated so it can survive the stomach and be absorbed as a tablet rather than needing to be injected. Once absorbed, it works the same way as the injection: it's a GLP-1 receptor agonist, copying a natural gut hormone released after eating.

• Slower stomach emptying. Food stays in the stomach for longer, so meals feel more filling for longer.

• Steadier blood sugar. Insulin is released more appropriately after eating, smoothing out the sugar spikes and crashes that drive cravings.

• Reduced hunger signals. GLP-1 acts on the brain's appetite centre, cutting cravings and the urge to snack between meals.

  
  

Taking the tablet correctly matters

Because it's absorbed differently to a standard tablet, how you take it affects how well it works. It should be swallowed whole, on an empty stomach, after fasting for at least eight hours, with only a small sip of water. No food or drink for at least 30 minutes afterwards. Taking it any other way, with breakfast, or with a full glass of water, significantly reduces how much of the medication your body actually absorbs.

What the trial evidence shows

The UK-approved dose (25mg) was studied in the OASIS 4 trial, a 64-week study of adults with obesity who did not have diabetes. Participants on the 25mg tablet lost an average of 13.6% of their body weight, compared with 2.2% in the group given a placebo alongside diet and lifestyle support.

Sources:

• First GLP-1 tablet for weight loss approved in the UK, MHRA

• Oral Semaglutide at a Dose of 25mg in Adults with Overweight or Obesity, NEJM

As with any medication, these are trial averages, and individual results vary. It's worth flagging that some published figures for oral semaglutide quote a higher 50mg dose, which was studied in an earlier trial (OASIS 1) but isn't the dose licensed for use in the UK, the 25mg figures above are the relevant ones here.

Dose titration: what to expect

Like the injection, the tablet is introduced gradually so the digestive system has time to adjust.

The schedule looks like this:

Duration	Dose
Month 1	1.5mg (starting dose, not yet at a treatment level)
Month 2	4mg
Month 3	9mg
Month 4+	25mg (maximum dose)

Each step is held for a minimum of one month. If you're currently on the 2.4mg weekly injection and tolerating it well, your clinician may be able to move you straight across to the 25mg tablet rather than titrating from the start again.

Common side effects during escalation

As with the injection, the most frequently reported side effects are gastrointestinal, nausea, diarrhoea, constipation and vomiting. These tend to cluster around dose increases and settle within a week or two. Sticking to the fasting and timing instructions, and keeping meals lighter around a dose change, both tend to help.

The bottom line

The Wegovy tablet gives you the same mechanism as the injection in a once-daily pill, provided it's taken correctly on an empty stomach. If you'd like to know whether the tablet or the injection is the better fit for you, our clinical team can talk through your history, goals and the titration plan in detail.

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