The convenience of taking a daily pill to lose weight is attracting a new group of patients to try emerging oral GLP-1 drugs such as Foundayo and Wegovy.
Although patients and doctors have reported similar side effects and slightly less dramatic weight loss when taking a pill instead of a weekly injection, the pill's ease of use has been welcomed.
Foundayo, developed by US firm Eli Lilly, was approved for use in the UAE in April. Meanwhile, semaglutide was launched in June by the Danish manufacturer Novo Nordisk as a Wegovy pill rather than as an injectable drug.
Both medications have given doctors new options to help patients control their obesity, which is related to a host of health problems, from diabetes to cardiovascular disease and cancer.
Happy with the switch
Juma Elsa Alsuwaidi, 33, a police officer in Abu Dhabi, was prescribed Mounjaro injections when he had a BMI of 42 and weighed 122kg. But after experiencing gastrointestinal problems associated with the medicine, he switched to a daily pill.
“Before I was taking injections, and in the first two months I lost around 8kg,” he said. “But it made me want to vomit all through the week. I didn’t have any other health problems, so the main goal was to lose weight.”
As soon as the pills became available, he asked his doctor to switch him to Foundayo. After an initial headache and minor stomach cramps, he now takes the oral drug without side effects. Since April, he has lost 21kg through a combination of dietary improvements, exercise and medication.
“I’m trying to get my BMI down, so I’ll be on these pills until I’m in the green zone for that,” Mr Alsuwaidi said. “There are pros and cons for both the pill and the injection, but the pill is easier to take.”
Medical checks
Oral GLP-1 pills are available only on prescription following medical evaluation.
Patients must have a BMI above 30, or a BMI of 27 if they also have a weight-related comorbidity, to qualify for a GLP-1 prescription in either injectable or oral form.
Associated health problems include high blood pressure, Type 2 diabetes, high cholesterol, pre-diabetes or obstructive sleep apnoea.
Dr Noor Naji, head of the department and an internal medicine consultant at Burjeel Medical City, has been prescribing both Foundayo and Wegovy oral pills to patients since they became available.
“They're not created to replace the injectables, which are still showing more efficacy and more weight loss compared to the new pills,” she said. “However, it's used for people who do not prefer to take injections, who maybe are afraid of the side effects, as they are associated with way more gastrointestinal problems.
“It is also for those who want to try something new and prefer tablets every day. They think it's easier to be consistent with a daily pill. Most of those people taking weight loss medications for the first time prefer tablets. However, certain patients tried the injectables, did not like them and now want to switch.”
Cost factor
Cost is also a factor, with oral pills costing slightly less than injectable pens for a month-long supply. On average, pens cost around $200 a month, while oral pills cost around $150 a month.
Rania Alkhani, pharmacy manager at International Modern Hospital Dubai, said the new oral drugs have been in demand as they do not require cold storage, unlike injection pens.
“Their introduction has been a significant development, providing patients with an effective oral alternative that eliminates the need for weekly injections and worry about refrigeration,” she said. “Since their launch, we have seen growing interest from both physicians and patients.”
“The convenience of storing the tablets at room temperature and taking them orally has made them an attractive option. However, injectable GLP-1 therapies continue to be preferred by patients seeking greater weight loss. They are generally perceived to provide a stronger effect.”
Although oral drugs have not been paired in direct head-to-head trials, clinical tests have shown that oral Wegovy generally produces slightly higher average weight loss – between 13.6 and 16.6 per cent body-weight reduction – than Foundayo (between 11.1 and 12.4 per cent).
Other changes relate to when the medicine can be taken and in what quantities. Wegovy must be taken orally in the morning on an empty stomach; patients are advised to wait 30 minutes before taking any food or drink. Foundayo is more flexible and can be taken at any time, with or without food.
Dr Yasmeen Ajaz, a consultant in endocrinology at Medcare Hospital in Al Safa, Dubai, said there is huge interest in new oral pills. “The biggest advantage has been its convenience – many patients were reluctant to start injectable therapy because of needle anxiety, travel or lifestyle considerations,” Dr Ajaz said.
“I’ve also seen patients who travel frequently or have demanding professional lives appreciate the convenience of an oral therapy. While injectables may still achieve greater average weight loss in some patients, the oral formulation offers an excellent balance between efficacy and convenience, making it an important addition to our therapeutic options.”
