Authors: Brianna M Cartwright, MS ⊕, Truveta, Inc, Bellevue, WA Madhura S Vachon, PhD, MPH ⊕, Truveta, Inc, Bellevue, WA Emma J Holler, PhD, MPH ⊕, Truveta, Inc, Bellevue, WA Nina B Masters, PhD, MPH ⊕, Truveta, Inc, Bellevue, WA Karen G Farrar, PhD ⊕, Truveta, Inc, Bellevue, WA
- 182,101 patients initiated oral semaglutide for weight loss through September 30, 2026.
- More than one in three patients with an encounter in the prior year had no prior evidence of GLP-1 therapy.
- Among patients with available prescriber specialty, 83.2% were prescribed oral semaglutide by general practice providers.
- These patterns are consistent with those observed during the first six weeks after oral semaglutide for obesity became available.
This report is an extension of our poster presented at AMCP Nexus 2026, titled Early uptake of oral semaglutide for obesity (Wegovy pill).
GLP-1 receptor agonists have become an important treatment option for patients with obesity, cardiometabolic disease, and type 2 diabetes (1–4). These medications mimic the activity of glucagon-like peptide-1, a hormone involved in glucose regulation and appetite. Injectable semaglutide in adults with overweight or obesity is very effective for weight loss, helping establish GLP-1-based medications as an important pharmacologic approach to obesity treatment (1, 5).
GLP-1 medications indicated for weight loss were administered only by injection until December 2025, when the FDA approved once-daily oral semaglutide (Wegovy pill), the first oral GLP-1 treatment indicated for weight loss in adults (6). The pill offered an alternative to injectable therapies and raised an important real-world question: Would it primarily be adopted by current GLP-1 users or would it encourage new patients to start GLP-1s?
Our initial analysis, conducted within weeks after approval, found evidence of both (7). Among patients with sufficient prior encounter history, 36.1% had no evidence of prior GLP-1 therapy, while many others had previously received injectable anti-obesity medications. Those first few weeks provided an early signal, but prescribing patterns immediately after a drug launches may not reflect how the treatment is used as adoption grows.
With additional months of real-world data now available, we explored oral semaglutide uptake to assess whether those initial patterns persisted. We characterized adults receiving oral semaglutide for weight loss from December 22, 2025 through September 30, 2026, examining prescribing trends over time, prior GLP-1 therapy, and prescribing provider specialty.
Methods
Using a subset of Truveta Data, we identified adult patients with a prescription or dispensed prescription from a pharmacy for oral semaglutide for weight loss between December 22, 2025 (FDA approval date) and September 30, 2026.
We described patient characteristics and temporal trends in oral semaglutide prescriptions. Among patients with available prescribing provider data, we characterized prescriber specialty (prescriber analysis). Prior GLP-1 therapy was assessed among patients with an encounter during the year before initiation of oral semaglutide for weight loss (prior GLP-1 therapy analysis). Analyses were descriptive.
Results
Patient characteristics
We identified 182,101 patients who initiated oral semaglutide for weight loss during the analysis period. Most patients were female (74.5%), 34.4% were aged 45–59 years, and 36.3% were aged 60 years or older. The majority of the population was White (73.9%) and non-Hispanic or Latino (79.9%). Overall, 77.1% had evidence of overweight or obesity without type 2 diabetes, while 8.2% had both overweight or obesity and type 2 diabetes. The overall population and cohorts included in the prior GLP-1 therapy analysis and prescriber analysis were similar across demographics.
First-time prescribing increased quickly following approval and was highest during the early months of 2026 before declining later in the observation period.
Prior GLP-1 therapy
The majority of the population (87.5%) had a health care encounter within the prior year and were included in the prior GLP-1 therapy analysis. Forty-one percent of these patients had no prior evidence of GLP-1 therapy. Among patients initiating oral semaglutide for weight loss, 26.0% had most recently used injectable AOM semaglutide or AOM tirzepatide.
Prescribing practitioner
Prescriber specialty was available for 42.8% of patients. Within this group, 83.2% of prescribing practitioners were general practice providers, with smaller proportions represented by other specialties.
Discussion
Nine months after FDA approval, oral semaglutide for weight loss had been initiated by more than 182,000 patients in this analysis. First-time prescribing peaked in the early months of 2026, reflecting strong initial uptake following approval.
Importantly, more than one-third of patients included in the prior-therapy analysis had no prior evidence of GLP-1 therapy. These findings extend what we observed immediately after approval (7). In the original six-week analysis, 36.1% of patients had no evidence of prior GLP-1-based medication use. The updated analysis continues to show that a substantial portion of patients receiving oral semaglutide had no prior evidence of GLP-1 therapy, even as use expanded from the 8,762 patients captured in the original analysis to 182,101 patients in the current analysis. At the same time, more than one in four patients had most recently used injectable semaglutide or tirzepatide for obesity, indicating that oral semaglutide is also serving as an alternative formulation for patients already receiving injectable anti-obesity therapy. This switching pattern underscores the need to examine whether route of administration influences treatment preference, persistence, and outcomes.
The prescriber results also indicate broad adoption in routine care. General practice providers accounted for 83.2% of prescribing practitioners among patients with available provider specialty data. The predominance of general practice prescribers suggests that oral semaglutide is being adopted in routine care settings.
This analysis has a few limitations. Prior GLP-1 therapy was assessed only among patients with an encounter in the preceding year, and prescriber specialty was available for only 42.8% of the overall population. In addition, the analysis is descriptive and cannot establish why an individual patient or clinician chose oral rather than injectable therapy.
In this large real-world cohort, we were able to characterize early prescribing patterns among more than 182,000 patients during the first nine months after approval. Future analyses should examine whether switching from injectable to oral therapy influences treatment persistence and clinical outcomes.
These findings are consistent with data accessed on October 16, 2026.
Citations
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- Novo Nordisk Inc., FDA approves Novo Nordisk’s Wegovy® pill, the first and only oral GLP-1 for weight loss in adults (2025). https://www.prnewswire.com/news-releases/fda-approves-novo-nordisks-wegovy-pill-the-first-and-only-oral-glp-1-for-weight-loss-in-adults-302648344.html.
- Truveta Research, Early uptake of oral semaglutide for obesity (Wegovy pill) following FDA approval, Truveta (2026).
