EVERYONE’S talking about fat jabs – the ‘miracle’ injections trimming inches off waistlines, and helping turn the tide on the obesity epidemic.
But what if there was an even easier – and cheaper – way than Ozempic-like injections, Wegovy and Mounjaro?
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Science sits still for no slimmer and already, the next big thing is looming large on the horizon – and it could be as simple as popping a pill.
Slimming tablets have been around for decades, but now scientists want to harness the new momentum in obesity medicine – and use the billions being made from the jabs – to bring pills back with a bang.
Professor Jason Halford, of the European Association for the Study of Obesity, tells Sun Health: “I think pills will eventually replace injections.
“People don’t particularly like them and they’re a bit afraid of injecting themselves.
“You’ve got to have the device, the needle, the sharps bin, it’s got to be refrigerated, there are all sorts of challenges.
“If you can move it all to a tablet you can increase acceptance and hopefully it will be cheaper and become more widely available.”
Professor Richard Donnelly, editor of the medical journal Diabetes, Obesity and Metabolism, and clinical adviser at online weight loss clinic Juniper, agrees.
“Thirty years ago weight loss tablets had a terrible reputation and nobody really wanted to prescribe them,” he adds.
“They had rare but severe side effects and weren’t particularly effective.
“Now there is a whole flood of development and a lot to be optimistic about.
“There is a big hope that developing pills will improve accessibility and cost less.”
There are several pills in development – some stimulate the same hormones as jabs to make us feel full, while others mimic bariatric surgery.
The end goal is the same – to do what willpower alone fails to achieve and stop us eating so much.
While some are yet to even be trialled in humans, one has already been submitted for approval in the US, meaning they could be available before the end of the year.
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The most advanced pills being made are by the same companies behind the fat jabs.
Novo Nordisk, creator of Wegovy and Ozempic, has developed a tablet version of semaglutide, the active drug in those injections.
It applied for approval from the US Food and Drugs Administration last month.
Trials showed patients lost an average of 15 per cent of their bodyweight over 17 months on a 50mg daily dose, compared with eight per cent over 12 months on Wegovy.
Participants were three times more likely to achieve “meaningful” weight loss when they were taking the pill, compared to those not taking the tablet.
Rival company Eli Lilly, which makes Mounjaro (tirzepatide) announced the results of its pill orforglipron in April.
The two drugs both work by stimulating GLP-1 hormones that make you feel full.
What are the other side effects of weight loss jabs?
Like any medication, weight loss jabs can have side effects.
Common side effects of injections such as Ozempic include:
Nausea: This is the most commonly reported side effect, especially when first starting the medication. It often decreases over time as your body adjusts.
Vomiting: Can occur, often in conjunction with nausea.
Diarrhea: Some people experience gastrointestinal upset.
Constipation: Some individuals may also experience constipation.
Stomach pain or discomfort: Some people may experience abdominal pain or discomfort.
Reduced appetite: This is often a desired effect for people using Ozempic for weight loss.
Indigestion: Can cause a feeling of bloating or discomfort after eating.
Serious side effects can also include:
Pancreatitis: In rare cases, Ozempic may increase the risk of inflammation of the pancreas, known as pancreatitis, which can cause severe stomach pain, nausea, and vomiting.
Kidney problems: There have been reports of kidney issues, including kidney failure, though this is uncommon.
Thyroid tumors: There’s a potential increased risk of thyroid cancer, although this risk is based on animal studies. It is not confirmed in humans, but people with a history of thyroid cancer should avoid Ozempic.
Vision problems: Rapid changes in blood sugar levels may affect vision, and some people have reported blurry vision when taking Ozempic.
Hypoglycemia (low blood sugar): Especially if used with other medications like sulfonylureas or insulin.
Patients taking 36mg of orforglipron lost eight per cent of their bodyweight in 10 months, equating to 1st 2lbs from an average starting weight of 14st 3lbs – while participants taking a placebo lost just 3lbs.
It compares with 15 per cent weight loss in a year on Mounjaro.
Lilly said their pill “could be readily manufactured and launched at scale for use around the world”.
But injections and pills have not been compared head-to-head yet.
Studies are ongoing and taking the science behind these game-changing jabs and applying it to tablets, does not guarantee success.
Pfizer abandoned the development of its drug lotiglipron in 2023 when a trial indicated potential liver damage as a side effect.
Drugs tend to be more easily absorbed by the body when they are injected directly into the bloodstream, compared to being digested through the gut.
And that’s another key consideration – what the potential side effects of these new pills could be.
Unpleasant side effects were the downfall of the old generation of slimming pills.
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The NHS has prescribed a pill called orlistat for years, dishing out £12million worth of it in England last year.
It works by preventing the gut from absorbing fat from food – but it means fat must be passed out in poo instead of digested.
This can lead to flatulence, more regular bowel movements and diarrhoea.
It can also cause bladder pains and breathing troubles – and weight loss doesn’t match up to the jabs.
About eight in 10 patients suffer at least one side effect when using injections, most commonly tummy upset, according to trials.
Everything you need to know about fat jabs
Weight loss jabs are all the rage as studies and patient stories reveal they help people shed flab at almost unbelievable rates, as well as appearing to reduce the risk of serious diseases.
Wegovy – a modified version of type 2 diabetes drug Ozempic – and Mounjaro are the leading weight loss injections used in the UK.
Wegovy, real name semaglutide, has been used on the NHS for years while Mounjaro (tirzepatide) is a newer and more powerful addition to the market.
Mounjaro accounts for most private prescriptions for weight loss and is set to join Wegovy as an NHS staple this year.
How do they work?
The jabs work by suppressing your appetite, making you eat less so your body burns fat for energy instead and you lose weight.
They do this my mimicking a hormone called GLP-1, which signals to the brain when the stomach is full, so the drugs are officially called GLP-1 receptor agonists.
They slow down digestion and increase insulin production, lowering blood sugar, which is why they were first developed to treat type 2 diabetes in which patients’ sugar levels are too high.
Can I get them?
NHS prescriptions of weight loss drugs, mainly Wegovy and an older version called Saxenda (chemical name liraglutide), are controlled through specialist weight loss clinics.
Typically a patient will have to have a body mass index (BMI) of 30 or higher, classifying them as medically obese, and also have a weight-related health condition such as high blood pressure.
GPs generally do not prescribe the drugs for weight loss.
Private prescribers offer the jabs, most commonly Mounjaro, to anyone who is obese (BMI of 30+) or overweight (BMI 25-30) with a weight-related health risk.
Private pharmacies have been rapped for handing them out too easily and video calls or face-to-face appointments are now mandatory to check a patient is being truthful about their size and health.
Are there any risks?
Yes – side effects are common but most are relatively mild.
Around half of people taking the drug experience gut issues, including sickness, bloating, acid reflux, constipation and diarrhoea.
Dr Sarah Jarvis, GP and clinical consultant at patient.info, said: “One of the more uncommon side effects is severe acute pancreatitis, which is extremely painful and happens to one in 500 people.”
Other uncommon side effects include altered taste, kidney problems, allergic reactions, gallbladder problems and hypoglycemia.
Evidence has so far been inconclusive about whether the injections are damaging to patients’ mental health.
Figures obtained by The Sun show that, up to January 2025, 85 patient deaths in the UK were suspected to be linked to the medicines.
Early data suggests pills might have similar rates.
Around six per cent of people taking any of Lilly or Novo Nordisk’s pills or injections quit the medicines because of side effects.
Dr Leyla Hannbeck, of the Independent Pharmacies Association, says: “The old generation drugs tended to be uncomfortable for a lot of people whereas these new ones are much more effective.
“All medicines will have side effects but the fact that the results are much better now means people are more willing to endure them.”
Prof Donnelly said he still does not expect new tablets to be as strong as jabs, adding: “I don’t think anybody believes these will cause the same level of weight loss that you might be reporting with Mounjaro.
“The flipside of that is that major weight loss might not all be good.
“Some of that might be muscle and if you lose 30 per cent of your body weight that is a fairly major transformation.
“Having an oral agent that reduces your weight by, say, 10 or 15 per cent, might actually be more sustainable, better tolerated and medically safer in some respects.”
While the GLP-1 tablets are likely to be first to market, inventors are also working on a daily pill that mimics the effects of gastric bypass surgery.
‘GASTRIC BYPASS’ PILL
US company Syntis Bio’s offering, named Synt-101 creates a 24-hour lining in the gut that means food cannot be absorbed in the top six inches of the small intestine.
Rather, digestion is redirected to the lower areas of the gut, where hormones that tell the brain we are full, are triggered faster.
Working in a similar vein to surgery, it means patients feel fuller faster – and the lining is passed when the patient goes to the loo the next day.
Synt-101 has passed its first human safety tests and is expected to enter a full-scale clinical trial next year.
Another pill in development, Sirona, is made by UK-based Oxford Medical Products, and contains a “dual polymer hydrogel” that expands in the stomach when it comes into contact with water.
It works like a gastric balloon, filling the patient’s tummy making them feel full for hours, but is passed in their stools “several days” later.
Early data from an NHS trial found patients lost 10 to 12 per cent in a year of treatment and there were no serious side effects.
Experts believe weight loss pills will serve a variety of purposes – as a follow-on treatment after stopping fat jabs, as an option for those who can’t or don’t want to use jabs and for people with less severe obesity, and less weight to lose.
There are hopes they will be less toxic than injections, which often cause side effects like stomach aches, vomiting or diarrhoea.
Weight regain after treatment is also an emerging issue with the jabs, which can currently only be prescribed for up to two years in the UK.
Rahul Dhanda, chief executive of Syntis Bio, said: “Patients don’t want to be stuck on a revolving door of injections and their side effects; they want to be on a manageable and sustainable weight loss path.
“Oral drugs that are simple, tolerable and safe will be the rational choice for maintenance therapy.”