GLP‑1 pill cleared; strength now emphasized

A hormone drug that slows stomach emptying and cuts appetite now comes in a daily weight-loss pill, and doctors are telling patients the next job is protecting muscle. (fda.gov) The United States Food and Drug Administration approved Wegovy tablets, oral semaglutide 25 milligrams once daily, on December 22, 2025, for adults with obesity or adults who are overweight with at least one weight-related condition. The label also says the pill is approved to lower the risk of major cardiovascular events in adults with established cardiovascular disease and overweight or obesity. (fda.gov) In the phase 3 OASIS 4 trial, people taking oral semaglutide lost 13.6% of body weight at 64 weeks in the treatment-policy analysis, versus 2.2% with placebo. In an analysis of participants who stayed on treatment, mean weight loss reached 16.6%. (nejm.org) Semaglutide is a glucagon-like peptide-1 receptor agonist, a drug that imitates a gut hormone released after eating. It helps people feel full sooner, eat less, and lose weight over months rather than days. (fda.gov) That matters because weight lost on these drugs is not all fat. A 2025 comment in *Nature Reviews Endocrinology* said rapid weight loss with glucagon-like peptide-1 therapy can reduce skeletal muscle, which can weaken strength and physical function if patients do not train and eat enough protein. (nature.com) The Obesity Society says resistance training done at least two to three times a week is the most effective way to preserve lean mass during active weight loss. The group also recommends protein intake of 1.2 to 1.6 grams per kilogram of body weight per day, or 1.5 grams per kilogram of lean body mass per day. (neobesitysociety.org) Bone is part of the conversation too. A 2025 semaglutide study in adults at increased fracture risk found lower bone-formation marker levels and lower lumbar-spine and total-hip bone mineral density after 52 weeks, even as body weight fell. (thelancet.com) The cardiovascular claim on the new pill rests on earlier semaglutide evidence, not a new tablet-only outcomes trial. In SELECT, weekly injected semaglutide cut the combined risk of cardiovascular death, heart attack, or stroke in adults with overweight or obesity and preexisting cardiovascular disease who did not have diabetes. (nejm.org) The label keeps the same core warning pattern patients already know from injectable semaglutide, including gastrointestinal side effects and a boxed warning about thyroid C-cell tumors seen in rodents. It also says the pill should be used with a reduced-calorie diet and increased physical activity, which is where strength work now moves from optional to central. (fda.gov)