semaglutide · 64 weeks
OASIS 4
Weight changed by −13.6% with oral semaglutide 25 mg and −2.2% with placebo at 64 weeks.
Randomized controlled trial
OASIS 2: oral semaglutide 50 mg in East Asian adults
At 68 weeks, weight changed by −14.3% with oral semaglutide 50 mg and −1.3% with placebo; the estimated difference was −13.07 percentage points (95% CI, −15.61 to −10.52).
Kadowaki T et al. Oral Semaglutide in an East Asian Population With Overweight or Obesity, With or Without Type 2 Diabetes: The OASIS 2 Randomized Clinical Trial. JAMA Internal Medicine, 2025. DOI: 10.1001/jamainternmed.2025.3599
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- Alex Gonzalez
- Last updated
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Key facts
- Drug
- semaglutide
- Design
- Randomized controlled trial
- Participants
- 201
- Duration
- 68 weeks
- Funding
- Novo Nordisk
- Registry
- NCT05132088
- Population
- 201 adults in Japan and South Korea with a BMI of 27.0 or more and at least two weight-related complications, or 35.0 or more and at least one, 25.4% of them with type 2 diabetes, randomized 2:1 to oral semaglutide 50 mg daily (134) or placebo (67); mean age 49 years, mean weight 91.9 kg and 43.3% women.
- Primary outcome
- Two co-primary objectives at 68 weeks: percentage change in weight and proportion of participants who reduced their weight by at least 5%, with oral semaglutide 50 mg daily versus placebo, both with lifestyle recommendations.
What it found
- Oral semaglutide 50 mg daily (pill)−14.3%
- Placebo−1.3%
Difference: −13.07 points vs placebo (95% CI, −15.61 to −10.52).
Figures from the paperSee the results in a chart
At 68 weeks, weight changed by −14.3% with oral semaglutide 50 mg and −1.3% with placebo; the estimated difference was −13.07 percentage points (95% CI, −15.61 to −10.52). Weight fell by at least 5% in 107 of 127 participants on semaglutide (84.3%) and 11 of 64 on placebo (17.2%) (OR 23.00; 95% CI, 10.28 to 51.42). These are results for the treatment-policy estimand, which includes everyone randomized whether or not they stopped treatment or used other weight-loss therapies. Digestive adverse events affected 63.4% on semaglutide and 34.8% on placebo, and 4.5% on semaglutide stopped treatment because of adverse events.
Limitations
Funded by Novo Nordisk, which took part in the design, the data analysis and the writing. It was a small trial, with 201 participants, only in Japan and South Korea, so its results cannot simply be applied to other populations. It studied a daily dose of 50 mg, which 81.4% of those who completed semaglutide treatment were taking at the end, and it was not compared with injectable semaglutide. In the subgroup with type 2 diabetes, of only 51 people, weight loss was smaller (−10.7% with semaglutide versus −1.5% with placebo).
What it means for you
In adults in Japan and South Korea, semaglutide as a 50 mg daily pill reduced weight by an average of 14.3% over 68 weeks, compared with 1.3% on placebo, with frequent digestive side effects. It is a small trial, with a dose different from that of other oral forms. If you prefer an oral option, ask your doctor which doses and forms are authorized where you live.
Further reading
- How Much Weight Do People Lose on Ozempic, Wegovy or Zepbound? Trial Data
- Ozempic vs Mounjaro (and Zepbound): Real Differences From the Trials and Labels
- What Happens When You Stop Ozempic, Wegovy or Zepbound: Weight Regain, Explained
- GLP-1 drug pages
- All study summaries
- Original paper: doi.org/10.1001/jamainternmed.2025.3599
Sources
The original paper and the records consulted for this summary, with the date they were accessed.
- JAMA Internal Medicine.Kadowaki T, et al. Oral Semaglutide in an East Asian Population With Overweight or Obesity, With or Without Type 2 Diabetes: The OASIS 2 Randomized Clinical Trial. JAMA Intern Med. 2025;185(10):1206-1217.accessed .
- National Library of Medicine (PubMed).PubMed record PMID 40758358 (abstract).accessed .
- PubMed Central (National Library of Medicine).Full text PMC12322823 (estimands, dose at week 68, type 2 diabetes subgroup and role of the funder).accessed .