General information with sources. Never a substitute for your doctor.

MethodologyAbout the authorESEN
SaciedadSearch

Randomized controlled trial

OASIS 4: oral semaglutide 25 mg (the Wegovy pill) for obesity

Weight changed by −13.6% with oral semaglutide 25 mg and −2.2% with placebo at 64 weeks; the estimated difference was −11.4 percentage points (95% CI, −13.9 to −9.0).

Wharton S et al. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity. New England Journal of Medicine, 2025. DOI: 10.1056/NEJMoa2500969

Prepared by
Last updated
Sources
2 sources

No clinical review. No advertising from drug companies and no affiliate links.How we work

Key facts

Drug
semaglutide
Design
Randomized controlled trial
Participants
307
Duration
64 weeks
Funding
Novo Nordisk
Registry
NCT05564117
Population
307 adults without diabetes with obesity (BMI of 30 or more) or with a BMI of 27 or more and at least one obesity-related complication, at 22 sites in four countries.
Primary outcome
Percentage change in body weight and proportion reducing their weight by at least 5% at 64 weeks with oral semaglutide 25 mg daily versus placebo, both with a lifestyle intervention.

What it found

Weight changed by −13.6% with oral semaglutide 25 mg and −2.2% with placebo at 64 weeks; the estimated difference was −11.4 percentage points (95% CI, −13.9 to −9.0). More participants on semaglutide achieved reductions of at least 5, 10, 15 and 20% and improved their IWQOL-Lite-CT physical function score. Digestive adverse effects were more frequent with semaglutide (74.0% versus 42.2%).

Limitations

Funded by Novo Nordisk. Small sample (205 participants on oral semaglutide and 102 on placebo) and no people with diabetes. It was compared with placebo, not with injectable semaglutide, so it does not say which of the two forms reduces weight more.

What it means for you

Oral semaglutide at 25 mg daily, the maintenance dose of the Wegovy pill in the US, reduced weight by an average of 13.6% over 64 weeks in people without diabetes. It was not compared with the injection, so it does not say which of the two works better. If you prefer an oral option, it is a topic to discuss with your doctor.

Further reading

Related trials

  • semaglutide68 weeks

    OASIS 1

    At 68 weeks, weight changed by −15.1% with oral semaglutide 50 mg and −2.4% with placebo.

  • semaglutide68 weeks

    OASIS 2

    At 68 weeks, weight changed by −14.3% with oral semaglutide 50 mg and −1.3% with placebo.

  • semaglutide72 weeks

    STEP UP

    At 72 weeks, weight changed by −18.7% with semaglutide 7.2 mg, −15.6% with 2.4 mg and −3.9% with placebo.

  • semaglutide120 weeks

    STEP 1 (extension)

    From week 0 to week 68, weight fell by an average of 17.3% with semaglutide and 2.0% with placebo.

Sources

The original paper and the records consulted for this summary, with the date they were accessed.

  1. New England Journal of Medicine.Wharton S, et al. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity. N Engl J Med. 2025;393(11):1077-1087.accessed .
  2. National Library of Medicine (PubMed).PubMed record PMID 40934115 (abstract).accessed .