Weight loss pills vs. injections: Which is right for you?

Pros and cons of weight loss pills

The main benefits of weight loss pills are affordability, variety of medications and the fact that you don’t have to use a needle. For some people, having to give themselves a weekly injection will be a dealbreaker — taking a pill might be a less intimidating alternative.

That said, weight loss pills also have some drawbacks. You have to take them every day and there are often rules for timing the dose around food that need to be followed. Additionally, they may be more likely to cause stomach-related side effects, such as nausea, bloating and abdominal pain.

One of the most effective and popular weight loss medications on the market right now is semaglutide. Semaglutide is what’s known as a glucagon-like peptide-1 (GLP-1) receptor agonist drug and it’s used for weight loss and to treat type 2 diabetes. It works primarily by slowing the rate at which your stomach empties, which in turn causes you to feel fuller for longer. It can also help reduce hunger signals in your brain.

Semaglutide is available in both pill and injectable form, and the pill form is a perfect example of the pros and cons above. Oral semaglutide is taken daily and, compared with injections, tends to be as effective, but shows greater stomach-related side effects.

Pros and cons of weight loss injections

Weight loss injections are essentially the opposite of pills in terms of pros and cons. They’re generally more effective and there are fewer restrictions around the timing of the dose than pills. They’re typically only taken once per week, which may be an easier schedule to stick to, especially for people who don’t take many medications regularly.

However, injectable medications obviously require you to use a needle, which can be a big source of anxiety for some people. Additionally, there can be injection-site reactions such as swelling and pain. Finally, injections tend to be significantly more expensive than most weight loss pills.

Injectable semaglutide is one of the most popular injectable weight loss medications. It’s been shown to be highly effective in various studies and the fact that it has once-a-week dosing makes it attractive to many. The most common potential side effects are similar to oral semaglutide and they are nausea, vomiting, bloating and other stomach issues, along with fatigue and headache.

Effectiveness of weight loss pills vs. injections

Weight loss injections tend to be more effective than pills. Some of the most effective weight loss medications on the market right now are the glucagon-like peptide-1 (GLP-1) receptor agonists — semaglutide, tirzepatide and other similar medications. Semaglutide, for example, has been shown to help people lose as much as 15–20% of their body weight over a 68-week period. As such, these are far more promising for actual long-term weight loss success than older options, such as phentermine (common brands Lomaira, Suprenza) and bupropion (common brands Wellbutrin XL, Aplenzin). However, until fairly recently, GLP-1 receptor agonist class drugs were only available as injections.

The only GLP-1 medication available in pill form, at the time of this writing, is semaglutide. Studies seem to indicate that the pill form of semaglutide is just as effective as the injectable, making it a great option for those who wish to avoid needles.

Safety and side effects of weight loss pills vs. injections

Many (if not most) medications have potential side effects and weight loss medications are no different. The side effects you might experience really vary depending on the specific medication you’re taking. For example, phentermine will have a different set of potential side effects compared to semaglutide.

Common side effects for both weight loss pills and injections include:

• Nausea
• Constipation
• Diarrhea
• Fatigue
• Burping

These generally lessen as your body gets used to the medication.

Stomach-related side effects seem to be more common with weight loss pills, particularly the pill form of semaglutide. Injections, on the other hand, carry the risk of injection-site reactions, such as itching, swelling, redness and pain.

More rare but severe side effects for GLP-1 receptor agonist class drugs can include:

• Pancreatitis
• Medullary thyroid cancer
• Acute (sudden) kidney injury
• Worsening diabetes-related retinopathy

There have also been case reports of gastroparesis (a condition that prevents proper stomach emptying).

Weight loss pills vs. injections cost comparison

Cost is one of the bigger differences between weight loss pills and injections. As a general rule, injectable weight loss medications are very expensive, whereas pills are much more affordable. For example, phentermine averages roughly $20 per month for 30 pills (a one-month supply).

Injectable semaglutide, on the other hand, can be roughly $300 per month for compounded versions and over $1,000 per month for branded versions, like Wegovy. The pill forms of semaglutide tend to be about the same cost as the injectable forms, making it an exception to the general cost rule.

Another exception is the new single-dose vials of Zepbound available from LillyDirect, which are between $399 and $549 for a four-week supply, depending on the dose. While that’s still a lot more than older drugs like phentermine, it’s by far the most affordable brand-name weight loss injection currently available.

Due to the increased effectiveness of most injectable medications, the added cost may be worth it for many people. The main exception to this rule is semaglutide: the pill form seems to be just as effective as the injectable form.

Personalization and suitability of weight loss pills vs. injections

Aside from cost, the main factor in deciding between weight loss pills vs. injections is going to be personal preference and lifestyle. This is especially true with semaglutide, where you have a choice of pill or injection of the same medication.

Here are some of the considerations for pills:

• They’re often more affordable.
• It can be easier for some people to remember to take something every day — you can establish a routine, basically.
• There are no needles involved — this can be a big deciding factor for a lot of people.

Injections have their own set of considerations:

• The once-a-week nature of most injectable weight loss medications can help some people stick with them — it’s less to remember compared to a daily pill dose.
• You have to give yourself a shot. This can be a dealbreaker for some people.
• There’s also the possibility of injection site reactions to consider, even if you’re okay with needles.

This is an area where a good doctor or other health professional can really help. They can offer guidance on which specific medication, as well as which delivery method, is best for you and your circumstances.

It’s also important to remember that medication is just one part of successfully losing weight (and keeping it off). Lifestyle changes are often necessary to both support the initial weight loss and ensure that you maintain a healthy weight down the line.

Bottom line

Generally speaking, weight loss injections are more effective than weight loss pills. However, there are exceptions, such as semaglutide, where the pill and injection are basically equally effective. Ultimately, then, the choice comes down to other considerations, such as cost and personal preference.

For example, some people may not be able to get an injection approved by their insurance, so pills will be far more affordable. Others may want to avoid needles, while some may actually prefer the weekly dosing schedule of injections.

Everyone will need to work with their health care provider to weigh the pros and cons of each medication and decide what’s best for their situation and fits their lifestyle. The good news is that there are more weight loss medication options approved for weight loss than ever before, so you’re more likely to find something that works for you.