EASD 2026: Oral semaglutide users lost 4.1% of body weight 3 months after switching from injections in an observational study without a comparator group.
Adults with overweight or obesity who switched from injectable semaglutide or tirzepatide to once-daily oral semaglutide (Wegovy) lost an average of 4.1% of body weight over 3 months, according to results announced by Novo Nordisk. The retrospective OCTANE analysis included 194 patients who remained on oral treatment throughout follow-up; it does not establish whether switching is more effective than continuing injections.¹,²
“In everyday clinical practice, we see patients who respond well to injectable GLP-1 based therapy but who, for personal or practical reasons, want to try an oral option,” study coauthor Louis J. Aronne, MD, director of the Comprehensive Weight Control Center at Weill Cornell Medicine, said in the release.¹
The findings were presented September 30 at the 2026 European Association for the Study of Diabetes annual meeting in Milan, Italy. They provide early observational evidence about outcomes after switching formulations, rather than randomized evidence to guide comparative treatment selection.¹,²
OCTANE used deidentified electronic health records, patient-reported information, and pharmacy records from the Ro telehealth platform. Eligible adults had obesity or overweight, defined as BMI 27 to 29.9 kg/m², with at least 1 obesity-related complication. Listed complications included hypertension, dyslipidemia, obstructive sleep apnea, and cardiovascular disease. Patients with diabetes or a history of bariatric surgery were excluded.¹,²
Participants had a mean baseline weight of 100.5 kg and BMI of 34.5 kg/m². Mean weight loss at 3 months was 4.0 kg, or 8.8 lb (P<.001); 40.7% lost at least 5% of baseline weight. The proportion with BMI of at least 30 kg/m² declined from 87.1% to 65.5%, a 21.6-percentage-point reduction (P<.001), according to the release.¹
Among participants with available patient-experience data, 82.4% reported at least 1 improvement. Approximately 69% reported better-fitting clothes and 51% reported healthier eating. The release did not specify the denominator for these responses.¹
Obesity is a chronic, relapsing disease requiring ongoing management.³ For patients considering a change in treatment route, OCTANE describes short-term outcomes among persistent users, but crossing a BMI threshold does not establish resolution of obesity-related complications.
No minimum duration of previous injectable treatment or prior weight loss was required. The mean interval between the last injectable prescription and oral semaglutide initiation was 36.8 days, adding uncertainty about patients’ treatment trajectories before switching.¹
Selection is an important limitation: participants needed baseline and follow-up self-reported weights and no treatment gap exceeding 30 days. Patients who discontinued were therefore not represented in the final cohort. Variable data collection, self-reporting, and the telehealth setting further limit interpretation and generalizability.¹ Longer-term comparative evidence is needed to assess durability and outcomes among patients who discontinue.
The release did not report OCTANE-specific adverse-event rates. It cited prescribing information warning of possible thyroid tumors, including cancer, and contraindications for personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. Listed common adverse effects included nausea, diarrhea, vomiting, and constipation.¹,⁴
Novo reported commercial launches in the United States, United Arab Emirates, United Kingdom, and Germany. The announcement was a study update, not a new regulatory decision.¹
