Novo Nordisk's explosive Wegovy pill launch draws a new wave of patients into GLP-1 weight loss treatment

After years of trying to lose weight "the right way," Jane Zuckerman realized that "putting in the work just wasn't enough." 

Zuckerman, a 32-year-old data analyst based in Washington, D.C., said she lost 90 pounds in college and spent years cycling through nutritionists, therapy and strict routines — only to find herself at her heaviest after the pandemic, at 270 pounds. 

Zuckerman said GLP-1 injections were out of the question, because she's afraid of needles. But when the first GLP-1 pill for obesity became available in early January, Zuckerman called her doctor immediately, she said. 

Almost a month after starting Novo Nordisk's new Wegovy pill shortly after it launched, she said, she had lost around 11 pounds.

Zuckerman is among tens of thousands of patients who drove an explosive demand for prescriptions for Novo's pill just three months into its launch. Many of them share a common thread: They had long held off on using GLP-1s due to barriers such as high out-of-pocket costs for injections or a fear of needles.

That's one of the earliest takeaways from the rollout: Novo's pill appears to be expanding the obesity treatment market, largely drawing in new patients rather than converting existing ones from injections. CNBC spoke with five U.S. patients who recently started the pill following its launch, all of whom said they have not previously taken branded GLP-1 injections.

But it's early days for the pill. Many patients have yet to reach higher doses of the drug, and their experiences vary. It will take more time to determine how effective the pill is in supporting patients' long-term weight loss journeys, whether it helps keep users on GLP-1s for longer than injections do and whether demand for Novo's product will hold in the face of fresh competition from Eli Lilly. 

Novo has a head start in the pill arena over Lilly, which just won U.S. approval of its own GLP-1 drug for obesity last week. Analysts previously told CNBC they still expect that rival pill, called Foundayo, to capture a segment of the market, in part because it lacks the dietary restrictions that come with Novo's oral drug. 

Still, the Wegovy pill appears to have had the most explosive launch of a GLP-1 product yet. The latest number that Novo disclosed in February is that more than 600,000 prescriptions had been written since its launch, including for more than 3,000 patients in the first week.

Analysts at BMO Capital Markets attributed some of the early uptake to an "attractive" entry price of $149 per month and its connection to the well-known Wegovy brand. The pill carries one of the lowest cash prices for a GLP-1 therapy, ranging from $149 to $299 per month, depending on the dose.

Even so, the pill's launch has done little to boost Novo's stock price, as the Danish drugmaker is struggling to win back market share from Lilly in the broader obesity space and convince investors that its drug pipeline can help it grow beyond its existing products.

Novo is expected to report first-quarter sales, which will include the pill for the first time, in May. But sales of the overall Wegovy portfolio are expected to increase from $13.5 billion in 2026 to $18.9 billion in 2031, with the pill contributing $2.76 billion, according to a March GlobalData report.  

The Wegovy pill is attracting patients with a fear of needles, which is estimated to affect up to 25% of U.S. adults. But the drug is also an alternative for those who have had difficulty accessing branded GLP-1 injections or other medications. 

"There are a handful of patients that don't want to be stung by the needle in the case of a vial and syringe, or stung by the price," Jamey Millar, Novo's head of U.S. operations, told CNBC in an interview last week. "We're appealing to both." 

Dr. Eduardo Grunvald, medical director of the UC San Diego Health Center for Advanced Weight Management, said the main reason he's prescribed the Wegovy pill to some patients is cost, since its cash prices are slightly lower than those of injections. But Grunvald said overall, obesity medicine specialists like him will still be inclined to prescribe injections over oral drugs, in part because the shots are more effective. 

Cost was a deciding factor for Amy Sawyer-Williams, who works at a theater company in Raleigh, North Carolina, and has gestational diabetes. In 2023, a few years after her son was born, she said, she began developing prediabetes and met the criteria for obesity. She said she would have started using GLP-1 injections sooner, but her insurance would not cover them for her. 

That was long before Novo and Lilly slashed the cash prices of their obesity and diabetes injections. 

The list prices of their shots are roughly $1,000 per month before insurance and other rebates, or discounts for cash-paying patients — a sum that has long prevented many others from starting and staying on treatment. Novo has committed to cutting the monthly list prices of its drugs in the U.S. by up to 50%, but that change won't go into effect until 2027. 

High prices also shut Sawyer-Williams out from taking the branded weight management treatment Contrave, pushing her to combine two generic medications to mimic the drug's effects, she said. But earlier this year, she said, her endocrinologist recommended the Wegovy pill, in part due to its lower $149 per month pricing for the starting dose. 

Sawyer-Williams became the first patient at her doctor's practice and local Walgreens to take the pill, starting in mid-January, she said. 

Some Wegovy pill users are patients who wanted to switch over from injections, said Dr. Heather Hofflich, a physician and endocrinologist at UCSD Health. She said she's prescribed the pill for some people whose insurance stopped covering the injections but who want to continue treatment. 

Hofflich said she has also prescribed the oral drug to patients who lost weight initially on a shot but are now trying the pill to maintain that progress. 

While it's still early, some patients said they're already benefiting from taking Novo's drug. 

Zuckerman was initially skeptical of how effective the product would be, because it's an oral medication. But, she said, "I swear I felt the impact on the first day," particularly decreased appetite and disinterest in food. 

"Things that used to give me enjoyment, or things I used to binge on, they just don't taste as good anymore, and I just don't see the point in eating them, honestly," Zuckerman said, listing coffee, cheese, bread and fries, among other food and beverages. 

She said she dealt with nausea — a common side effect of the GLP-1 class — but that became more manageable after the first two weeks on the pill.

Zuckerman also said what matters more than the weight loss or food urges is how she feels: "My clothes are looser, I have more energy, I genuinely feel better." 

Cherie Marcus, 72, a retired fabric designer and theater editor based in Brooklyn, said she's also seen gradual progress — even on the lowest 1.5-milligram dose of the drug. She said that over the last 30 years, after her daughter was born, she's gained weight and seen her hemoglobin A1c — a key measure of blood sugar levels — creep up. 

Marcus said she started the pill on Jan. 24, and has lost about a pound a week while taking the lowest dose for seven weeks. Patients typically increase their dosage after a month, but Marcus said she's still taking the lowest strength as of early April. 

But her weight has "leveled off" over the past few weeks, she said, so she will likely move to a higher dose if she stops losing weight entirely. Marcus sees herself taking the pill long term, with a goal of losing around 30 pounds. 

Novo's Millar last week said some patients may start on lower doses and "be perfectly fine with that," hitting their own personal goals for weight loss. But the company is monitoring how many patients increase to higher doses of the drug, particularly the 9-mg and 25-mg versions.  

Courtney Kim, a stay-at-home mom based in Pittsburgh, is among the patients taking the Wegovy pill who have yet to experience notable side effects. 

While she doesn't qualify as obese, Kim said, the "weight would just not come off" after she had her three children. She started the pill around mid-February after struggling to lose weight with the use of other prescription medications and supplements, she said. 

Kim started at a weight of roughly 158 pounds and has so far lost nearly 7 pounds on the pill, she said. She recently started the 4-mg dose of the drug. 

"It's actually working, and I'm shocked that the weight is actually like coming off and staying off," Kim said. "So far I've had a positive experience."

The early experience with the pill hasn't been smooth for everyone. UCSD's Hofflich said she had one patient who could not tolerate the pill due to its gastrointestinal side effects, which is a common issue with the injections, as well. 

Another patient had to switch to an injection because the pill's dietary restrictions — which involve taking it with a small amount of water and waiting 30 minutes before eating or drinking — did not fit into their lifestyle, Hofflich said. Two patients who haven't seen progress on higher doses of the pill are switching to injections, she said. 

Hofflich said other patients who haven't seen progress on lower doses are starting to take higher doses to see if that will make a difference. 

That includes a patient based in New Hampshire named Amy, who said she began taking the Wegovy pill in early February. She asked CNBC not to use her last name, for privacy reasons.

Amy said she initially considered a branded GLP-1 treatment two years ago after her weight crept up to 190 pounds, but her doctor said her insurance wouldn't cover it. Amy then turned to cheaper, unapproved compounded versions of GLP-1s for a year and lost 30 pounds before stopping in November. 

She said the two lowest doses of the Wegovy pill — 1.5 mg and 4 mg — "did absolutely nothing for me" over two months. 

Novo's cash discounts allowed Amy to pay roughly $300 total for a month's worth of each dose, but she said she feels "frustrated" that she still feels hungry and has noticed no changes apart from side effects including constipation. Amy said her weight is "hovering" around 170 pounds.

"It just kind of felt like a waste of time," she said. 

Amy said she plans to start the 9-mg dose of the pill soon, hoping that she'll begin to see the benefits of treatment. She said if that doesn't work, she'll discuss with her doctor whether to try the highest dose, 25 mg, or potentially turn back to compounded GLP-1s. 

Meanwhile, Sawyer-Williams is restarting the lowest dose of the pill after pausing the drug due to gastrointestinal side effects. She said she was nervous about starting the pill, because she's always had a sensitive stomach. 

During her first three weeks on the 1.5-mg dose of the oral drug, she did not notice any weight loss, but experienced nausea if she didn't eat, Sawyer-Williams said. She started to feel less interested in food by her fourth week, she said, but began taking the next dose, 4 mg, shortly after.  

On the seventh day of taking that dose, Sawyer-Williams said, she experienced "the worst" nausea, vomiting and dehydration, which caused her to stop treatment. 

"I wish I had just stayed on the 1.5" dose, she said. "I was really, really sick. Even when I quit the pill, I just couldn't keep down water."

Sawyer-Williams started at a weight of 177 pounds and lost five pounds overall after taking the drug, she said. She's been off treatment for a few weeks, but started the lowest dose of the pill as of early April with new habits, including staying hydrated and starting to lift weights, she said.

"We're going to just have to hope that it's enough to help me," she said, referring to the lowest dose. 

Dr. Andrea Traina, Novo's obesity medical director, recommended that patients who are struggling with side effects talk to their health-care provider about strategies to mitigate them. For example, she said some people may benefit from staying on a lower dose until they tolerate the drug better before increasing to a higher dosage.

"Treating obesity, just like most chronic diseases, is kind of a marathon, not a sprint," Traina said in an interview. "So adding an extra month or two to help with tolerability upfront can help with kind of long-term success."

Several questions remain about the long-term use of the pill, especially on higher doses, and it may not be the best obesity treatment for every patient, experts said. 

Traina said each patient has an individual response, and they may respond well above or well below average in terms of weight loss and side effects. That can be tied to their genetics, environment or dietary habits, and experiences can vary slightly across certain populations and age groups, she said.

"It's very tough to know why one patient's responding to something and another isn't," Traina said, adding that it's "one of the many benefits of having multiple treatment options available."

Having an oral option at lower cash prices that "can be attainable for a larger population is a very good thing, to help us cure or alleviate this chronic disease state," said UCSD's Hofflich. 

She said in the coming months, particularly with the rollout of Lilly's new drug, "we'll have many more stories and outcomes" of pills to evaluate, allowing for clearer comparisons between the two pills as well as injections.

Patients such as Zuckerman may offer an early glimpse of those who stand to benefit most from the pill — and the cases where it resonates.

"I was in this boat of seeing the pill as cheating and feeling like I had to lose the weight the hard way," she said. "But that doesn't work for everybody, and eventually I got to the point where I was like, do I want to be stubborn and try to do this the 'right way,' or do I want to die from being obese?"

"Jumping on the opportunity to the pill at this stage in my life was the right decision," Zuckerman said.