Obesity treatment has changed considerably in recent years. Weight loss injections such as Wegovy (semaglutide) and Mounjaro (tirzepatide) have given people more options for managing their weight alongside diet, lifestyle changes and clinical support.
Now there is another option. In June 2026, the Medicines and Healthcare products Regulatory Agency (MHRA) approved oral semaglutide (Wegovy) – the first GLP-1 tablet approved specifically for weight loss and weight management in the UK.
For people who would prefer a tablet to a weekly injection, this represents another potential treatment option. With another weight loss treatment now available, what does this mean for people considering bariatric surgery?
Medication and surgery work in different ways, and one does not necessarily replace the other. The most appropriate treatment depends on factors such as a person’s health, weight, previous treatment, and individual circumstances.
What Is the New Wegovy Weight Loss Pill?
Wegovy contains semaglutide, a GLP-1 receptor agonist. It mimics the action of a naturally occurring hormone called GLP-1, which is involved in regulating appetite. This can help people feel fuller for longer, reduce hunger and eat less.
Until recently, Wegovy for weight management in the UK was available as a once-weekly injection. The newly approved Wegovy weight loss pill provides semaglutide in tablet form and is taken once daily.
According to the MHRA, oral Wegovy may be prescribed alongside a reduced-calorie diet and increased physical activity to adults with a BMI of 30 or above. It may also be prescribed to adults with a BMI between 27 and 30 who have at least one weight-related health condition.
Like injectable Wegovy, the tablet is a prescription-only medicine, so patients need an appropriate clinical assessment before it can be prescribed.
How Do You Take Oral Semaglutide?
Unlike the weekly Wegovy injection, oral semaglutide needs to be taken every day.
Treatment starts at 1.5 mg once daily before gradually increasing to 4 mg, 9 mg and then 25 mg. According to the MHRA approved dosing schedule, each dose is taken for at least one month before progressing to the next level.
How the tablet is taken is also important. It should be swallowed whole with a small amount of water on an empty stomach after fasting for at least eight hours. Patients should then wait at least 30 minutes before eating or drinking, as doing so sooner can reduce the absorption of semaglutide.
Although the tablet has been approved for use in the UK, the MHRA states that it is not currently available through the NHS. Decisions about NHS use will follow the usual processes, including an evaluation by the National Institute for Health and Care Excellence (NICE).
What Does the Research Say About Oral Semaglutide?
There is growing interest in weight loss pills that actually work, but it is important to look at the clinical evidence rather than relying on headlines or marketing claims.
A Phase 3 clinical trial published in The New England Journal of Medicine in 2025 studied a once-daily GLP-1 tablet 25 mg in adults with overweight or obesity who did not have diabetes.
After 71 weeks, participants receiving oral semaglutide had an estimated average reduction in body weight of 13.6%, compared with 2.2% among those receiving placebo.
Injectable semaglutide also has substantial clinical evidence behind it. In the STEP 1 trial, participants receiving once-weekly semaglutide 2.4 mg alongside lifestyle intervention achieved an average weight reduction of approximately 14.9% after 68 weeks, compared with 2.4% with placebo.
These figures should not be used to decide that the tablet or injection is “better”. They come from separate studies involving different participants and study designs rather than a direct comparison between the two treatments.
Like all medicines, oral semaglutide can cause side effects. The MHRA lists nausea, diarrhoea, constipation and vomiting among the most common.
How Is Bariatric Surgery Different?
GLP-1 medication and bariatric surgery can both support weight loss, but they work in different ways.
Medicines such as oral semaglutide work on biological pathways involved in appetite and fullness and are taken according to a prescribed treatment plan.
Bariatric surgery makes physical changes to the digestive system. A gastric sleeve, for example, reduces the size of the stomach. A gastric bypass creates a smaller stomach pouch and changes how food travels through part of the digestive system.
Depending on the procedure, bariatric surgery can affect stomach capacity, appetite, fullness, gut hormones and metabolism. Surgery also involves preparation and recovery, followed by long-term nutritional monitoring and aftercare.
For this reason, comparing medication and surgery simply by looking at percentages of weight lost does not give the full picture.
Is Bariatric Surgery Still Relevant in the GLP-1 Era?
Yes. The introduction of new treatments such as Wegovy weight loss pills does not mean bariatric surgery no longer has a role.
Metabolic and bariatric surgery remains an established treatment for appropriately selected people living with obesity, particularly those with severe or complex obesity and associated health conditions.
There is long-term evidence supporting bariatric surgery. A large 2021 meta-analysis published in The Lancet, involving more than 170,000 participants, found that metabolic-bariatric surgery was associated with lower all-cause mortality and longer life expectancy compared with non-surgical obesity management.
That does not mean surgery is automatically a better choice than medication. For some people, medically supervised weight loss medication may be appropriate. For others, bariatric surgery may be considered following specialist assessment.
Factors such as BMI, existing health conditions, weight history, previous treatments and individual circumstances all need to be taken into account.
The important point to be noted is that people living with obesity now have more evidence-based treatment options available to them.
What Does This Mean for People Considering Weight Loss Surgery?
The approval of oral semaglutide for weight management adds another non-surgical option for eligible patients alongside injectable weight loss medications.
Bariatric surgery continues to have an established role for patients for whom surgery is considered appropriate.
At Phoenix Health, our specialist area is consultant-led bariatric care. We provide a range of bariatric procedures, from initial assessment and surgery through to long-term aftercare.
If you are considering bariatric surgery and would like to understand which surgical options may be suitable for you, our team can discuss your individual circumstances and explain the treatments available.
Explore bariatric surgery treatments at Phoenix Health.
References
1. Medicines and Healthcare products Regulatory Agency (MHRA) (2026). First GLP-1 tablet for weight loss approved in the UK. Published 11 June 2026. Available at: https://www.gov.uk/government/news/first-glp-1-tablet-for-weight-loss-approved-in-the-uk
2. Wharton, S. et al. (2025). Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity. The New England Journal of Medicine, 393. Available at: https://doi.org/10.1056/NEJMoa2500969
3. Wilding, J.P.H. et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England Journal of Medicine, 384, 989–1002. Available at: https://doi.org/10.1056/NEJMoa2032183
4. Syn, N.L. et al. (2021). Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174,772 participants. The Lancet, 397, 1830–1841. Available at: https://doi.org/10.1016/S0140-6736(21)00591-2
Medically Reviewed by Lujain Alhassan, BSc, ANutr
Registered Associate Nutritionist and Bariatric Nutrition
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