Could a once-a-day pill replace weight loss injections? Phase II oral GLP-1 drug trial shows promising results

by Sanjukta Mondal, Medical Xpress

Sanjukta Mondal

Author

Meet our staff & contributors
Learn about our editorial standards

edited by Sadie Harley, reviewed by Robert Egan

Sadie Harley

Scientific Editor

Meet our editorial team
Behind our editorial process

Robert Egan

Associate Editor

Meet our editorial team
Behind our editorial process Editors' notes

This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

peer-reviewed publication

trusted source

proofread

The GIST Add as preferred source

For those scared of needles but who need GLP-1 receptor agonists to help manage their weight, there might be some good news. Researchers are testing a new oral, small-molecule GLP-1 receptor agonist called Elecoglipron, which could offer the weight-loss benefits of GLP-1 therapy without injections.

To see how well it works, researchers conducted VISTA, a Phase II clinical trial across seven countries involving adults living with obesity or overweight who did not have diabetes. The study enrolled 310 participants, who received either varying doses of Elecoglipron (5 mg to 75 mg) or a placebo over 36 weeks.

They found that the drug lowered body weight and blood sugar levels in a dose-dependent manner. In other words, people taking higher doses of the pill lost significantly more weight than those taking lower doses or a placebo.

At week 26, participants taking 5 mg of Elecoglipron had lost an average of 2.6% of their baseline body weight. Those taking 75 mg had lost 10.5% of their body weight, reaching a weight-loss level often recommended in medical guidelines to reduce the risk of obesity-related health conditions. In the 75 mg group, the weight-loss momentum continued, reaching 11.8% by week 36.

The findings are published in The Lancet.

Pill over poke

For decades, obesity was dismissed as a simple consequence of eating too much and moving too little. Today, we know it's far more complex, shaped by a combination of genetic, social, environmental and economic factors. Beyond its effect on body weight, obesity increases the risk of conditions such as type 2 diabetes and cardiovascular disease.

In children and adolescents, it can also take a toll on mental health because of lower school performance, quality of life and bullying. Despite its widespread impact, obesity wasn't officially recognized as a chronic disease and a public health problem by the WHO until 1997, and in 2013 it was also established as a disease by the American Medical Association.

GLP-1 receptor agonist injections have changed the way doctors treat obesity and type 2 diabetes. Many people are reluctant to take injections, which can make it harder to stay on treatment long term.

Injectable GLP-1 receptor agonists also need refrigerated transport and storage, adding to both cost and complexity. Even oral options come with trade-offs. Oral semaglutide, for example, must be taken under strict fasting conditions. Elecoglipron, on the other hand, can be taken at any time of day, with no restrictions on food or drink, making it a potentially more convenient option for patients.

The new non-peptide GLP-1 receptor agonist Elecoglipron can be taken once daily without food or water restrictions. The clinical trial found that up to 89% of participants on the highest dose lost at least 5% of their body weight at 26 weeks, compared with only 16% in the placebo group.

Participants progressively lost weight over 36 weeks, with results clearly tied to the dose. Those on the lowest dose of 5 mg lost around 2.7% of their body weight by 36 weeks; the 15 mg group lost 6.5%, and the 50 mg group lost 9.2%. For the highest dose, 75 mg, those with weekly titration, or dose escalation, lost 11.8% of baseline weight by the end of the study, and those with every-two-week titration lost 11.1%.

By the end of the 36-week study, weight loss had not yet plateaued, suggesting that participants may have lost even more weight if treatment had continued. Beyond weight loss, the drug also led to improvements in blood pressure and inflammation markers such as C-reactive protein.

The most commonly reported side effects were nausea, constipation, diarrhea and vomiting. For most participants, these symptoms were mild to moderate and most noticeable during the early stages of treatment as they adjusted to the medication.

• Efficacy outcomes. The percentage change (A) and the absolute change (B) from baseline in bodyweight by week in the efficacy estimand are shown. Credit: The Lancet (2026). DOI: 10.1016/s0140-6736(26)00748-8
• Efficacy outcomes. Proportion of participants who had weight reductions of at least 5%, at least 10%, and at least 15% by week 26 (C) and week 36 (D). The results were calculated according to Rubin's rule. Credit: The Lancet (2026). DOI: 10.1016/s0140-6736(26)00748-8

"While these effects do not yet fully match the most potent injectable therapies, they are clinically very effective, with much greater convenience. From a practical perspective, a once-daily tablet could enable earlier and wider use of GLP-1-based treatment, including in settings where injectables are less feasible," said Prof Martin Whyte, professor of metabolic medicine at the University of Surrey, about the implications of this study.

The researchers, however, stated that Phase III studies will be required to confirm its long-term efficacy and safety before it can be adopted into clinical practice.

Written for you by our author Sanjukta Mondal, edited by Sadie Harley, and fact-checked and reviewed by Robert Egan—this article is the result of careful human work. We rely on readers like you to keep independent science journalism alive. If this reporting matters to you, please consider a donation (especially monthly). You'll get an ad-free account as a thank-you.

Publication details

Melanie J Davies et al, Elecoglipron, an oral small molecule GLP-1 receptor agonist in adults with obesity or overweight (VISTA): a multicentre, phase 2, randomised, placebo-controlled clinical trial, The Lancet (2026). DOI: 10.1016/s0140-6736(26)00748-8

Matthias Blüher, Treatment potential of oral small-molecule GLP-1 receptor agonists, The Lancet (2026). DOI: 10.1016/s0140-6736(26)01135-9

Journal information: The Lancet

Key medical concepts

ObesityGLP-1 Receptor Agonist [EPC]Diabetes Type 2C-Reactive Protein

Clinical categories

EndocrinologyWeight management Who's behind this story?

Sanjukta Mondal

Master's in Chemistry. Freelance science journalist and communicator. Published in Chemistry World, BioSpace, and The Hindu. Full profile →

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Robert Egan

Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →

© 2026 Science X Network

Citation: Could a once-a-day pill replace weight loss injections? Phase II oral GLP-1 drug trial shows promising results (2026, June 13) retrieved 13 June 2026 from https://medicalxpress.com/news/2026-06-day-pill-weight-loss-phase.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.