Wegovy Pill or Shot? Both Work. The Choice Is Yours

While both the pill and the shot deliver the same active ingredient—semaglutide—they differ significantly in how they enter your body, their dosage frequency, and their administration requirements.

The Wegovy Shot (Injectable Semaglutide)

• Delivery: A subcutaneous injection (under the skin) administered once weekly.

• Absorption: Because it is injected directly into the fatty tissue, it bypasses the harsh environment of the stomach. This allows for excellent bioavailability, meaning a high percentage of the drug is absorbed and active.

• Dosing Schedule: It follows a “titration” schedule, typically starting at 0.25 mg weekly and gradually increasing over several months to the maintenance dose of 2.4 mg weekly.

• Convenience: You only need to think about it once a week. However, it requires refrigeration (until the first use) and involves using a needle.

The Wegovy Pill (Oral Semaglutide)

• Delivery: A daily tablet taken by mouth.

• Absorption: The stomach is designed to break down proteins and peptides, which poses a challenge for oral semaglutide. To overcome this, the pill uses a special absorption enhancer (SNAC technology).

• Strict Administration: To work effectively, the pill must be taken on an empty stomach immediately after waking up, with no more than 4 ounces of plain water. You must wait at least 30 minutes before eating, drinking, or taking other medications.

• Dosing: Oral versions for weight loss (often researched at doses like 25 mg or 50 mg daily) require much higher doses than the injectable version to account for the digestive breakdown.

• Convenience: It is needle-free and shelf-stable (no refrigeration required), making it ideal for travel. However, it requires strict daily discipline.

Choosing between the pill and the shot often comes down to lifestyle preference rather than efficacy, as both have been shown to induce significant weight loss. Dr. Carreon typically helps patients weigh the following factors during their consultation at LCS Medical Spa:

Choose the Shot if:

• You struggle with daily routines: If you often forget to take daily vitamins or medications, a weekly shot ensures you don’t miss doses.

• You have a complex morning schedule: If you need to drink coffee immediately upon waking or take other critical morning medications that cannot be delayed, the 30-minute waiting period for the pill might be disruptive.

• You want maximum proven bioavailability: Injections generally offer more consistent absorption since they don’t depend on your stomach’s acidity levels or food content.

Choose the Pill if:

• You have a needle phobia: For many patients, the anxiety of self-injection is a barrier to treatment. The pill eliminates this stress entirely.

• You travel frequently: If you are often on the road or flying, carrying a pill bottle is simpler than managing refrigerated pens and needles.

• You want “privacy”: Taking a pill in the morning is discreet, whereas storing injection pens in a shared fridge might not be.

Patients are often eager to see the scale move. Generally, the timeline for results is similar for both administration methods, though the perception of speed can vary.

• Initial Weight Loss (Weeks 1-4): Whether on the pill or shot, the first month is an introductory phase meant to accustom your body to the medication. You may see some weight loss (often water weight and reduced inflammation) during this time, but the primary goal is safety, not speed.

• Therapeutic Weight Loss (Weeks 12+): Significant fat loss typically accelerates once you reach therapeutic doses (e.g., 1.7 mg or 2.4 mg for the shot; equivalent high doses for the pill).

• Comparison: Clinical data suggest that adherence is the biggest predictor of speed. Because the shot ensures 100% adherence for a full week with one action, some patients may see faster, consistent results with injections simply because they can’t “miss” a day. However, if taken perfectly as prescribed, the pill offers comparable efficacy, with patients often seeing a 15-20% reduction in body weight over 68 weeks.

Dr. Carreon emphasizes that “slow and steady” wins the race. Rapid weight loss can lead to muscle loss, so her protocol often includes recommendations for protein intake and resistance training to ensure the weight lost is primarily fat.

Yes, switching is possible and becoming increasingly common as supply chains fluctuate or patient preferences change. However, you cannot simply swap them day-to-day due to the massive difference in dosing units (milligrams vs. micrograms/low milligrams).

The Switching Protocol:

Dr. Carreon and her medical team oversee transitions carefully to prevent adverse side effects.

• From Shot to Pill: Typically, a patient on the max dose of the injection (2.4 mg) would stop the injection, wait one week (7 days) after their last shot, and then begin the daily oral tablet (e.g., 25 mg or 50 mg) the following day.

• From Pill to Shot: A patient would stop the daily pill and start the weekly injection the very next day.

Never attempt to switch formulations without direct medical supervision. Mismatched dosing can lead to severe nausea or vomiting.

Both the Wegovy pill and shot may cause some common side effects as your body adjusts to the medication. The most frequently reported side effects include nausea, vomiting, diarrhea, and headaches. These symptoms are usually temporary and may lessen over time as your body becomes accustomed to the medication. Some individuals may also experience abdominal pain, fatigue, or dizziness. It’s important to discuss any side effects with your healthcare provider, as they can help manage symptoms and adjust your treatment if necessary.

In rare cases, some people may experience more severe side effects, such as pancreatitis, gallbladder problems, or kidney issues. If you experience symptoms like persistent stomach pain, vomiting, or changes in urination, seek medical attention immediately. Your healthcare provider will monitor your progress and ensure the medication is working safely and effectively for you.

Whether you choose the convenience of the Wegovy pill or the steady consistency of the shot, the medication is merely a tool. The true driver of success is the medical supervision and lifestyle modification that accompanies it.

Dr. Melanie Carreon at LCS Medical Spa offers a safe, accredited, and supportive environment for this journey. To determine if you are a candidate for the Wegovy pill or shot, schedule a consultation with Dr. Carreon at LCS Medical Spa in Seguin, TX. For more information, contact us or schedule an appointment online. We are located at 1199 E College St, Seguin, TX 78155.