Once the beginning was made, there was no turning back. The new anti-obesity drugs—injectable or not—which are expected to be released soon in Greece as well, including in pill form, have opened a new and promising path, not only in the treatment of obesity but also of other serious health problems associated with it.

Within 2026, following approval by the relevant regulatory bodies, the new anti-obesity formulations are expected to be launched in our country. At the same time, internationally, research is ongoing into the development of similar—yet even more effective and safer—drugs that are expected to become available worldwide over the next five years.

The fact that these medications, in addition to injectable forms, will also be available as once-daily oral pills is expected to help include people who are uncomfortable with injections and to increase treatment adherence, according to three scientists from different specialties speaking to the Athens–Macedonian News Agency.

At the same time, newer injectable drugs are emerging that, in clinical studies, have achieved weight loss of up to one-third of a patient’s total body weight.

As with every new medication, however, priority remains the safety profile, as well as its combination with a personalized nutrition and exercise program, so that users maintain valuable muscle mass and receive all necessary nutrients to remain healthy.

The big question, of course, is how many people will use them. It appears that this “revolution” in medicine is intended to help people with obesity and obesity-related diseases, rather than to flood pharmacies with lifestyle drugs for achieving a “ring-size waist” or extreme weight loss in people with borderline normal weight or just a few extra kilos.

The new drugs

Vaia Lampadari, MD, PhD, Professor of Internal Medicine–Endocrinology at the National and Kapodistrian University of Athens, speaking to Michalis Kefalogiannis, notes that the FDA has recently approved, and that the first obesity drug in the category of incretin analogues in pill form for adults will soon be launched on the U.S. market.

“It is semaglutide in doses of 1, 5, 4, 9, and 25 mg, administered once daily in the morning while fasting. The dose starts at the lowest level and is gradually increased monthly up to 25 mg per day. In Europe, it is expected to receive approval from the EMA in late 2026 or early 2027,” she explains. She continues: “The second similar drug, orforglipron, is expected to receive FDA approval in April 2026. It is a small non-peptide molecule acting as a GLP-1 agonist, administered once daily in doses of 6, 12, and 36 mg, with gradual monthly titration.”

Injection or pill?

Do studies so far show that these drugs are as effective as injectables? Does the fact that someone may take a pill for life to control weight make this approach easier for those wishing to treat obesity?

“As far as semaglutide is concerned, both forms lead to significant weight loss, with a slight advantage for the injectable form (average loss for the pill ~13%). Orforglipron shows comparable effectiveness (average loss ~11.2%),” replies Dr. Lampadari.

Regarding whether oral administration is indeed expected to increase long-term adherence to obesity treatment, her answer is clear: “Oral administration is indeed expected to increase long-term treatment retention, compliance, and patient satisfaction.”

Overcoming barriers

Evangelos Fusteris, MD, PhD, an internist specializing in diabetes and a doctoral graduate of the Medical School of the University of Athens, believes that oral administration will help overcome significant barriers: “Economic barriers, as these drugs are expected to be more affordable, as well as psychological barriers related to injections.”

For many patients, injections are discouraging—not only because of fear, but also because of the symbolism of a ‘serious’ treatment. “The option of taking a pill may broaden the pool of patients seeking medical help, especially those in the early stages of obesity, allowing early and effective intervention to control the disease and prevent complications,” he adds.

With proper medical evaluation

However, he stresses that accessibility alone is not enough. Proper medical evaluation, clear selection criteria, and long-term monitoring are required. “The risk of indiscriminate or ‘aesthetic’ use is real. Prescription must remain evidence-based, personalized, and integrated into a comprehensive obesity management plan.”

Using these drugs as “lifestyle” medications without medical guidance undermines their true value and may even be dangerous. They are not tools for cosmetic intervention but for treating obesity as a disease, emphasizes Maria Psoma, MD, clinical pathologist, PhD of the University of Athens, and founding member of the European Society of Lifestyle Medicine.

She explains that the mechanism of new oral drugs, as with injectables, reduces appetite and improves glycemic control, but does not ensure healthy body composition. “Adequate protein intake combined with resistance exercise is absolutely necessary. Without these, the risk of losing lean muscle mass—an active metabolic organ—increases,” she warns.

Dietary recommendations do not change; on the contrary, they become even more important to ensure sufficient nutrient intake and muscle preservation. Ideally, nutrition should be personalized, with protein intake adjusted to body type, age, and physical activity level.

Drug therapy—injectable or oral—is an adjunct tool in obesity treatment and does not replace a healthy lifestyle.

Not a “magic solution”

Before we even become accustomed to existing injectable obesity drugs, new ones are arriving—promising even greater effectiveness—capable of contributing to weight loss of up to one-third of a person’s body weight.

“Indeed, retatrutide, expected to be released in late 2026 or early 2027, has shown impressive effectiveness in clinical trials, reaching up to 27%. Other drugs under development include amycretin, the cangrilintide/semaglutide combination, and survotutide, also with significant effectiveness in weight loss and management of comorbidities,” says Dr. Lampadari. She emphasizes, however, that drug selection will be based on the patient’s clinical profile, comorbidities, adherence, and individualized needs and goals, to ensure long-term use with optimal tolerance and minimal side effects.

Dr. Psoma adds that while these drugs affect appetite, energy expenditure, and metabolism, “they are certainly not a ‘magic solution.’ Obesity is a chronic, relapsing disease with biological mechanisms that promote weight regain after treatment discontinuation. Data show that stopping therapy often leads to weight regain. Without proper individualized nutrition, education, and exercise, we may achieve the opposite result: increased fat mass, reduced muscle mass, and premature aging.”

Cardiovascular benefits

What does increasing effectiveness mean in practice? That goals can be achieved where current treatments fail?

According to Dr. Fusteris, the growing effectiveness of newer obesity therapies translates into greater and more sustainable weight loss, as well as meaningful impact on “hard” clinical endpoints. “This means we can achieve goals that until recently were mainly attainable through metabolic surgery.”

Moreover, cardiovascular benefits are already documented. Semaglutide is the first obesity drug to demonstrate a reduction in cardiovascular events in patients with obesity and very high cardiovascular risk. In the SELECT study, a 20% reduction in the risk of myocardial infarction, stroke, and cardiovascular death was recorded with semaglutide 2.4 mg compared to placebo. “This changes the framework: we are not just talking about weight loss or improved markers, but about proven prevention of serious cardiovascular events.”

How safe are they?

What about the safety profile of these drugs, which many people sometimes pressure their doctors to prescribe?

“The safety profile of GLP-1 agonists is relatively well documented. The most common side effects involve the gastrointestinal system (nausea, vomiting, diarrhea, constipation), which are also the most frequent reasons for discontinuation. Rare but significant adverse events include pancreatitis, gallstones, and gastroparesis. There are contraindications (e.g., a history of medullary thyroid carcinoma). Long-term data beyond five years, however, remain limited,” notes Dr. Psoma.

Experts believe these drugs will likely become chronic treatments for patients with BMI ≥30 or ≥27 with comorbidities, under medical supervision. Some even describe this development as a “revolution” in obesity management.

“The progress of newer incretin therapies, such as semaglutide and tirzepatide, has radically changed not only our strategy but also how we view obesity itself,” concludes Dr. Fusteris. “Obesity is not merely a risk factor; it is the central metabolic disease underlying many non-communicable conditions, such as type 2 diabetes, hypertension, and dyslipidemia. When we achieve substantial and sustained weight loss, we influence the shared pathophysiological ground driving cardiometabolic complications. With these new therapies, we see not only improvement but remission of diabetes, hypertension, and more—giving rise to the term ‘cardiometabolic remission,’ meaning simultaneous remission of multiple cardiometabolic disorders.”

He adds a final note of caution: “This does not mean a definitive cure. Obesity is a chronic, relapsing disease and requires long-term follow-up.”