The short answer
Oral semaglutide 25 mg produced greater average weight loss than placebo in OASIS 4. This study compared a tablet with placebo—not a tablet with an injection.
Who took part?
The trial assigned 307 adults with overweight or obesity, without diabetes, to daily oral semaglutide or placebo, alongside lifestyle support. There were 205 participants in the semaglutide group and 102 in the placebo group.
The study lasted 71 weeks; its main weight comparison was at week 64. Average change was −13.6% with semaglutide and −2.2% with placebo.
Percent of starting weight
Original chart based on the study. Values are reported group averages.
| Group or measure | Average result |
|---|---|
| Oral semaglutide 25 mg | −13.6% |
| Placebo | −2.2% |
The trade-off
Digestive adverse events occurred in 74.0% of semaglutide participants and 42.2% of placebo participants. Those figures describe reported events, not how many people had persistent symptoms or stopped treatment.
The finding supports the tested oral regimen. It does not establish that oral and injected semaglutide are interchangeable or equally effective.
Sources
OASIS 4, NEJM, 2025. Funded by Novo Nordisk. Study abstract · Paper.