Australia has approved its first GLP-1 weight loss tablet. What the TGA approved, how it compares with the injection, and why the plan matters more than the medicine.
Australia has approved its first GLP-1 tablet for weight management. On 3 November the TGA registered a once daily oral form of semaglutide, the same medicine as the weekly injection, and it is expected in pharmacies around the end of the year.
That is real progress. Some people who would never start a weekly injection will take a tablet. But a tablet changes how the medicine gets into your body. It does not change what good treatment looks like: clear goals, tracked with your doctor and adjusted along the way. Set and forget is not a treatment plan.
Let me be precise about what was approved, how it compares with the injection, and why I think a weight loss medicine without a plan is poor care, whatever form it comes in.
Is the weight loss tablet available in Australia?
Not yet. The TGA has added it to the Australian Register of Therapeutic Goods in four strengths, taken once a day. According to newsGP, the approved uses are chronic weight management and lowering the risk of major cardiovascular events, such as heart attack and stroke, in eligible adults.
It is approved for the same adults as the weight management injection: a BMI of 30 or more, or 27 or more with a weight related condition such as high blood pressure or sleep apnoea, used alongside diet and physical activity. It is not approved for anyone under 18. Unlike the injection, it does not need a fridge.
A few details matter. The TGA still has to check packaging and manufacturing before the product is released, so the end of year date is an expectation, not a promise, and some reports put it in 2027. No price has been set. The medicine sits under the TGA's Black Triangle Scheme, which flags new medicines for closer monitoring of side effects. And the TGA has said it should not be used alongside any other semaglutide product or any other GLP-1 medicine.
Oral semaglutide is not new here. A lower strength tablet has been registered for type 2 diabetes for some time. What is new is the weight management registration. A second oral GLP-1, orforglipron, is also awaiting a TGA decision.
On subsidy, nothing has changed this week. The PBS currently subsidises these medicines only for type 2 diabetes. In late 2025 the Pharmaceutical Benefits Advisory Committee recommended listing injectable semaglutide for adults with obesity who have already had a cardiovascular event, but that listing had not started when this article was written.
Be wary of anyone offering a semaglutide tablet before it reaches Australian pharmacies, or without a proper assessment. In June, Victoria's Chief Health Officer issued an alert after people were hospitalised with acute liver injury from unapproved products sold as retatrutide, an experimental weight loss peptide. In September the TGA reported a person who tore their oesophagus from vomiting after taking a counterfeit product. I have written about these risks in The truth about unregulated peptides sold online.
How does the tablet compare with the injection?
On the trial evidence, closely. The main trial behind the approval is OASIS 4, published in the New England Journal of Medicine in 2025. It followed 307 adults with obesity, or overweight plus a related health problem, none with diabetes, for 64 weeks. Everyone also had lifestyle support: a diet about 2,100 kilojoules (500 calories) a day below their needs, and at least 150 minutes of activity a week. The results came with that work, not instead of it.
People taking the top strength tablet lost 13.6% of their body weight on average, against 2.2% on placebo. Among those who took it exactly as directed, the average was 16.6%. For comparison, the weekly injection produced about 15% weight loss over 68 weeks in the earlier STEP 1 trial. No trial has yet compared the two head to head, so similar is the honest word, not identical.
Side effects were also familiar. Gut symptoms, mostly nausea, vomiting and diarrhoea, affected 74% of people on the tablet and 42% on placebo, and most were mild to moderate and settled with time.
The real difference is the routine. Semaglutide is a peptide, and the gut normally breaks peptides down before they can be absorbed. The tablet gets around this with an absorption enhancer called SNAC, which helps a small amount cross the stomach lining. Even so, only about 1 to 2% of each tablet reaches the bloodstream, and food, drink or other tablets in the stomach cut that further. So the product information asks for the same routine every day: swallow it whole after an overnight fast with no more than half a glass of plain water, then wait at least 30 minutes before eating, drinking or taking other medicines. Public health researchers at the University of Queensland, writing in The Conversation this week, made the point that this stricter routine makes adherence the key issue. A weekly injection is one decision a week. A tablet is seven.
On evidence grading, weight loss with oral semaglutide is established. The large cardiovascular outcome trial in people without diabetes, SELECT, used the injection.
How GLP-1 medicines changed diabetes and weight care
These medicines started as diabetes treatments. They copy a gut hormone that helps the body release insulin after meals, slows stomach emptying and quietens appetite. Doctors noticed the weight loss, and the trials followed.
The turning point was SELECT, published in the New England Journal of Medicine in 2023. It enrolled 17,604 adults with overweight or obesity and existing heart disease, but no diabetes. Over about three years, major cardiovascular events (heart attack, stroke or cardiovascular death) occurred in 6.5% of people on weekly semaglutide and 8.0% on placebo, a 20% relative reduction. It was the first time a treatment for obesity was shown to prevent hard cardiovascular events.
That changed the conversation. Excess weight stopped being treated as a question of willpower and started being treated as a chronic disease that drives other diseases. In Australia the scale is large. The AIHW reported in June this year that 67% of adults were living with overweight or obesity in 2022 to 2024, and that overweight and obesity had overtaken tobacco as the leading risk factor for ill health and death.
Longevity medicine works upstream of disease. GLP-1 medicines are one of the few tools that act on an upstream driver of diabetes, heart disease, fatty liver and joint disease at once. That is why I take them seriously. It is also why I think they deserve better than a script and a schedule.
Why a medicine without a goal is poor care
Here is my view after more than 20 years in general practice. If nobody has asked what you are trying to achieve, you are not being treated. You are being prescribed to.
A number on the scale is rarely the real goal. The real goals are things like lower blood sugar, lower blood pressure, less fat in the liver, better sleep, less knee pain, or being able to keep up with your kids. Each one changes what success looks like and how fast you should get there. OASIS 4 shows why. In a later analysis of participants who started with prediabetes, 71% on the tablet had normal blood sugar at 64 weeks, against 33% on placebo. For them, that result matters more than the kilos. Keeping muscle is a goal too, and it is easy to lose sight of when the weight is falling.
Obesity specialists say the same. A 2025 joint advisory from four US obesity, nutrition and lifestyle medicine societies, published in the American Journal of Clinical Nutrition, put patient centred starting first on its list: agreeing goals for both weight and health, and screening for disordered eating and other risks before the first dose.
Then there is the dosing schedule. Every product comes with a standard plan for stepping up the dose. That plan was built for trial populations, and it is a sensible default. It is not a prescription for you. A good prescriber adjusts it to the person in front of them: their side effects, how fast they are losing weight, their other medicines, their work and their life. Sometimes the right move is to stay at a dose for longer. Sometimes it is to step back. Moving up is not automatically progress.
The University of Queensland researchers flagged two risks here. Doubling a dose, a common misconception, does not speed up results but can increase harm. And short appointments can miss screening for eating disorders, body image concerns and mental health. Handing someone a box and a schedule, then leaving them to step themselves up, is not a plan, wherever the prescription came from.
What should be checked before starting?
Good care starts before the first dose. These medicines are not for everyone, and the product information is clear about who needs extra care.
They are not suitable for anyone with a personal or family history of medullary thyroid cancer, or the related inherited condition MEN2.
They are not for use in pregnancy or breastfeeding, and should be stopped at least two months before a planned pregnancy.
Severe abdominal pain needs urgent assessment, because pancreatitis and gallbladder problems are recognised risks with this class.
Sudden loss of vision, even partial, needs an urgent eye review. A rare optic nerve condition called NAION has been reported with semaglutide.
Anyone having a procedure under anaesthetic or sedation should tell the team, because these medicines slow stomach emptying.
Changes in mood should be reported. In December 2025 the TGA aligned warnings across the class to monitor for depression and suicidal thoughts, while noting the evidence does not establish that the medicines cause them.
Other medicines matter too, and the tablet brings an issue the injection does not. In studies, taking oral semaglutide raised the amount of thyroid hormone absorbed from a levothyroxine dose by about a third, so people on thyroid replacement may need their thyroid tests rechecked. And because the tablet has to be taken on its own, anyone with several morning medicines needs a plan for timing them.
What should be measured?
If there is a goal, there have to be numbers to track it. Weight alone does not tell you what you lost.
Blood tests come first. A baseline of blood sugar, cholesterol, liver and kidney function shows where you started and whether the medicine is doing the job that matters. As people eat less, iron, vitamin B12 and vitamin D can drift down, so these are worth checking along the way.
Body composition is the next layer. In the STEP 1 trial, 140 participants had DEXA scans before and after 68 weeks of weekly semaglutide. Fat mass fell by 19.3% and lean mass by 9.7%, which means roughly two fifths of the weight lost was lean mass. That figure gets quoted as muscle loss, and it needs care. Lean mass on DEXA includes water, organs and connective tissue as well as muscle, and the proportion of the body made up of lean mass actually went up. The honest middle is this: most of what was lost was fat, some of what was lost was muscle, and you only know which is happening to you if you measure it. A scan before starting and again a few months in answers that question far better than a scale.
Wearables add the day to day picture. They do not diagnose anything, but steps, resting heart rate and sleep show whether activity is holding up while appetite falls. Data only helps when someone interprets it with you.
Measurement only helps if someone acts on it. The value of a structured program is the review: results checked against the goal at set points, and the plan changed when they drift. That might mean holding a dose, treating a side effect, changing the training or protein, or resetting the goal itself. Without those reviews, the numbers are just a record.
What has to go with the medicine?
The medicine reduces appetite. It does not build muscle, choose food or get you to the gym. Those parts are still yours, and they decide what kind of weight you lose.
Resistance training is the main protection for muscle. Australia's physical activity guidelines recommend muscle strengthening on at least two days a week, and lifting, bands or body weight work all count. I have written about why muscle predicts a longer, healthier life in Resistance Training: The Longevity Tool Hiding in Plain Sight.
Protein matters more when you are eating less. The 2025 joint advisory notes that targets of 1.2 to 1.6 grams per kilogram of body weight a day have been proposed during active weight loss, while acknowledging there is no consensus yet on exactly how to set them. Spreading protein across the day is easier than one large serve, especially when a few mouthfuls make you feel full.
Supplements come last. Whole food first, then fill genuine gaps: vitamin D if it is low, fibre if constipation is a problem, and creatine if you are training and want the best studied option for strength, which I covered in Creatine: Muscles vs Cognitive Function, What the Evidence Says. A blood test tells you what is actually missing.
The plan also has to cover the long term. In the STEP 1 trial extension, published in Diabetes, Obesity and Metabolism in 2022, people who stopped weekly semaglutide regained about two thirds of the weight they had lost within a year, and most of the gains in blood pressure, blood sugar and cholesterol faded too. For many people these are long term medicines. Whether you continue, change or stop is a decision for you and your doctor, made with your numbers in front of you.
Where this leaves you
The tablet is good news. It gives people another way to take a medicine with strong evidence behind it, and some will find it easier than a needle. But the tablet and the injection share the same molecule, the same side effects and the same need for a plan. An oral option will change how many people start treatment. It should not change the standard of care. These medicines work best inside a structured program, with clinical guidance, regular measurement and a plan that changes as you do.
If you are thinking about one of these medicines, a few questions are worth taking to your own doctor. What is my goal, beyond a number on the scale? What will we measure, and when? How will we handle side effects? What am I doing to protect my muscle? What happens at 12 months and beyond? A good answer to each of those is worth more than the choice between a tablet and an injection.
Frequently asked questions
Can I get the weight loss tablet now?
No. It was approved on 3 November, but the TGA still has to check packaging and manufacturing before release. It is expected around the end of the year, possibly later, and no price has been set.
Does the tablet work as well as the injection?
Roughly, on current evidence. The OASIS 4 trial found 13.6% average weight loss at 64 weeks, close to what the injection achieved in its trials. No trial has compared them directly.
Can I take the tablet and the injection together?
No. The TGA says the tablet should not be used with any other semaglutide product or any other GLP-1 medicine.
Will the PBS cover it?
Not for weight management at this stage. The PBS currently subsidises these medicines only for type 2 diabetes.
General information, not individual medical advice. Speak to your own doctor.
References
Wharton S et al. Oral semaglutide at a dose of 25 mg in adults with overweight or obesity. N Engl J Med. 2025.
Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021.
Lincoff AM et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023.
Australian Institute of Health and Welfare. Overweight and obesity. Accessed November 2026.
Mozaffarian D et al. Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. Am J Clin Nutr. 2025.
Wilding JPH et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab. 2022.
