Oral GLP-1s change the form—not the fundamentals

The new pill form may spark interest, but the essentials of effective obesity care stay the same

By Dr. Paul Sarmiento, Senior Medical Director, Clinical Quality

Since the first oral GLP-1 for weight loss was approved in late December 2025, commercials may have led people to believe all the barriers have been removed. The new pill form changes how GLP-1s are taken but not the underlying reality that outcomes hinge on day-to-day behavior change.

As weight loss medications evolve, employers’ questions are shifting too. Below is a breakdown of what the oral GLP-1 means for demands, costs and an organization’s weight management strategy.

Does the oral GLP-1 change the need for lifestyle modifications?

With the oral GLP-1, lifestyle changes remain critical for maximizing and maintaining weight loss—same as the injectable form. The once-daily Wegovy pill demonstrated up to 17% average weight loss when used along with a reduced calorie diet and exercise.

For employers, this part of their obesity care strategy stays the same: lifestyle support continues to be essential.

At Teladoc Health, lifestyle modifications—specifically proper nutrition, physical activity, sleep and stress management—remain the foundation of our program. With flexibility to meet employers’ needs based on GLP-1 coverage, our lifestyle-modification-first approach supports the behaviors needed to optimize results.

How will the oral GLP-1 change demand?

While there hasn’t been a published study to estimate changes in demand, we know that interest in GLP-1s likely exceeds usage. One survey shows about 12% of U.S. have used a GLP-1 drug, while 14% are interested.

For some people, injections were the barrier. They may have never considered a GLP-1 because of needle hesitancy or may have stopped because injections were challenging. The new form may increase interest among your employees even if it doesn’t dramatically change utilization because barriers still exist.

Oral GLP-1s require strict daily routines that can lead to lower adherence compared to injectable GLP-1s, and cost remains a challenge. Today, oral GLP-1s for weight loss are similarly priced to injectables, which means employer benefit design trends are unlikely to shift and paying out of pocket may be the most accessible path for many employees.

What financial impact could the oral GLP-1 have on employer spending and coverage?

A common question is whether oral GLP-1s will help reduce pharmacy costs. The new form could increase interest and, therefore, pressure to cover, but in many ways, the financial dynamics remain similar to injectables.

Until costs change, employer coverage for GLP-1s continues to be financially challengingfor many. Direct-to-consumer platforms, such as LillyDirect or NovoCare, make FDA-approved GLP-1s accessible to their population, and employers can support them with behavior change tools to optimize either form of the GLP-1.

Employers who elect to cover GLP-1s will still prioritize balancing access and cost. They will continue to seek wraparound support programs that allow for tracking engagement and require employees to participate in a behavior change program for coverage. Additional levers for cost containment include leveraging a narrow network of care providers to provide an added level of quality.

How does the oral GLP-1 change how Teladoc Health care providers prescribe?

We’re dedicated to evidence-based, high-quality care. With adherence, both versions (oral and injectable) can be effective, so our care providers have options based on a patient’s needs and preferences.

For employers, the added value of partnering with Teladoc Health is that our providers have experience in obesity medicine. This expertise ensures safe, clinically appropriate prescribing and helps them develop personalized care plans that may include no medication, lower cost anti-obesity medication, an oral GLP-1 or an injectable GLP-1.

Teladoc Health is prepared for the evolution of GLP-1s

The first oral GLP-1 for weight loss is a big step forward. We’re excited that our care providers have this at their disposal to treat our patients, but it won’t shift our underlying care approach.

As obesity care evolves, Teladoc Health will continue to focus on high-quality care. The form of GLP-1 may change, but lifestyle modification will remain foundational.