Novo Nordisk starts late-stage trial of lower-dose oral Wegovy
A new Novo Nordisk study will test whether smaller doses of oral Wegovy still drive weight loss, a question that could affect supply and self-pay costs for US patients.
Novo Nordisk has started a late-stage trial of lower doses of its oral Wegovy pill, testing whether smaller amounts of oral semaglutide can still produce meaningful weight loss in adults with obesity [2].
The study, called OASIS-5, is a 60-week randomized, placebo-controlled trial expected to finish in 2028 [2]. It plans to enroll 450 adults. Participants must have a body mass index of 30 or higher, or a BMI of 27 along with at least one obesity-related health condition, and must have a history of unsuccessful weight-loss attempts [2].
The trial will compare weight-loss results for two lower doses of oral semaglutide against placebo. Novo Nordisk has not disclosed which doses are being tested [2]. The pill is currently available in 1.5 mg, 4 mg and 9 mg strengths, with 25 mg as the approved long-term maintenance dose, according to a report on the study [2].
People with diabetes cannot join the trial. Neither can people whose weight has changed significantly in a recent period, or people already being treated with another GLP-1-based therapy [2]. Those exclusions are designed to isolate the effects of the lower-dose oral semaglutide.
Beyond weight loss, the trial will track changes in waist circumference and other health markers, and it will gather data on side effects and how well the lower doses are tolerated [2].
A crowded market
The company is testing smaller doses while the obesity drug market is projected to surpass $100 billion by 2030, and while it faces competition from Eli Lilly [2]. The World Health Organization estimates that more than 1 billion people worldwide are obese [2]. Asked about any plans to study lower doses of its own oral obesity drug, Eli Lilly did not respond to questions [2].
Novo Nordisk chief executive Mike Doustdar pointed to patient behavior as part of the rationale. "People are using low dosages of these products… they just decide on their own," he said, according to the report [2]. Doustdar also said patients often seek benefits beyond weight loss [2].
In November 2025, Novo Nordisk's Phase 3 OASIS 4 trial found that Wegovy reduced cardiovascular risk factors in people with obesity [2].
Why it matters for patients
A lower dose that still works would matter for two practical reasons: how much drug each patient needs, and what that drug costs. The report raises the possibility that lower doses could lead to lower price points and reach more patients, but no pricing, supply or insurance plans have been disclosed [2].
It is also not known whether Novo Nordisk would seek approval for a lower maintenance dose, or when. No lower dose is approved today, and the trial does not change any current prescribing [2].
The results will not answer every question. Because people with diabetes and people already using another GLP-1 medication are excluded, the trial will not show how a lower dose of oral Wegovy performs alongside or instead of those treatments [2].
The trial focuses on people who have struggled to lose weight before, which is a narrower group than everyone with obesity [2].
What happens next
The OASIS-5 trial began in August 2026 and is expected to conclude in 2028 [2]. Novo Nordisk has not disclosed the two lower doses under study, and no interim results have been reported [2]. It also has not been disclosed whether the company plans additional lower-dose studies beyond this one [2].
Sources
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