In recent years, there has been a significant shift in the approach to obesity treatment. Whereas in the past obesity was seen mainly as the result of willpower, diet, or physical activity alone, today it is clear that this is a complex metabolic medical condition. It is influenced by hunger and satiety mechanisms and by hormones. Genetics,
stress, sleep, medications, age,
emotional state, and lifestyle also play a role. Proper treatment of these conditions may include innovative medications designed to treat obesity.
The new medications for obesity, including drugs from the GLP-1 and GIP families, act on satiety mechanisms in the brain and the digestive system. They help reduce hunger and increase the feeling of fullness. In addition, they help reduce food cravings and improve metabolic markers such as blood sugar and fatty liver. There is also an improvement in cardiovascular risk factors. For many patients, they make significant and sustained weight loss possible for the first time. However, it is important to understand: the medication is an important medical tool, not a standalone solution. There are currently many medications on the market developed specifically to address obesity. But not all of them work the same way. There are weekly injections, daily pills, older appetite-suppressing drugs, and even a capsule that is not a drug at all. At the same time, the next generation is advancing rapidly.
Ozempic: The Drug That Changed the Conversation About Obesity
Ozempic contains semaglutide, a GLP-1 receptor agonist. The drug was developed and approved for the treatment of type 2 diabetes. It improves blood sugar control, reduces hunger, and increases the feeling of fullness. The weight loss observed in patients made it one of the drugs most closely identified with the GLP-1 revolution. However, it is important to be precise:
Ozempic itself is intended mainly for the treatment of diabetes and was not originally designed as a dedicated obesity drug.
Wegovy: Semaglutide Designed for Obesity Treatment
Wegovy is also based on semaglutide, but it was developed and approved specifically for the chronic treatment of excess weight and obesity. The drug reduces food intake by affecting hunger and satiety mechanisms. It has also accumulated significant data on health benefits beyond weight. During 2025–2026, the indications and dosages of
Wegovy were expanded in the US, and the treatment continues to evolve beyond the original model of a “weight-loss injection.”
The difference between Ozempic and Wegovy illustrates an important principle: the same active ingredient can serve different purposes, at different doses and for different indications. Therefore, it is better not to choose a treatment based on a familiar name, but according to the patient’s medical goal.
Mounjaro: Two Hormones in One Drug
Mounjaro contains tirzepatide. Unlike semaglutide, which acts on GLP-1, tirzepatide activates two receptors, GIP and GLP-1.
The combination affects appetite, food intake, and blood sugar control. In obesity studies, tirzepatide led to very significant weight loss. In the US, tirzepatide is marketed for obesity under the name Zepbound, while the name Mounjaro is identified with the treatment of type 2 diabetes.
The drug illustrates how obesity treatment is advancing toward acting on several biological pathways at the same time.
Razin – Phentermine: An Older Drug That Can Still Be Useful
Not every obesity treatment has to be a GLP-1.
Razin – Phentermine contains phentermine, a drug that reduces appetite through the central nervous system.
In Israel it is marketed at a 15 mg dose and is intended for the treatment of obesity in suitable patients.
It is a much older drug than the new injections, but in properly selected patients it can still be a useful tool. It is particularly suitable when the main problem is significant hunger or difficulty controlling portion sizes. Unlike incretin drugs, it does not act through GLP-1 and does not mimic gut hormones.
There is also real-world data on longer-term use of
phentermine. In a large cohort study, longer use was associated with greater weight loss, with no observed increase in cardiovascular events or mortality among a low-risk population. However, this was an observational study, so patient selection and medical follow-up are required.
Rybelsus: GLP-1 in a Pill
Rybelsus also contains semaglutide, but unlike Ozempic and Wegovy, it is taken as a daily pill.
This was an important step in the development of the incretin field. It showed that GLP-1–based treatment can also be delivered without an injection.
Rybelsus itself is approved for the treatment of type 2 diabetes, not as a dedicated obesity drug. It also has special dosing rules: it is taken in the morning on an empty stomach with a small amount of water, and one must wait at least 30 minutes before eating, drinking, or taking other medications.
The development of oral semaglutide continues. It signals a clear trend: in the future, a large part of obesity treatment may shift from injections to pills.
Epitomee: A Capsule, but Not a Drug
Epitomee is interesting precisely because it works in a completely different way.
Epitomee is not a drug but a medical device that is swallowed as a capsule. After it is swallowed, the material inside expands in the stomach and forms a structure that takes up volume and helps increase satiety. It later breaks down and passes through the digestive system.
The FDA cleared the device for use in adults with a BMI of 25–40, alongside diet and physical activity.
In the randomized
RESET study, after 24 weeks the average weight loss was 6.6% with Epitomee compared with 4.6% in the control group, with both groups also receiving an intensive lifestyle program. 56% of the patients using the capsule achieved a loss of at least 5% of their body weight.
This option may be of particular interest to people who prefer a treatment that is neither a drug nor involves injections.
The Next Generation: Pills and Combinations That Will Change the Field Again
The race to develop obesity drugs has already moved to the next stage. The goal is not only to achieve greater weight loss. Companies are trying to develop more convenient treatments, improve tolerability, act on several metabolic pathways, and better maintain the results over time.
Orforglipron: The Oral GLP-1 That Has Already Reached the US
Orforglipron is a small, non-peptide molecule that activates the GLP-1 receptor. Its great advantage is how it is taken: a pill once a day, which can be taken with or without food and without special restrictions on drinking.
And here is an important update: as of August 2026, orforglipron is no longer an experimental drug in the US.
The FDA approved it on April 1, 2026 under the name
Foundayo for chronic weight management in adults with obesity, or with overweight and a related condition.
This is a significant step because it opens the possibility of advanced GLP-1 treatment without an injection.
Retatrutide: Three Receptors and Weight Loss Approaching Surgical Levels
Retatrutide is one of the most intriguing drugs still in development. It activates three receptors: GLP-1, GIP, and glucagon.
In May 2026, Eli Lilly published the phase 3 results of
TRIUMPH-1. At the 12 mg dose, the average weight loss was 28.3% of body weight after 80 weeks. Among participants with a starting BMI of 35 or above who continued to 104 weeks, the average loss reached 30.3%.
These are very impressive figures, but it is important to remember: retatrutide is not yet an approved drug. It continues in its phase 3 research program, so products sold online under the name Retatrutide should not be used as a substitute for an approved drug.
CagriSema: Combining GLP-1 and Amylin
CagriSema tries to reach the same goal in a different way. It combines semaglutide with cagrilintide, a long-acting analog of the hormone amylin.
In the
REDEFINE 1 study, the average weight loss was 22.7% after 68 weeks among participants who stayed on treatment, compared with 2.3% on placebo. More than 40% achieved a loss of at least 25% of body weight.
Novo Nordisk submitted CagriSema to the FDA in December 2025. As of August 2026, it is still in the regulatory process and is not an approved drug for routine use.
Lifestyle Change
Real success comes when drug treatment is combined with a gradual, personalized lifestyle change. The recommendation is to follow a Mediterranean diet rich in protein, vegetables, legumes, whole grains, and quality fats. It is also advisable to reduce sugar, sweetened drinks, and ultra-processed food. It is recommended to include physical activity, especially strength training to preserve muscle mass. Make sure to drink enough and sleep well. In addition, stress management and monitoring body composition, not only the number on the scale, are important. Innovative obesity medications can be incorporated as part of this plan.
Structured medical follow-up is an integral part of treatment. The medication, dose, and rate of escalation should be adjusted individually. Side effects and blood tests should be monitored. In addition, monitor the feeling of satiety, nutritional status, reduction in circumferences, and preservation of muscle mass. Furthermore, even after weight loss, it is important to plan a maintenance phase. This is because obesity is a chronic condition that tends to return when treatment is stopped without a follow-up plan. It is important to note that drugs intended to treat obesity require close medical follow-up and guidance.
The goal is not only to lose weight, but to build better metabolic health, vitality, function, confidence, and quality of life. Modern obesity treatment puts the person at the center: no blame, no criticism, but precise medicine. There is personal support and a change that can be maintained over time. Now, with advanced obesity treatments, the path to health is more accessible.
I am with you every step of the way
Dr. Asnat Raziel
