WASHINGTON, U.S.: Lower costs and greater convenience are driving growing interest in pill-based weight-loss treatments, as patients weigh alternatives to injectable drugs in a fast-expanding obesity market.

Doctors say many first-time users are opting for oral medications from Novo Nordisk and Eli Lilly, reflecting a shift in how patients approach treatment in a market expected to exceed $100 billion annually within the next decade.

Novo Nordisk's oral Wegovy has been available since January, while Eli Lilly's newly approved pill, Foundayo, is set to begin shipping this week.

Both drugs offer an alternative to injectable GLP-1 therapies, which have dominated the market in recent years but require refrigeration and regular injections.

The appeal of pills lies in their simplicity, doctors say. "They don't need refrigeration, are more discreet and don't require the use of needles," said Dr. Christina Nguyen, an obesity and family medicine physician in Atlanta. "One person said I'd rather stay fat than ever use a needle. That's a true fear," she added.

All seven doctors interviewed by Reuters said they had begun prescribing oral Wegovy, with some estimating that about 10% of their patients are using the pill. Most of these patients are new to GLP-1 drugs rather than switching from injectables.

"It is expanding access to people who are not sure that an injectable is something they would feel comfortable doing on themselves, might be leery of needles, and they're excited to have an option that is easier and more familiar to take," said Dr. Stefie Deeds, an internal and obesity medicine specialist in Seattle.

Doctors, however, are cautious about switching patients who are already responding well to injections. "The patients we see who are taking medicines, whether it's Wegovy or (Lilly's) Zepbound, we're not telling them to switch to oral Wegovy if they're doing well," said Dr. Louis Aronne of Weill Cornell Medical College.

Injectable drugs such as Zepbound, which contains tirzepatide, remain the preferred option for patients with severe obesity due to their higher efficacy. Clinical trials have shown weight loss of around 20% or more with such treatments, compared with roughly 12% for Foundayo and about 14% for oral Wegovy. "For somebody who is in the lower end of the weight spectrum, people who are more likely to be seen by primary care physicians, they would be more likely to use the orals," Aronne said.

Still, the introduction of Eli Lilly's pill is expected to intensify competition.

Unlike oral Wegovy, which must be taken on an empty stomach with water at least 30 minutes before eating or taking other medications, Foundayo can be taken at any time without food restrictions.

Nguyen said that if the Lilly pill is priced competitively, "most likely everyone will go with the orforglipron."

Novo has said its research suggests patients are not significantly bothered by its dosing requirements.

Beyond weight loss, semaglutide, the active ingredient in Wegovy, has been shown to reduce cardiovascular risks. Some doctors caution that newer drugs may not yet demonstrate the same additional health benefits. "I can't guarantee that this totally different type of molecule is going to carry the same benefits," said Dr. Michael Weintraub of NYU Langone Health.

Cost remains the most critical factor influencing patient decisions.

Oral Wegovy and Foundayo are priced from about $149 per month at the lowest dose for self-paying patients, compared with around $299 for Zepbound and $349 for Ozempic and injectable Wegovy.

Insurance coverage varies widely, and doctors say they often spend significant time helping patients navigate affordability. "I feel more like a financial planner these days than a physician," said Dr. Catherine Varney of the University of Virginia School of Medicine.

Despite lower-cost options, many doctors say these treatments remain out of reach for a large portion of the population. "This still is a market for upper-middle-class and above," Varney said.