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Oral semaglutide 50 mg has a small benefit (additional 12% total weight reduction) over the maximum dose of the Wegovy pill which is 25 mg but with higher GI AE rates and double the cost.

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Key domains requiring structured oversight include: Pancreatitis and gallbladder disease Progression of diabetic retinopathy Severe gastrointestinal intolerance Visual loss and rare opticnerve complications Nutritional/metabolic issues with rapid weight reduction In India, where continuity of care is variable and prescribing often occurs outside endocrinology, these risks can be underrecognised or misattributed