How the Wegovy pill could leave you sick, exhausted and depressed. Patients reveal the brutal side effects from constant nausea to never-ending fatigue… and many say they are even WORSE than the jabs

When a box containing Sophie Ashton’s first pack of Wegovy pills arrived on her doorstep, the 39-year-old felt a flicker of hope.

Finally, she thought, here was a way to control her weight – without the eye-watering cost of the injections she could no longer afford. Like thousands of others, she had been forced to stop taking weight-loss jab Mounjaro last year after its manufacturer dramatically increased the price from around £100 a month to more than £200.

Over nine months on the drug, the mother of one had lost one-and-a-half stone. But once she stopped taking it, inevitably, her weight slowly began to creep back up.

So when a pill version of Wegovy became available – containing semaglutide, the same drug used in the injection – for just £60 for a month’s supply, Sophie jumped at the chance to try it.

‘I just wanted to feel better in my body,’ says the content creator from Greater Manchester. ‘I was in quite a bad place, having been through a difficult break-up. I knew something had to change.’

She had recently been prescribed sertraline, an antidepressant, which helped steady her racing thoughts and lift her low mood. Losing weight felt like the final piece of the puzzle – or so she thought.

On Mounjaro, Sophie had barely been troubled by common side effects such as nausea, constipation and bloating. She assumed switching to a daily pill would be similarly straightforward.

But just ten days into treatment, her mental health began to spiral.

‘My mind was racing constantly,’ she says. ‘I was waking up in the middle of the night, I couldn’t focus and just had this overwhelming feeling of anxiety.

‘The worst part was that even my three-year-old daughter could tell something was wrong. I became irritable and short with her. I just felt out of control.

‘I hate to think what could have happened if I stayed on the pill.’

When she reported her symptoms to the online firm that prescribed the drug, Sophie alleges she was advised to switch back to injections – after being told some patients may experience mood disturbances on the drug.

‘In my mind it wasn’t that simple – I don’t want to take another weight-loss drug. I know it means I’m likely to carry on gaining weight, but I just don’t want to take that risk again.’

Her story is concerning, yet she is far from the only patient to report troubling symptoms after taking the new pill. The daily Wegovy tablet was billed as a cheaper, easier alternative to jabs. But experts speaking to The Mail on Sunday have warned there may be a significant downside.

To get enough semaglutide into the bloodstream when swallowed rather injected, the pills contain a far higher dose. And experts say this could help explain a growing catalogue of reported side effects – including gastrointestinal problems, mood disturbances and, in some cases, potentially serious complications affecting the kidneys and pancreas.

It comes as UK health officials have linked 216 deaths to weight-loss drugs – although there is no way of knowing whether the medications caused the deaths, only that it was suspected.

‘The pill may be easier to take [than jabs], but it does come with its own set of issues,’ says Dr Madusha Peiris, a neurogastroenterologist at Queen Mary University of London.

For a start, taking it is more complicated than simply swallowing a tablet with breakfast. The pill must be taken on a completely empty stomach – meaning first thing in the morning, before breakfast – with only a small amount of water. Users must then wait at least 30 minutes before eating, drinking or taking any other oral medication.

But there is another striking difference between the pill and the jab – the dose. While the standard maintenance dose of injected Wegovy is 2.4mg once a week, the pill contains 25mg of semaglutide – taken every day.

The reason for this huge difference is that semaglutide is poorly absorbed when swallowed. Much of the drug never makes it from the digestive system into the bloodstream, so more is needed to achieve the desired effect. But experts say the large amount of semaglutide passing through the digestive system every day could explain why some patients report particularly troublesome gastrointestinal side effects.

On paper, the side-effect profile of the pill looks remarkably similar to that of the jabs. The most commonly reported issues include nausea, vomiting, diarrhoea, constipation, bloating, heartburn, fatigue and dizziness – many of the complaints familiar to users of injectable weight-loss drugs.

In clinical trials, around 70 per cent of people on Wegovy injections experienced these gastrointestinal side effects.

The figure for the pill was roughly the same. In late-stage trials, 74 per cent of those taking oral semaglutide reported at least one gastrointestinal problem, with nausea among the most common. Yet anecdotal reports from patients taking the pill paint a rather different picture. Online forums and TikTok pages are awash with users complaining of relentless nausea, frequent vomiting and debilitating diarrhoea after starting the drug.

One Reddit user who switched from jabs to pills claimed ‘the side effects, specifically nausea, have been off the charts’.

‘First month on the starting dose completely fine, but after increasing the dose in the second month, I have had two instances of debilitating nausea and one of them I went to the ER because I thought I was dying,’ they added. ‘I never had side effects on the shot, so I am going back to the shot.’

Another user described the nausea as ‘unbearable’. ‘I was on the lowest-dose pill for a week and the nausea was debilitating. I could barely breathe and certainly couldn’t eat. It was awful,’ they said. ‘I stopped taking it today. I just can’t do it. And I’m still feeling terrible.’

And unlike many jab users, who often find the side effects improve over time, some Wegovy pill users say it only gets worse. After increasing the dose from 1.5 to 4mg, one user wrote: ‘Out of nowhere, I could no longer eat. I threw up non stop. Even an empty stomach made me sick.

‘I went to the doctor twice and despite improvements in my cholesterol levels, I was advised to come off the pill, and warned it could take a month to feel better.’

On TikTok, accounts are largely similar. In one video, which has racked up more than 107,000 views, a user named Meg talks of coming off the pill after experiencing nausea for three weeks. ‘I seriously don’t know how people do this,’ she says. ‘I thought after I stopped taking it I would feel better, not worse. I am still throwing up, to the point I can’t get through a short car journey.’

Others speak of headaches, migraines, severe bloating and fatigue. One Reddit user said the pill left them so exhausted they could hardly get through the day without a nap.

Another replied saying their ‘never ending fatigue’ couldn’t be relieved by coffee or sleep, and was interfering with their work and exercise routine.

And according to Dr Peiris, these heightened adverse effects – along with mood disturbances such as those suffered by Sophie – may not be entirely surprising.

Experts have long questioned whether delivering a large dose of semaglutide directly into the stomach every day could prove tougher on the body than a much smaller injection given just once a week.

Indeed, Dr Peiris says these concerns were being raised even while the oral version was undergoing clinical trials. ‘With jabs, you get a steady release of the drug over seven days. With the pill, however, the drug is released relatively quickly once it dissolves in the stomach,’ she says.

Dr Peiris believes this could help explain why some patients experience particularly severe nausea on the pill. GLP-1 drugs such as Wegovy mimic a hormone naturally released by the gut after eating. One of its effects is to slow the rate at which the stomach empties, keeping food there for longer and helping us feel full.

This is part of what makes the drugs so effective for losing weight. But if digestion slows too much, it can leave patients feeling bloated and nauseous – and, in severe cases, cause vomiting.

Dr Peiris believes exposing the stomach to a large dose of semaglutide every day could amplify these effects in some patients.

And there may also be another consequence – one that could help explain the mood problems of patients such as Sophie. This involves serotonin, a chemical messenger best known for its role in regulating mood and anxiety.

Perhaps surprisingly, the vast majority of the body’s serotonin is produced in the gut, which does not travel directly into the brain.

But the digestive system and brain are in constant communication via a complex network of nerves, hormones and chemical signals – known as the gut-brain axis. GLP-1 drugs are known to act on this, and early research suggests a large daily dose delivered by the pill may alter serotonin signalling in the gut.

Dr Peiris argues this could have downstream effects on the signals travelling between the digestive system and the brain, potentially affecting areas involved in mood and anxiety.

‘When you have all this drug hitting the stomach at the same time, it can trigger a surge in serotonin activity,’ she says. ‘There will be a knock-on effect in the brain.’

Dr Peiris stresses this link is not yet proven, but she believes it could offer one explanation why some patients report anxiety, depression or other changes in mood while on the drugs.

With the injection, by contrast, semaglutide is absorbed gradually from beneath the skin into the bloodstream, rather than a large oral dose passing into the stomach every day.

Dr Peiris believes this difference in how the drug enters the body could explain why some patients find the pill particularly difficult to tolerate.

Part of the appeal of a daily tablet is that it could make GLP-1 drugs far more attractive to people put off by needles or the idea of a weekly injection. That, doctors say – and no doubt the drug’s maker hopes – could open this new wave of weight-loss treatments up to a much wider group of patients.

But Dr Peiris says it also makes proper medical oversight even more important. ‘These are still medicines, they need to be prescribed by someone who knows the patient and is keeping an eye on them,’ she says.

‘Making them easier to take is good, but we don’t want people to start thinking of them as just another weight-loss product.’

Currently, the daily tablet is available to patients with a BMI (body mass index) of 30 or above – the same threshold as the Wegovy injection.

Patients with a BMI of between 27 and 30 who also have a weight-related condition – such as heart disease, high blood pressure or sleep apnoea – may also be eligible. But it is not yet available on the NHS.

Dr Peiris says the concern is that many people taking GLP-1 drugs are also being treated for other health problems and may be taking several different drugs.

‘We still don’t know everything about how these drugs interact,’ she warns. ‘That’s why proper medical supervision matters.’

Like the injections, the pills also carry a risk of the rebound effect, whereby when treatment stops, the weight piles back on and its health benefits disappear.

‘As such, we may end up with a generation of people who have to take these drugs for life, unless we can come up with an exit strategy,’ says Dr Peiris.

‘The biggest danger is not the drug itself, but poor information, rushed decisions and the assumption that the pill is just another online purchase.’

She says that ‘in a perfect world we would have clear guidelines’, but cautions that ‘until then it’s up to providers to give the best care possible’.

In response to the claims made by Dr Peiris and users of the pills, Wegovy manufacturer Novo Nordisk told The Mail on Sunday: ‘We care deeply about patient safety.

‘Like all medicines, treatments used for chronic conditions can have side effects, and these can vary from person to person. That is why medicines are prescribed by healthcare professionals, who consider the potential benefits and risks for each individual.

‘Consistent with the available evidence, anxiety and mood disorders are not currently listed on the UK label of side effects for the Wegovy pill.’

The company added: ‘We are committed to ensuring healthcare professionals and patients have a detailed understanding of our medicine’s safety profile.

‘Anyone with concerns about side effects should speak to their doctor, nurse or pharmacist, who can provide personalised medical advice and support.’