April 13, 2026

Oral Wegovy sounds easy, but the reality is more complicated

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Is the new oral Wegovy pill a breakthrough or a risk most patients never hear about? Shiv K. Goel, an internal medicine and functional medicine physician, joins the show to unpack his KevinMD article, "Oral Wegovy: the miracle and the mess of the new GLP-1 pill," and why treating this drug casually could hurt you. He breaks down emerging data linking high-dose semaglutide to ischemic optic neuropathy, with reporting odds nearly five times higher for Wegovy than Ozempic, and explains why the obesity population faces unique hemodynamic risks. You will learn why he never prescribes a GLP-1 without prescribing a plan, including slow titration, protein and resistance training to protect lean mass, hormone optimization, and red flag education. Goel also addresses the rebound weight gain most patients face after stopping, the dangers of buying compounded GLP-1 medications from medical spas, and why losing just 10 pounds may not warrant these drugs at all. If you are considering oral Wegovy or already on a GLP-1, this episode could change how you approach weight loss medication.

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