OCTANE Retrospective Cohort Reports 4.1% Additional Weight Loss After Switch to Oral Semaglutide

The OCTANE study reviewed records of adults with overweight or obesity and at least one comorbidity who switched from injectable semaglutide or tirzepatide to daily oral semaglutide between January and February 2026. Participants had no diabetes or prior bariatric surgery, a mean baseline weight of 221.6 lb and BMI of 34.5 kg/m2, and were required to report consistent oral use plus weight at baseline and three months. No minimum prior injectable duration or weight loss was mandated.

After three months, mean weight fell 8.8 lb (4.1%), 40.7% of participants achieved ≥5% loss, and the proportion with BMI ≥30 declined 21.6 percentage points. Self-reported outcomes included better-fitting clothes in 69% and healthier eating in 51%, with 82.4% noting at least one improvement. These figures derive from self-reported weights without verified adherence or dose titration data.

Because the design was retrospective, uncontrolled, and unblinded, observed losses cannot be attributed to the switch itself; regression to the mean, continued lifestyle effects, or differential tolerability may contribute. Oral semaglutide’s lower bioavailability compared with injectables is acknowledged, yet the magnitude of additional loss aligns with earlier phase-3 oral semaglutide trials.

Peer-reviewed publication and randomized switch trials measuring body composition, adherence, and gastrointestinal tolerability over six to twelve months are required before clinical recommendations can shift.