The United Arab Emirates has become only the second country in the world to approve oral semaglutide for weight management, and according to Novo Nordisk Gulf General Manager Venkat Kalyan, that’s no accident. It’s the payoff from years of groundwork rather than a lucky roll of the regulatory dice.

Venkat Kalyan points to a longstanding relationship between the company and UAE authorities, built alongside the country’s healthcare vision, its infrastructure and the pace at which its regulatory system can move. The timing also lines up with a bigger bet: Novo Nordisk recently announced a new regional distribution centre based in the UAE that will serve up to 70 countries, alongside a new Gulf affiliate overseeing operations across six countries from the same base. As Kalyan puts it, the UAE isn’t just an early recipient of the medicine. It’s becoming the hub for how the company serves the wider region.

That ambition shows up in how fast the approval moved through the Emirates Drug Establishment. Kalyan describes a review process that was considerably quicker than in other markets, while still holding to exacting safety standards for a brand new molecule. Patient safety, he says, stayed central throughout, and what made the approval possible was a regulator combining genuine thoroughness with a real appetite to get innovation to patients early.

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Pill or Injection, the data behind the choice

Naturally, comparisons with the injectable Wegovy come up. Kalyan is careful to frame these as conversations for patients to have with their own doctors rather than blanket verdicts. Trial data show the oral formulation delivering around 17 per cent mean body weight reduction at 64 weeks, broadly comparable to the injectable version, with a safety and tolerability profile consistent with semaglutide’s established track record. Whether someone takes the pill or the injection, he says, should come down to individual clinical needs, treatment goals, lifestyle and personal preference, and having both options simply gives physicians and patients more flexibility.

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Eligibility is a clinical call, typically based on BMI thresholds and the presence of weight related health conditions in line with the approved label, not something patients can walk in and ask for. As for how quickly results show up, Kalyan notes that in clinical trials, meaningful weight loss began within the first weeks of treatment and built progressively over the full 64-week period, with the pace and extent varying from person to person.

The science that took years to crack

Behind the tablet sits a problem that has stumped this class of drugs for years peptides like semaglutide are normally broken down by stomach acid before they can be absorbed, which is why GLP-1 medicines have historically come as injections. Novo Nordisk’s fix is SNAC technology, or sodium N-(8-[2-hydroxybenzoyl] amino) caprylate, a co-formulated absorption enhancer that creates a localised protective environment around the semaglutide molecule in the stomach, shielding it from breakdown and helping it cross the gastric lining. Kalyan calls it one of the genuine scientific breakthroughs behind the medicine, and the first time this kind of peptide-based absorption enhancement has made it to market. It also explains the strict dosing rules: once daily, in the morning, on an empty stomach, with a sip of water, and at least 30 minutes before any food, drink or other oral medicines, so the SNAC technology has the conditions it needs to do its job.

Patient selection follows the approved label and lines up with international clinical guidelines, though Kalyan resists reducing it to a checklist. His message is simple, anyone considering the pill should talk to a doctor first, since a physician is best placed to weigh up BMI, relevant comorbidities and prior treatment history, and decide whether the medicine, alongside diet and physical activity, is the right and safe choice for that person.

A health crisis the UAE can’t look away from

The scale of the opportunity is shaped by the UAE’s obesity burden, which sits well above global averages. Citing figures from the Ministry of Health and Prevention, Kalyan notes that around 28 per cent of UAE adults live with obesity and around 67 per cent have overweight or obesity, while the World Obesity Federation projects nearly 7.5 million people in the UAE will be living with overweight or obesity by 2035. Novo Nordisk’s access strategy is built around that reality, with the oral pill already listed and accessible within Abu Dhabi’s Personalised Weight Management Programme, which pairs medication access with broader clinical support.

That access already extends into public health channels. The pill is available through SEHA clinics and reimbursed under the Abu Dhabi programme, and Kalyan says the company is working with relevant authorities to widen that further, alongside active talks with other public and private insurers across the country. He frames the investment case in economic terms too, pointing to research suggesting early intervention in obesity is one of the most cost-effective levers in healthcare. In the United States, he notes, an estimated 90 per cent of type 2 diabetes cases are attributable to excess weight and obesity, with obesity related conditions and lost productivity costing the economy more than $210 billion a year. The UK’s National Institute for Health and Care Research has similarly modelled BMI reduction interventions as likely to be cost effective against their impact on cancer, cardiovascular disease, cerebrovascular disease and type 2 diabetes, with excess weight linked to at least 13 types of cancer. For Kalyan, treating obesity early isn’t just a clinical decision. It’s one of the more effective ways a health system can reduce its long-term disease burden.

Why the work doesn’t stop at the prescription

Underpinning all of this is a view of obesity as a chronic, relapsing condition that calls for sustained treatment rather than a short course of pills. Novo Nordisk backs UAE clinicians through ongoing scientific dialogue and patient support resources aimed at keeping people engaged over the long term, alongside NovoCare, its patient education platform. NovoCare includes digital tools and apps for patients, a dedicated call centre, and a team of patient educators working directly with both healthcare professionals and patients.

On what happens when patients stop treatment, Kalyan draws a comparison with conditions like hypertension or high cholesterol, where ongoing management matters for sustaining results over time. This isn’t unique to the oral pill, he stresses. It reflects how the clinical community more broadly thinks about long term weight management, whether through medication, lifestyle change or both. Novo Nordisk continues to study outcomes across the full course of treatment, including what happens when patients reduce or stop their dose, and that evidence feeds into how it supports physicians managing their patients. Above all, Kalyan keeps coming back to one point: any change in treatment should happen in conversation with a physician, who’s best placed to weigh the patient’s overall health, goals and response so far, a decision made together, not navigated alone.