# Can a Pill Keep Weight Off After the Injection? ATTAIN-MAINTAIN, Read Carefully In ATTAIN-MAINTAIN, an orforglipron tablet held 74.7% and 79.3% of earlier weight loss against 49.2% and 37.6% on placebo. No arm continued the injectable. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/can-a-pill-keep-weight-off-after-the-injection Updated: 2026-09-17 Published: 2026-09-17 [← Research](https://thisglp.com/research) Evidence # Can a Pill Keep Weight Off After the Injection? ATTAIN-MAINTAIN, Read Carefully A daily tablet held about three quarters of the weight people had already lost. Placebo held about half, and no arm stayed on the injection. [This GLP Editorial Team](https://thisglp.com/about)September 20266 min read Share of the earlier weight loss still held at one year · tablet, after tirzepatide · 74.7% · placebo, after tirzepatide · 49.2% · tablet, after semaglutide · 79.3% · placebo, after semaglutide · 37.6% · Share of prior loss kept — not a share of body weight. **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). ## Key takeaways - ATTAIN-MAINTAIN gave a daily orforglipron tablet or placebo to people who had already lost weight on an injectable, then followed them a year. - After tirzepatide, the tablet group held 74.7% of their earlier loss against 49.2% on placebo. After semaglutide, 79.3% against 37.6%. - Every figure is a share of weight already lost — not a share of body weight. - No arm stayed on the injection, so the trial never tested the tablet against simply continuing. Partly, and the trial does not answer the question most people are asking. It compared a tablet against nothing, not against staying on the injection. ## What the trial did Participants had already been treated with tirzepatide or semaglutide in an earlier trial [\[1\]](https://thisglp.com/research/can-a-pill-keep-weight-off-after-the-injection#ref-1). They were then randomized to a daily orforglipron tablet or placebo for 52 weeks. Cohort 1 followed tirzepatide and had 205 people. Cohort 2 followed semaglutide and had 171. Share of the earlier weight reduction still held at week 52. | Prior injectable | Kept on the tablet | Kept on placebo | Difference | | --- | --- | --- | --- | | Tirzepatide | 74.7% | 49.2% | 25.5 points (95% CI 14.5 to 36.5) | | Semaglutide | 79.3% | 37.6% | 41.7 points (95% CI 24.4 to 59.0) | Share of the earlier weight reduction still held at week 52. ATTAIN-MAINTAIN, model-based estimates Read what the percentage is a share of 74.7% is not 74.7% of body weight. It is the share of the weight a person had already lost that they still held a year later. Someone who had lost 20% and kept 74.7% of it is about 15% below their starting weight. A page printing these as weight-loss figures is off by a factor of five. This site keeps that distinction in [the same percentage in different kilograms](https://thisglp.com/research/do-glp1-drugs-work-the-same-in-asian-patients). ## The comparison the trial did not run The authors name it themselves. There was no arm that continued the injectable. So the trial shows a tablet beats nothing. It does not show a tablet matches the injection you were already on. Those are different claims, and only the first is supported. The authors also state the second limit: the trial ran one year. What happens in year two is untested. ## What the placebo arms did Placebo held 49.2% of the earlier loss in cohort 1. In cohort 2 it held 37.6%. So roughly half the loss persisted with no drug at all after tirzepatide. That is the baseline the tablet has to beat. It also explains why the two cohorts differ so much. The tablet added 25.5 points after tirzepatide and 41.7 after semaglutide, because the placebo floors were not the same. The withdrawal evidence behind those floors is in [what happens when you stop tirzepatide](https://thisglp.com/research/what-happens-when-you-stop-tirzepatide). ## A different tablet, a different question Orforglipron is not oral semaglutide. They are separate molecules and the trials ask separate questions. Oral semaglutide 25 mg was tested from a standing start rather than as maintenance [\[2\]](https://thisglp.com/research/can-a-pill-keep-weight-off-after-the-injection#ref-2). Over 64 weeks weight fell 13.6% against 2.2% on placebo, a difference of 11.4 points with an interval from 13.9 to 9.0. Gastrointestinal adverse events ran 74.0% against 42.2%. That is what a tablet does when it is the treatment. ATTAIN-MAINTAIN asks what a tablet does after the treatment. The approval status of the oral route is in [the oral one is approved now](https://thisglp.com/research/does-the-glp1-pill-work-as-well-as-the-injection). What it costs is in [the fifty-milligram dose](https://thisglp.com/research/oral-semaglutide-fifty-milligrams). Neither trial priced anything. Orforglipron is not approved and not sold. ## Frequently asked Can a pill keep weight off after stopping the injection? It helped. A daily orforglipron tablet held 74.7% of earlier weight loss after tirzepatide and 79.3% after semaglutide, against 49.2% and 37.6% on placebo. Does 74.7% mean 74.7% of body weight? No. It is the share of the weight already lost that was still held a year later. Someone who had lost 20% and kept 74.7% of it is about 15% below their starting weight. Is the tablet as good as staying on the injection? The trial cannot say. Its authors list the absence of an arm that continued the injectable as a limitation, so the tablet was only ever compared against placebo. How much weight stays off with no drug at all? In this trial the placebo groups held 49.2% of the earlier loss after tirzepatide and 37.6% after semaglutide, over one year. Is this the same as oral semaglutide? No. Orforglipron is a different molecule. Oral semaglutide 25 mg was tested as a treatment from a standing start and produced 13.6% weight loss against 2.2% on placebo over 64 weeks. ## Sources 1. \[1\] Aronne LJ, Horn DB, le Roux CW, Chao AM, Ho W, Halpern B (2026). Orforglipron for maintenance of body weight reduction: the double-blind, randomized phase 3b ATTAIN-MAINTAIN trial Nature Medicine. [PMID 42120723](https://pubmed.ncbi.nlm.nih.gov/42120723/) 2. \[2\] Wharton S, Lingvay I, Bogdanski P, Duque do Vale R, Jacob S, Karlsson T (2025). Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity The New England Journal of Medicine. [PMID 40934115](https://pubmed.ncbi.nlm.nih.gov/40934115/) ## Where to get it ### Oral GLP-1, ranked Tablets, troches and capsules priced on the oral product itself — never on a number borrowed from the same seller's injection page. [Compare providers →](https://thisglp.com/best/oral-glp1) ## More in Evidence - [ 150 minutes · Weekly activity goal · 2 days · Muscle strengthening · Adapt · Symptoms and ability ### Exercise on Ozempic: Building Strength Without Ignoring Symptoms ](https://thisglp.com/research/exercise-on-ozempic) - [ STEP 1, semaglutide 2.4 mg vs placebo, % change at 68 weeks · LDL cholesterol · −2.5% vs +1.3% · Total cholesterol · −3.3% vs +0.1% · HDL cholesterol · +5.2% vs +1.4% · Triglycerides · −21.9% vs −7.3% · Wegovy label, Table 13. Adults without diabetes. Ozempic doses are lower. ### Does Ozempic Lower Cholesterol? What the Lipid Results in the Trials Show ](https://thisglp.com/research/does-ozempic-lower-cholesterol) - [ Where the insulin reduction came from, units per day · week 4 · 13.4 total · week 26 · 21.9 · the drug itself · the weight loss · The drug’s own contribution barely moved: 11.1 then 11.4. · Everything added between weeks 4 and 26 came from weight. ### Does Semaglutide Help Type 1 Diabetes? What Two Small Trials Found ](https://thisglp.com/research/semaglutide-in-type-1-diabetes)