Octane Aesthetics Tech Forum Panelists React to FDA Approval of Oral Semaglutide

At the 2026 Octane Aesthetics Tech Forum, panelists weighed in on the recent FDA approval of oral semaglutide, offering a mix of cautious optimism and clinical realism. While the approval marks a milestone in expanding GLP-1 receptor agonist (RA) access, most experts on the panel said oral versions are unlikely to rival the transformative impact of weekly injectable formulations, at least for now.

“We have had [oral semaglutide] and they were not transformative like the weekly injection,” said Jennifer Pearlman, MD, a regenerative aesthetic specialist from Toronto, Ontario, Canada. “… I think it is going to supplement. I think it is going to [interest] some people that maybe were just hesitant.”

Panelists agreed that the convenience of once-weekly injections remains a strong advantage in adherence and clinical outcomes. However, some believe that oral options may help reduce entry barriers for patients new to GLP-1 RA therapies.

“Maybe it will be the gateway to the point around, ‘Oh, I can take a pill, but it's not working well now. I guess I'll try the injection,’” Johnny Franco, MD, FACS, of Austin Plastic Surgery, said.

Dr. Pearlman noted the possibility that oral semaglutide could offer different therapeutic advantages due to its gastrointestinal route of delivery.

“We know [GLP-1 RA] has gut direct effects and probably has different biologic effects when taken orally versus systemically,” Dr. Pearlman said. “It would be interesting to see… sometimes you want to actually harness those differences and prescribe it differently for different patients.”

Rather than debating injectable vs oral, several panelists emphasized the importance of personalizing therapy. Dr. Pearlman described her strategy for "ultra microdosing" and "creative protocols" to help patients find what she called their "destination dose."

“It is not about discontinuation, but finding a destination dose,” she said. “That can be done creatively, like I already said, with creative schedules.”

The panel also addressed common misconceptions that GLP-1 RAs must eventually be stopped. Dr. Arash Moradzadeh pushed back on that idea, highlighting the broader health benefits.

“Why get them off?” Dr. Moradzadeh said. “Why not go to a lower dose and stay there? Because there are way too many other health benefits. It is much better than being on statins and being on cardiovascular medications. Being on GLP-1 is a lot safer.”

Dr. Franco added that continued innovation in GLP-1 RA class medications, including oral forms, is only just beginning.

“We're just scratching the surface, right? The oral medications got FDA approved. There are more medications coming,” he said. “I think we were talking earlier… over a hundred medications in clinical trials now.

“People tell me, ‘Oh, I missed the boat or I missed this train.’ We're just at the tip of this iceberg.”