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  • Wegovy injections vs. pills: Doctors explain the differences

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    Wegovy injections vs. pills: Doctors explain the differences

    When it comes to GLP-1 pills vs. injections, doctors share which form may be best for you.

    Updated: 3:01 PM PST Jan 15, 2026

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    GLP-1 (glucagon-like peptide-1 receptor agonists) like Ozempic and Wegovy continue to make headlines as more research points to the benefits of taking these medications. Traditionally, patients administer these via injection, but now, one medication in particular is available to take in pill form. So, which works best: Wegovy injection vs. pill? And is the answer the same for all GLP-1s?First, GLP-1s are a class of drugs that mimic the GLP-1 hormone that’s naturally released in your GI tract when you eat, explains Mir Ali, M.D., medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. These medications help to moderate blood sugar levels, reduce feelings of hunger in the brain, and delay emptying in the stomach, making you feel fuller, longer. As a result, a side effect is weight loss. There are some buzzy GLP-1 medications that have become household names, like Wegovy and Ozempic, but there are also other options you may not have heard about.Ultimately, the best GLP-1 medication is one that you and your healthcare provider agree will best serve your needs. But learning more about the medication you intend to use can’t hurt. Here, find the major differences between GLP-1 injections and pills.There are a lot of medications that fall into the GLP-1 class, including injectable drugs and pills. Some popular ones include Ozempic, Rybelsus, and Wegovy.It’s worth noting that Wegovy (the main active ingredient of which is semaglutide) is the only GLP-1 pill that’s approved for weight loss by the U.S. Food and Drug Administration (FDA). While Rybelsus is sometimes used off-label for weight loss, it’s technically FDA-approved for blood sugar management in people with type 2 diabetes (the same goes for Ozempic). So, keep in mind that the information ahead speaks primarily to Wegovy.Wegovy injection vs. pill: How does each work? GLP-1 injectable medications are usually injected into the belly. “GLP-1 injections deliver the medication into the subcutaneous fat, where it is slowly absorbed,” explains Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. “These drugs have a long half-life, about five to seven days, which is why they only need to be taken once a week.”After they’re injected, the medication steadily enters the bloodstream and activates the GLP-1 receptor, Dr. Buettner explains. Once it’s in your body, the medication signals to your brain to take in less food, says Martin Binks, Ph.D., professor and chair of the Department of Nutrition and Food Studies at George Mason University College of Public Health. “They also help delay stomach emptying, which ultimately improves satiety and reduces hunger,” he says. “The combined influences of these medicines regulate metabolism and appetite.”The GLP-1 pills work similarly, but these contain a higher dose of medication to compensate for absorption into the digestive tract, Dr. Binks says. (The injectable medications have lower doses of medication because they’re slowly released into the bloodstream and bypass the gastrointestinal tract, Dr. Ali explains.)These medications are taken by mouth once a day. They usually need to be taken on an empty stomach, and you can’t eat or take most other medications for up to an hour afterward, Dr. Buettner points out. “These requirements can be inconvenient for many patients,” he says.Which is most effective for weight loss?It depends. There have been a few clinical trials on the impact of GLP-1 injectable medications on weight loss with different results. However, People usually lose about 15% of their body weight while using semaglutide medications like Wegovy.Meanwhile, during clinical trials for the Wegovy oral route, people who took the pill lost about 16.6% of their body weight. (That’s compared to 3% weight loss achieved by people who used a placebo.)While Rybelsus isn’t FDA-approved for weight loss, people typically lose around eight pounds while taking this medication.Which works best?There are a few things to consider. “Both injectables and pill forms can be helpful,” says Dina Hagigeorges, PA.-C., a physician assistant who specializes in weight and wellness at Tufts Medicine Weight + Wellness – Stoneham. “Unfortunately, cost and insurance coverage are a huge deciding factor, as not all insurance plans cover these medications for people.” When paid for out of pocket, injectable GLP-1 medications are usually much more expensive than their oral counterparts.There’s a larger body of research to support injectable medications for weight loss, although the Wegovy pill shows promise, Dr. Ali says. “If someone can tolerate injections, it’s usually the better way to go—they’re taken less frequently,” he says. But these medications aren’t a good fit for people who are scared of needles, and they have to be refrigerated, Dr. Ali points out.“The pills are a good option for people who don’t like injections, and you can easily take them with you when you travel,” Dr. Ali says. “But they have to be taken daily, which is not for everyone.”Side effectsThe side effects are similar for both medications, Dr. Buettner says.These side effects may include:NauseaVomitingDiarrheaConstipationUpset Stomach “The most important thing is choosing a medication that you can use consistently and that aligns with your personal priorities—whether that’s maximum weight loss, convenience, avoiding injections, or simplifying your routine,” he says. “Many patients try one form first and later switch based on their experience.”So, talk to your healthcare provider and keep the line of conversation open. You may find one form of GLP-1 feels like a more natural fit over another.

    GLP-1 (glucagon-like peptide-1 receptor agonists) like Ozempic and Wegovy continue to make headlines as more research points to the benefits of taking these medications. Traditionally, patients administer these via injection, but now, one medication in particular is available to take in pill form. So, which works best: Wegovy injection vs. pill? And is the answer the same for all GLP-1s?

    First, GLP-1s are a class of drugs that mimic the GLP-1 hormone that’s naturally released in your GI tract when you eat, explains Mir Ali, M.D., medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. These medications help to moderate blood sugar levels, reduce feelings of hunger in the brain, and delay emptying in the stomach, making you feel fuller, longer. As a result, a side effect is weight loss.

    There are some buzzy GLP-1 medications that have become household names, like Wegovy and Ozempic, but there are also other options you may not have heard about.

    Ultimately, the best GLP-1 medication is one that you and your healthcare provider agree will best serve your needs. But learning more about the medication you intend to use can’t hurt. Here, find the major differences between GLP-1 injections and pills.

    There are a lot of medications that fall into the GLP-1 class, including injectable drugs and pills. Some popular ones include Ozempic, Rybelsus, and Wegovy.

    It’s worth noting that Wegovy (the main active ingredient of which is semaglutide) is the only GLP-1 pill that’s approved for weight loss by the U.S. Food and Drug Administration (FDA). While Rybelsus is sometimes used off-label for weight loss, it’s technically FDA-approved for blood sugar management in people with type 2 diabetes (the same goes for Ozempic). So, keep in mind that the information ahead speaks primarily to Wegovy.

    Wegovy injection vs. pill: How does each work?

    GLP-1 injectable medications are usually injected into the belly. “GLP-1 injections deliver the medication into the subcutaneous fat, where it is slowly absorbed,” explains Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. “These drugs have a long half-life, about five to seven days, which is why they only need to be taken once a week.”

    After they’re injected, the medication steadily enters the bloodstream and activates the GLP-1 receptor, Dr. Buettner explains. Once it’s in your body, the medication signals to your brain to take in less food, says Martin Binks, Ph.D., professor and chair of the Department of Nutrition and Food Studies at George Mason University College of Public Health. “They also help delay stomach emptying, which ultimately improves satiety and reduces hunger,” he says. “The combined influences of these medicines regulate metabolism and appetite.”

    The GLP-1 pills work similarly, but these contain a higher dose of medication to compensate for absorption into the digestive tract, Dr. Binks says. (The injectable medications have lower doses of medication because they’re slowly released into the bloodstream and bypass the gastrointestinal tract, Dr. Ali explains.)

    These medications are taken by mouth once a day. They usually need to be taken on an empty stomach, and you can’t eat or take most other medications for up to an hour afterward, Dr. Buettner points out. “These requirements can be inconvenient for many patients,” he says.

    Which is most effective for weight loss?

    It depends. There have been a few clinical trials on the impact of GLP-1 injectable medications on weight loss with different results. However, People usually lose about 15% of their body weight while using semaglutide medications like Wegovy.

    Meanwhile, during clinical trials for the Wegovy oral route, people who took the pill lost about 16.6% of their body weight. (That’s compared to 3% weight loss achieved by people who used a placebo.)

    While Rybelsus isn’t FDA-approved for weight loss, people typically lose around eight pounds while taking this medication.

    Which works best?

    There are a few things to consider. “Both injectables and pill forms can be helpful,” says Dina Hagigeorges, PA.-C., a physician assistant who specializes in weight and wellness at Tufts Medicine Weight + Wellness – Stoneham. “Unfortunately, cost and insurance coverage are a huge deciding factor, as not all insurance plans cover these medications for people.” When paid for out of pocket, injectable GLP-1 medications are usually much more expensive than their oral counterparts.

    There’s a larger body of research to support injectable medications for weight loss, although the Wegovy pill shows promise, Dr. Ali says. “If someone can tolerate injections, it’s usually the better way to go—they’re taken less frequently,” he says. But these medications aren’t a good fit for people who are scared of needles, and they have to be refrigerated, Dr. Ali points out.

    “The pills are a good option for people who don’t like injections, and you can easily take them with you when you travel,” Dr. Ali says. “But they have to be taken daily, which is not for everyone.”

    Side effects

    The side effects are similar for both medications, Dr. Buettner says.

    These side effects may include:

    • Nausea
    • Vomiting
    • Diarrhea
    • Constipation
    • Upset Stomach

    “The most important thing is choosing a medication that you can use consistently and that aligns with your personal priorities—whether that’s maximum weight loss, convenience, avoiding injections, or simplifying your routine,” he says. “Many patients try one form first and later switch based on their experience.”

    So, talk to your healthcare provider and keep the line of conversation open. You may find one form of GLP-1 feels like a more natural fit over another.

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  • Opinion: ‘Just say no’ can kill kids. Teach them how to stay safe in the fentanyl era

    Opinion: ‘Just say no’ can kill kids. Teach them how to stay safe in the fentanyl era

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    Melanie Ramos was only 15 years old when she died of a suspected overdose in a high school bathroom in Hollywood. Police reported that she and a friend had purchased pills they thought were prescription painkillers but which were likely fakes containing fentanyl, a potent opioid incorporated into counterfeit pills widely available in the illicit drug market.

    Fentanyl has caused such overdoses to rise sharply despite declining drug use among young people. Recent data suggest it kills an average of 22 teens every week around the nation. Tragic stories like Melanie’s are playing out across the country — and at an unprecedented rate. In a new analysis in the New England Journal of Medicine, we found that fatal overdoses among U.S. teens aged 14-18 hit an all-time high in 2022.

    Melanie was one of 111 teens who died between 2020 and 2022 in L.A. County, a hot spot where overdoses have spiked. We found hot spot counties across the U.S., but Southern California was uniquely hard hit. Of the 19 such counties we identified nationwide, six were in this region: Los Angeles, Orange (61 deaths), San Bernardino (55), Riverside (41), San Diego (36) and Kern (30).

    There are signs that teen overdoses in California dropped from 2021 to 2022, but this trend is still new, and hot spots can still occur anywhere — often unexpectedly. Every corner of America should be prepared.

    Overdose deaths are preventable. However, reducing teen overdoses requires a dramatic shift in drug-prevention programming: It needs to emphasize safety rather than abstinence alone.

    Drug use by teens is becoming more deadly, not more common. From 2002 to 2022, the share of high school seniors who had ever used illicit drugs declined from 21% to 8%. Teen drug use overall is at its lowest rate in decades. But fentanyl, which is found not only in counterfeit pills but also as a contaminant in other drugs, puts teens at unprecedented risk. Nearly two-thirds of teens who die from fentanyl have no known prior opioid use, a reminder that even first-time or infrequent exposure can be deadly.

    Drug prevention has long focused on keeping teens from trying drugs, which is a worthy goal. But it has lacked messaging for teens who do use and may end up in danger as a result. Teachers, parents, medical practitioners and others who provide drug prevention counseling should clearly communicate that any pill not prescribed by a physician or dispensed by a pharmacy has a significant chance of being a counterfeit containing a potentially lethal amount of fentanyl.

    This does not mean using scare tactics, which have been shown to backfire. As modeled by programs such as Safety First, available through Stanford, this approach should instead tap into teens’ desire to keep themselves and their peers safe and give them strategies to do so.

    These strategies include never using alone (so someone is available to intervene in an overdose), starting with a small amount of a drug (e.g., a quarter pill rather than a whole pill) to assess its potency, and avoiding mixing pills with alcohol and other sedating substances.

    Programming should also help teens recognize the signs of an overdose and teach them how to respond — by calling 911 and providing the nasal spray naloxone (Narcan) if it’s available. Schools should have naloxone on the premises — as has been the case in the L.A. Unified School District since late 2022, following Melanie Ramos’ death — and help teens understand how to access it on and off campus. Narcan recently became available over the counter, and teens can obtain it at pharmacies or get a doctor’s prescription for it.

    Teens who seek out pills to address depression, anxiety, trauma or other mental health concerns additionally need referrals to evidence-based mental health treatment such as counseling and, when appropriate, medications — which should be distinguished from the counterfeit pills widely available on the illicit market.

    There are some young people who might intentionally seek fentanyl, including the 1 in every 100 U.S. teens who has an opioid addiction. Keeping these adolescents safe requires educating them and their peers on how to recognize signs of addiction, where to receive care and the effectiveness of buprenorphine, a lifesaving but underused treatment for opioid misuse. Given the urgent need to intervene early, schools, families and doctors should be aware of local treatment programs and refer teens to them; the federal government maintains a searchable directory.

    Emphasizing safety in drug use messaging to young people will encounter opposition from policymakers and others, as it means confronting the uncomfortable reality that some teens use drugs. However, research indicates that teaching safety does not cause teens to use more drugs. Drug-prevention programming can still tell teens they shouldn’t use substances while equipping them with the tools to protect themselves if they do. Teens need this knowledge before more young lives are tragically lost.

    Scott Hadland (@DrScottHadland) is the chief of adolescent medicine at Mass General for Children and an associate professor of pediatrics at Harvard Medical School. Joseph Friedman (@JosephRFriedman) is a substance-use researcher at UCLA.



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    Scott Hadland and Joseph Friedman

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  • beguiled unaided fermented

    beguiled unaided fermented

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    Have you taken the VHS pill yet? A few years ago I started collecting VHS tapes as kind of a joke. But then I realized you can snag CRT TV’s for next to nothing, if not free on marketplace. Next thing I know I am watching Raiders of the lost ark on a luxury 90s media setup with over 700 more classic titles. My wife and I do weekly movie nights now and the kids are watching magic school bus. N64, pS1, movies, all look better on the native hardware. Take the VHS pill and join us in the last good era the world knew.

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  • Are You Sure You Want an Ozempic Pill?

    Are You Sure You Want an Ozempic Pill?

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    Within the first five seconds of a recent Ozempic commercial, a sky-blue injector pen tumbles toward the viewer, encircled by a big red O. Obesity drugs have become so closely associated with injections that the two are virtually synonymous. Like Ozempic, whose name is now a catchall term for obesity drugs, Wegovy and Zepbound come packaged in Sharpie-like injection pens that patients self-administer once a week. Patients “don’t come in asking for Wegovy,” Laura Davisson, a professor of medical weight management at West Virginia University, told me. “They come in asking for one of ‘those injectables.’”

    Needles are the present, but supposedly not the future. Nobody really likes injections, and taking a pill would be far easier. In the frenzy over obesity drugs, a class known as GLP-1 agonists, drugmakers have raced to create them in pill form, and Wall Street investors are hungry at the prospect. Earlier this year, Pfizer’s CEO, Albert Bourla, estimated that obesity pills could be worth $30 billion, or a third of the total obesity-drug market. Because people have a “preference” for pills, he said at a conference, they will be what ultimately “unlocks the market” for obesity medications. By one count, at least 32 oral GLP-1 drugs, from many different companies, are in the works.

    But a future dominated by obesity pills is hardly certain. So far, the only oral GLP-1 that exists is a pill for diabetes called Rybelsus. Like Ozempic and Wegovy, its active ingredient is a compound called semaglutide, but the shots come in far more powerful doses, making it possible to lose even more weight. Developing oral obesity drugs that are as tolerable and effective as their injectable counterparts has so far been a challenge. Earlier this month, Pfizer stopped testing one of its pill candidates, citing concerns about side effects and patient adherence. Even when pills do come to market, doctors told me, there’s no guarantee that people will flock to them.

    That drugmakers view the injectable nature of GLP-1s as one of their biggest flaws is no surprise. Getting a shot is a broadly despised experience, something people generally tolerate rather than choose. Children get stickers for enduring immunizations; adults who get vaccinated do so only because they must (and they are often rewarded with stickers too). The CDC estimates that one in four adults, and two out of three children, have strong fears about needles. “Some people hate needles, plain and simple,” Ted Kyle, an obesity-policy expert, told me.

    But not all needles are made equal. Wegovy and Zepbound are injected subcutaneously, or just under the skin. Relative to COVID or flu shots, which are jabbed into muscle, they don’t cause much discomfort. “I’ve been really surprised at how receptive my patients have been to using injectable medications,” Davisson said. Other doctors I spoke with agreed. “More patients than you would expect really don’t mind injectables,” because they’re easy and relatively painless to administer, Katherine Saunders, a clinical-medicine professor at Weill Cornell Medicine, told me.

    The unobtrusive dosing schedule of the injectables adds to their appeal. Wegovy and Zepbound are administered once weekly, unlike many of the pills in development, which are meant to be taken once or more daily. That can be a hassle, especially if they have to be taken at the same time every day, or if they come with restrictions on eating or drinking. “For some people, it’s easier to take an injection and forget about it for a week” than to remember to take a pill every day, Eduardo Grunvald, an obesity-medicine physician at UC San Diego Health, told me. Assuming pills are preferable to shots is a “knee-jerk reaction,” he added.

    Despite the unexpected upsides of the shots, they’re far from perfect. Making injectable pens is generally more expensive than pills and requires a lot of hardware, including the pen casing, cap, and needle cover. On top of that, the injectable obesity drugs must be refrigerated before they are first used, adding to storage and production costs. Pills are generally shelf-stable and don’t require much packaging beyond a child-proof bottle. Saunders predicts they would be less expensive and less prone to shortages that have plagued Wegovy.

    Still, creating an obesity pill isn’t as simple as packaging the same drugs in capsule form. Drugmakers have already run into a number of issues. Absorption is a big one: Because pills pass through the stomach before entering the bloodstream, they must be able to withstand a large degree of degradation. One way to get these drugs to lead to greater weight loss is to increase the dose. While the highest dose of Wegovy is 2.4 milligrams, Rybelsus maxes out at 14 milligrams.

    Hiking up the dose seems to work, though doing so could have consequences beyond weight loss. All GLP-1 drugs come with a range of unpleasant side effects involving the gastrointestinal system, and patients report nausea at similar rates in Rybelsus and Ozempic, according to the FDA. But this may differ in practice, as other doctors have noted. Saunders said that her patients on oral semaglutide report more nausea than those using injectables. Regardless, newer oral medications may have even more distinct differences, as drugmakers race to create more potent pills. In Pfizer’s discontinued trial of danuglipron, nausea rates reached up to 73 percent.

    Drugmakers also skirt the issue of degradation by pursuing sturdier drugs. The problem with semaglutide is that it’s a peptide—essentially a small protein—precisely the kind of molecule that the stomach excels at digesting. Some new drugs in the pipeline are so-called non-peptide small molecules, which are sturdier but still have the same biological effect. Orforglipron, a pill that Eli Lilly is testing, falls into this category, as does danuglipron, the drug responsible for Pfizer’s recent setbacks. Small-molecule drugs have the added benefit of being cheaper to produce at scale than peptides, Kyle, the obesity-policy expert, added.

    Another pesky problem with oral drugs is that they tend to come with strict dosing requirements. People on Rybelsus, for example, are instructed to take it 30 minutes before eating or drinking anything and can drink only four ounces of plain water along with it, because otherwise absorption could be compromised. “It can be a nuisance,” Grunvald said. Similarly bothersome instructions likely played a part in the drop-out rates reaching more than 50 percent in Pfizer’s recently discontinued trial: Danuglipron had to be taken twice daily. “A lot of people found it not worth the trouble,” Kyle said, noting that Pfizer is still pursuing a once-daily version of the same drug. A recent review of GLP-1 drugs showed that, compared with the injectable form, oral semaglutide is associated with lower rates of side-effect reporting but higher discontinuation rates, potentially reflecting its bothersome dosage requirements.

    Despite these hurdles, it seems inevitable that obesity-drug pills will eventually become available. Novo Nordisk is expected to file for FDA approval for its high-dose semaglutide obesity pill this year; Pfizer is forging ahead with a once-daily version of danuglipron, with more data expected “in the first half of 2024,” a spokesperson told me. A report from BMO Equity Research published in September predicted that oral formulations could be approved “by the late 2020s.” The biggest upside to pills may not be that they are pills but that they will, eventually, be cheaper than injectables—and cost is among the biggest impediments to more people taking obesity drugs.

    Whether they’ll replace injectables outright is far from certain. “It will come down to patient preference,” Grunvald said. Most likely, pills and injections will coexist to meet different needs, and perhaps even be used together to treat individual patients. In the so-called phased approach, obesity treatment could start with more expensive and powerful injectable drugs, then transition to less potent but cheaper orals for the long term. Eli Lilly, for one, sees its oral candidate, orforglipron, as a potential weight-loss-maintenance drug.

    There is so much competition in the obesity-drug space that future medications may take more unexpected forms. Amgen is studying a once-monthly injection; Novo Nordisk is developing a hydrogel form of semaglutide that would need to be taken only three times a year. If the future of obesity drugs will come down to what patients prefer, then the more options, the better.

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    Yasmin Tayag

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  • Jon Block Hosts Red Pill XP Retreat in San Diego – World News Report – Medical Marijuana Program Connection

    Jon Block Hosts Red Pill XP Retreat in San Diego – World News Report – Medical Marijuana Program Connection

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    Jon Block

    The Red Pill events are a great way to help entrepreneurs free themselves from the harmful belief systems that permeate their lives and keep them from their greatest achievements.”

    — Jon Block

    SAN DIEGO, CA, UNITED STATES, June 19, 2023/EINPresswire.com/ — HealthPreneur Jon Block recently hosted his Red Pill XP Retreat in San Diego. This three day event occurred May 19th-May 21st, 2023. The event is a health & business retreat designed to empower HealthPreneurs liberating others from the matrices of our planet. The HeathPreneurs are the Jedi of our galaxy. The ones who spread light across the 5 dimensions of health: mental, emotional, physical, spiritual, and social.

    Jon brings togethers leaders and empowers them to enter industries and communities to spread far greater health, wealth, and sovereignty through the power of leading their OWN retreats and communities. His events are a mixture of activities designed to awaken & unify attendees.. They experience sound healing, Reiki, yoga, Qigong meditation and movements, and more. Jon loves working with “Disruptor-preneurs” that do not accept the status quo and are looking to gain enlightenment through alternative teachings. The event was held in an upscale home in San Diego to create greater intimacy and connection than would be found in hotel ballroom seminars. Jon personally chooses each location to be conducive to human connection and warmth in order to encourage…

    Original Author Link click here to read complete story..

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    MMP News Author

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  • No One in Movies Knows How to Swallow a Pill

    No One in Movies Knows How to Swallow a Pill

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    There are two ways of taking pills—two and only two.

    You pinch the pill between your thumb and index finger, pick it up, and place it on your tongue. You take a drink of water. This method is the tweezers.

    Or else: You place the pill in your palm and launch it toward your mouth, as if your teeth were battlements and your arm a siege machine. Don’t bother with the water. This method is the catapult.

    In real-world situations, many people—let’s say most—make a habit of the tweezers. In the movies, the opposite is true. An on-screen pill bottle works like Chekhov’s gun: Eventually, its contents will be fired at an actor’s mouth, or smashed between his lips, or hurled into his gullet.

    Think of Austin Butler as the lead in Elvis, alone in his hotel room: He slaps those quaaludes in, liquid-free, sideburns tilted toward the ceiling. It’s a textbook movie swallow, the Stanislavski Fling. Butler got an Oscar nomination; so did Ellen Burstyn, popping diet pills in Requiem for a Dream. On Succession, Jeremy Strong and Kieran Culkin, each a two-time Emmy nominee, gobble meds on-screen. Going catapult is everywhere in cinema; it’s a gesture that befits the biggest stars. Angelina Jolie shoots her pills in Girl, Interrupted. So does Brittany Murphy. Jake Gyllenhaal catapults a pill in Donnie Darko. Albert Brooks in Modern Romance. In Goodfellas, Ray Liotta does it twice.

    Read: Elvis is utterly disappointing. That’s the point.

    I love the movies! But it’s time we had a public-health announcement: The catapult is not, in fact, how a person should be taking pills. The act of swallowing a medication is so pervasive—and so intimate—that one easily forgets it is a skill that must be learned. In the U.S., roughly three-fifths of all adults are on prescription drugs; perhaps one-sixth will falter when they try to gulp it down. Twenty years ago, Bonnie Kaplan, a research psychologist at the University of Calgary, devised a new technique for helping people overcome this problem. Her method, as laid out in a mesmerizing video, suggests that you turn your head to make a pill go in. (No one has ever done this in a movie and no one ever will.) The turning motion helps open your upper esophageal sphincter, Kaplan says, though she does admit that more familiar postures have their own advantages. Some people like to raise their chins: “They say it is easier for the pill to slide down their throat, as if their tongue is a ski jump and it is a straight shot down the hill.” Others tip their heads the other way, chin-to-chest, “because they say it is more relaxing in the neck.”

    But on the all-important matter of the hand, Kaplan’s messaging is very clear: You pick up the pill between your fingers; then you place it on your tongue. Which is to say, you do the tweezers. Other training methods are consistent with this rule. One approach for teaching children, published in 1984, describes “correctly placing” a pill on the back of the tongue—which clearly cannot be accomplished via a whole-hand toss; another, from 2006, says to “place the pill on your tongue towards the back of your mouth.”

    That’s how people ought to take their pills. But how do people really do it, in real life? At the start of her research, Kaplan told me, she wasn’t telling takers what to do; she spent time observing how they liked to swallow medications on their own. The cinematic catapult was simply nonexistent in the wild, she said. “I never saw anyone just throw it back.” Never? Anyone? I asked Kaplan to describe the way she swallows pills herself, and she paused before she answered, as if she’d never really thought this through. “My husband and I both turn our heads to the right,” she said at last. First she’ll place the pill on the back of her tongue, and then she’ll twist and swallow. “But you know what?” she said. “I do often clap my hand to my mouth with my last pill or two.”

    “It’s very individual,” Cindy Corbett, a nursing-science professor at the University of South Carolina, told me. She’s on a team that uses smartwatch accelerometers to track patients’ adherence to their medication regimen. Their system knows when someone moves a hand up to their face, she told me, but it won’t distinguish how a pill is being held, or whether it is placed or flung into the mouth. (Indeed, the study’s four-step “protocol-guided medication-taking activity” includes this ambivalent instruction: “Place/toss pill to mouth.”) When I asked Corbett what she’s seen herself in this regard, as a clinician, she drew a blank. “I’ve never thought about it that much.”

    Read: What happens to a pill after you pop it?

    Maybe this is it: If you even have to think about the way you swallow pills, then you’re almost certainly someone who has trouble taking pills; and if you’re someone who has trouble taking pills, then you really should be taking pills in tweezer mode. In the off-screen world, to catapult is a privilege reserved for those with floppy throats. It’s the difference between the gags and the gag-nots. That inequality is only reinforced by the movieland fantasy of universal tossing, which sets up (as only Hollywood knows how) an impossible and unhealthy standard for behavior. Look, Elvis gobbles benzos; why can’t I? “People’s preconceived notions of how they’re supposed to swallow pills does lead to mental barriers,” says Marissa Harkness, a co-creator of the Pill Skills training kit, a case of sugar-based placebos made in different shapes and sizes.

    When actors catapult on camera, they get the benefit of looking more dramatic: bigger gestures, more to see. But something more important is going on in movie swallows, a deeper meaning to the movement—an implied relationship of power. Taking pills by catapult suggests that you’re a victim, that your body and your mind are under siege. A hand that’s driven by compulsion fires drugs into the face. A teenage boy is pelted by his Prozac. But some stories need to have this flipped, so the pill can be a tool instead of an affliction. In Taxi Driver, Robert De Niro tweezers bennies. He’s a man on a mission. And the most famous pill-taking scene in movie history, from The Matrix, has Keanu Reeves pinch a pill between his thumb and index fingers in dramatic close-up, and deposit it into his mouth. Then he drinks a glass of water. (Is that a movie first?) A character who tweezers is going on a journey, the film director John Magary told me. He’s curious. He’s in control. (From Magary’s films to date: two catapults, zero tweezers.)

    Perhaps the movies have this figured out. There are two ways of taking pills—two and only two. The tweezers or the catapult; self-knowledge or oblivion. In the end, the choice is yours.

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    Daniel Engber

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