A tiny implant inserted under the skin could someday replace the weekly injections that millions of Americans now use for obesity and diabetes treatment.

Vivani Medical, a clinical-stage biotechnology company in California, is developing a matchstick-sized implant that slowly releases semaglutide — the same active ingredient used in Novo Nordisk's blockbuster drugs Ozempic and Wegovy — for six months to a year before needing replacement. It could relieve one of the biggest weaknesses of today's GLP-1 medications: keeping patients on treatment long enough to maintain their weight loss.

Unlike current GLP-1 drugs, which require weekly injections—or daily pills in some cases—the implant would be inserted during a brief office procedure and provide a steady flow of medication beneath the skin.

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ConsumerNews.aiJames R. Hood

Tackling the dropout problem

The promise comes at a time when obesity specialists are increasingly concerned about patients sticking to their injection regimen.

Studies have consistently found that many people discontinue GLP-1 medications within the first year. The reasons vary:

• Monthly costs that can exceed $1,000 without insurance.
• Gastrointestinal side effects such as nausea and vomiting.
• Frustration with weekly injections.
• Insurance coverage changes.
• Drug shortages.
• Weight regain after stopping treatment.

Once patients discontinue therapy, many regain a significant portion of the weight they lost, reinforcing the growing consensus among obesity specialists that the medications often need to be taken long term.

Vivani argues that a long-acting implant could remove several of those barriers by eliminating weekly injections and providing a more consistent drug level than periodic shots. A steady release may also reduce the medication peaks and valleys that can contribute to side effects, although that has not yet been demonstrated in large clinical trials, according to a trade publication.

GLP-1 Reality Check

Why do so many patients stop treatment?

According to obesity specialists and published research, the biggest reasons include:

• High out-of-pocket costs
• Insurance denials or loss of coverage
• Gastrointestinal side effects
• Weekly injection fatigue
• Drug shortages
• Believing treatment is only temporary
• Weight regain after discontinuing therapy

Consumer takeaway: If you're considering stopping a GLP-1 medication, talk with your physician first. Abruptly discontinuing treatment can lead to substantial weight regain, and there may be alternative dosing strategies or lower-cost options available depending on your insurance coverage and medical history.

Still an experimental technology

Consumers shouldn't expect the implant anytime soon.

The company's semaglutide implant program is only beginning Phase 1 clinical testing in Australia this year, with larger Phase 2 studies planned afterward if early safety results are positive. U.S. FDA approval would likely remain several years away even under an optimistic timeline.

Vivani previously completed an early human study using a different GLP-1 drug, exenatide, demonstrating that the implant could be inserted safely and release medication over several months. Those results encouraged the company to move forward with semaglutide, which has become the dominant medication in the weight-loss market.

A crowded race

The implant reflects the pharmaceutical industry's broader effort to make GLP-1 treatment easier.

Drug manufacturers are working on:

• Monthly injections.
• Oral GLP-1 pills.
• Longer-acting injectable formulations.
• Combination obesity drugs.
• New maintenance therapies designed to help patients preserve weight loss after initial treatment.

If successful, implants could become another option—particularly for patients who respond well to GLP-1 therapy but struggle with adherence.

Consumer questions remain

The technology also raises practical questions consumers will eventually face:

• Will insurers cover implantation procedures?
• How much will the device cost?
• Can it be easily removed if side effects develop?
• How often will replacements be needed?
• Will patients still need regular physician monitoring?

Those questions likely won't be answered until much later-stage clinical trials.

Why it matters

GLP-1 medications have transformed obesity treatment, but their long-term success depends heavily on patients staying on therapy.

If implants can safely improve adherence, they could help patients maintain weight loss while reducing complications linked to obesity, including Type 2 diabetes, heart disease and sleep apnea. But for now, the technology remains an intriguing possibility rather than an imminent consumer option.