Weight-loss pills
Two newer pills now work on the GLP-1 system: the Wegovy pill and Foundayo. Here is how they differ from each other, from the injections, and from older weight-loss pills.
Quick answer. The Wegovy pill is oral semaglutide, a peptide, made by Novo Nordisk. Foundayo is orforglipron, a , made by Eli Lilly. Both are once-daily tablets that switch on the receptor. They are different drugs, studied in different trials, and the Atlas does not have a head-to-head comparison.
The two newer pills side by side
| Compared item | Oral semaglutide for weight management (Wegovy pill) | Orforglipron tablets (Foundayo) |
|---|---|---|
| Generic name | Semaglutide | Orforglipron |
| Brand names | Wegovy pill (weight management), Rybelsus (type 2 diabetes) | Foundayo (weight management) |
| Medicine class | GLP-1 receptor agonist | GLP-1 receptor agonist (non-peptide pill) |
| Targets | GLP-1 | GLP-1 |
| How it is taken | Once daily. Per the label, the tablet is taken once a day in the morning on an empty stomach, with plain water (up to 4 ounces), and swallowed whole. The label says to wait at least 30 minutes before eating, drinking anything else or taking other oral medicines. | Once daily. Per the label, the tablet is taken once a day, with or without food, and swallowed whole. The label says not to break, crush or chew it. |
| U.S. status | FDA-approved for weight management. Approved in the U.S. for weight reduction in adults with obesity, or overweight plus a weight-related condition, and to lower cardiovascular risk in some adults. The tablet label does not include the injection's uses in children or for MASH. Used with diet and activity. Trade press dates the approval to December 2025. | FDA-approved for weight management. Approved in the U.S. for weight reduction in adults with obesity, or overweight plus at least one weight-related condition. Used with diet and activity. Trade press dates the approval to April 1, 2026. Type 2 diabetes is not recorded as an approved use here. |
| Trial figures | OASIS 4: −13.6% vs −2.2% placebo over 64 weeks. These figures come from weight-management studies, not from the diabetes products. | ATTAIN-1: −7.5%, −8.4%, −11.2% vs −2.1% placebo over 72 weeks. |
Not the same as Rybelsus
Rybelsus also contains oral semaglutide, but it is approved for type 2 diabetes. The Wegovy pill is a separate product approved for weight management. The same drug in a different product can have a different approved use, so check which product a prescription names.
Why the way you take it matters
Oral semaglutide is a peptide. The Wegovy label says the tablet is taken once a day in the morning on an empty stomach, with plain water, and that you wait at least 30 minutes before eating, drinking anything else or taking other oral medicines. Orforglipron is a small molecule, and the Foundayo label says the tablet can be taken with or without food. Always follow the current label and your prescriber, because instructions can differ by product.
Reading the pill numbers
The two pills were tested in different trials with different designs. OASIS 4 tested the Wegovy pill for 64 weeks. ATTAIN-1 tested orforglipron for 72 weeks. Their results sit side by side below because both are shown with the same scale, not because they are directly comparable.
What the pill trials found
OASIS 4
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 307 adults with obesity, or overweight plus at least one obesity-related complication, without diabetes (205 oral semaglutide, 102 placebo)
- Length
- 64 weeks
- Compared with
- Placebo once daily, with lifestyle support in both groups
- What was measured
- Estimated average change in body weight at week 64
- Analysis approach
- Not stated in the abstract. Check the full paper.
- Other results
- More people on oral semaglutide reached weight reductions of at least 5%, 10%, 15% and 20%. A trade-press report cites 16.6% vs 2.7% for time on treatment. That is a different analysis from the abstract's figures, so check which one a number comes from.
- Safety
- Gastrointestinal adverse events: 74.0% with oral semaglutide vs 42.2% with placebo.
- Limits
- A smaller trial than the injectable semaglutide program. Funded by the manufacturer.
Sources: Wharton S 2025, FDA approves Wegovy pill, the first oral GLP-1 to treat obesity
ATTAIN-1
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 3,127 adults with obesity, without diabetes
- Length
- 72 weeks
- Compared with
- Placebo once daily, with a healthy diet and physical activity in all groups
- What was measured
- Average change in body weight at week 72
- Analysis approach
- Treatment-regimen estimand in the intention-to-treat population: effects regardless of treatment discontinuation
- Other results
- In the highest-dose group, 54.6% lost at least 10% of body weight, 36.0% at least 15% and 18.4% at least 20%, versus 12.9%, 5.9% and 2.8% on placebo. The manufacturer's headline figure for the highest dose is larger because it counts only participants while they were taking the drug. Compare trials only on the same estimand.
- Safety
- Stopping treatment because of side effects: 5.3% to 10.3% across the three orforglipron groups vs 2.7% with placebo. The most common side effects were gastrointestinal and mostly mild to moderate.
- Limits
- Funded by Eli Lilly. Participants did not have diabetes. The tablet strengths used in the trial were named differently in later publications and do not all match the marketed strengths, so check the Foundayo label for what is sold. Group averages do not predict one person's result.
Sources: Wharton S 2025, ATTAIN-1 trial record (NCT05869903), Foundayo (orforglipron) tablets: prescribing information
Older weight-loss pills
These work differently from the GLP-1 pills and are older. Each has its own page.
| Medicine | Brand or other names | Type |
|---|---|---|
| Phentermine and topiramate | Qsymia | Appetite suppressant plus anticonvulsant combination |
| Naltrexone and bupropion | Contrave | Opioid antagonist plus antidepressant combination |
| Orlistat | Xenical, Alli | Lipase inhibitor |
| Phentermine | Adipex-P, Lomaira | Sympathomimetic appetite suppressant |
| Diethylpropion | Tenuate, diethylpropion hydrochloride | Sympathomimetic appetite suppressant |
Pills still in development
Zenagamtide, VK2735 are being developed in oral forms. They are investigational and are not approved products.
Questions to bring about pills
- Would a daily pill or a weekly injection fit my routine better?
- Does this pill need an empty stomach, or a wait before eating?
- What should I do if I miss a day?
- Is the product I am being offered FDA-approved, or compounded?
- How does my insurance treat the pill compared with an injection?
What is still unknown
- No head-to-head trial of the Wegovy pill and Foundayo is recorded in this atlas.
- Long-term results for both pills are shorter than for older injections.
- How much weight returns after stopping a pill is not yet well described.
- Real-world results can differ from trial results.
Approved versus compounded. The pills above are FDA-approved products, as far as this atlas has checked. A version is not the same thing.
Sources
- Oral semaglutide at a dose of 25 mg in adults with overweight or obesity (OASIS 4) Wharton S, et al. N Engl J Med. 2025;393(11):1077-1087. PMID 40934115. Funding: Novo Nordisk. Journal article
- FDA approves Wegovy pill, the first oral GLP-1 to treat obesity Healio. Trade press. Reports on-treatment OASIS 4 figures and how the pill is taken. Not the label. Trade press, secondary source
- Orforglipron, an oral small-molecule GLP-1 receptor agonist for obesity treatment (ATTAIN-1) Wharton S, et al. N Engl J Med. 2025;393(18):1796-1806. PMID 40960239. Funding: Eli Lilly. Journal article
- ATTAIN-1 trial record (NCT05869903) ClinicalTrials.gov identifier NCT05869903. Trial registry
- Foundayo (orforglipron) tablets: prescribing information Eli Lilly and Company, on DailyMed (U.S. National Library of Medicine). Label version 7/2026. Official FDA label on DailyMed
- Wegovy (semaglutide) injection and tablets: prescribing information Novo Nordisk, on DailyMed (U.S. National Library of Medicine). Label version 6/2026. One label covers both the injection and the tablets. Official FDA label on DailyMed
- FDA approves Novo Nordisk's Wegovy pill Pharmaceutical Commerce, December 2025. Trade press, secondary source
- DailyMed: current FDA drug labels U.S. National Library of Medicine. Regulator
- FDA approves orforglipron, an oral GLP-1 for adults with obesity Healio, April 1, 2026. Trade press, secondary source
Terms on this page
- compounded drug
- A medicine made or altered by a pharmacy for an individual patient. The FDA does not review compounded drugs for safety, effectiveness or quality before they are sold.
- GLP-1
- Glucagon-like peptide-1, a hormone released by the gut after eating. It helps signal fullness, slows how fast the stomach empties and raises insulin when blood sugar is high.
- small molecule
- A medicine built from a simple chemical structure rather than a chain of amino acids. Many pills are small molecules, which is part of how some can be taken by mouth.