The Wegovy pill vs Foundayo: which oral GLP-1 medication is better for weight loss?

Jump to: At-a-glance comparison | What each medication is | Peptide vs small molecule | Average weight loss in trials | Why each pill gets quoted at two different figures | How many people reach 10%, 15%, and 20% | Side effects compared | The fasting rule and what it means in practice | UK availability and who’s eligible | How the costs compare | Which oral GLP-1 might suit you | Frequently asked questions | Take home message

The Wegovy pill produces more weight loss than Foundayo in randomised controlled trials, with an average of 13.6% over 64 weeks compared with 11.2% over 72 weeks for Foundayo at the highest tested dose.^1,2

Both oral weight-loss medications are now licensed in the UK. The MHRA approved the Wegovy pill on 11th June 2026, and Foundayo on 10th August 2026.^3,4

The Wegovy pill is available now, and you can pre-order Foundayo through Second Nature if you meet the eligibility criteria; your medication will be sent out once it goes on sale.

The Wegovy pill has to be taken first thing on an empty stomach, with no more than 120 ml of water, then nothing else to eat or drink for 30 minutes.⁵

If that routine isn’t followed, less of the drug is absorbed, and the pill produces less weight loss.⁵

Foundayo can be taken at any time of day, with or without food.⁶

At-a-glance comparison

What each medication is

The Wegovy pill is a once-a-day tablet of semaglutide (up to 25 mg), made by Novo Nordisk.

It uses the same drug as injectable Wegovy and as Rybelsus (oral semaglutide for type 2 diabetes), but at a higher dose licensed for weight loss.⁵

Foundayo is the brand name for orforglipron, a once-a-day tablet made by Eli Lilly. The U.S. FDA approved it on 1st April 2026, and the UK’s MHRA followed on 10th August 2026.^4,6

Both medications mimic the gut hormone GLP-1, which signals fullness, slows digestion, and quiets the constant intrusive thoughts about food that many people describe as ‘food noise’.

Peptide vs small molecule

Semaglutide is a peptide. Peptides are chains of amino acids and are broken down by stomach acid before they reach the bloodstream.

That’s why Wegovy was first developed as an injection, so it can be absorbed directly into the bloodstream.

To make a tablet, Novo Nordisk added an absorption enhancer called SNAC (salcaprozate sodium), which neutralises the acid around the tablet long enough for the semaglutide to pass through the stomach lining.⁷

SNAC only works when the stomach is empty and with no more than 120 ml of plain water alongside the tablet. Food, other drinks, and even other tablets reduce absorption.⁵

Orforglipron is a small synthetic compound rather than a peptide. Stomach acid doesn’t break it down, so it needs no absorption enhancer and no fasting window.²

Average weight loss in trials

The two medications were tested in separate trials, and no trial has compared them directly. The comparison has to be drawn across studies with different designs and different numbers of participants.

OASIS 4 tested the Wegovy pill in 307 adults with obesity, or overweight with a weight-related condition, and without type 2 diabetes.

Participants took 25 mg of oral semaglutide or a placebo daily for 64 weeks, alongside lifestyle changes. Average weight loss was 13.6%, compared with 2.2% on placebo.¹

ATTAIN-1 tested Foundayo in 3,127 adults without type 2 diabetes over 72 weeks.

Participants took orforglipron at 6 mg, 12 mg, or 36 mg, or a placebo. At the highest dose, average weight loss was 11.2%, compared with 2.1% on placebo.²

Both produce less weight loss than the injections. Injectable Wegovy at 2.4 mg produced 14.9% in STEP 1, the 7.2 mg dose produced 20.7% in STEP UP, and Mounjaro at 15 mg produced 22.5% in SURMOUNT-1.^8,9,10

The gap between the tablets and the strongest injections is 9 to 11 percentage points.

Why each pill’s weight loss gets advertised differently

You’ll see the Wegovy pill quoted at both 13.6% and 16.6%, and Foundayo at both 11.2% and 12.4%. In each case, the two numbers come from the same trial, but measure different things.

The lower figure includes everyone who joined the trial, whether or not they completed it or stayed on the medication. It reflects what tends to happen across a real-world group, and it’s the one we use throughout our guides.

The higher figure describes the people who stayed on treatment; consider this the more optimistic figure.

For the Wegovy pill, that’s 16.6% among those who kept taking it and reached the highest 25 mg dose.¹ For Foundayo, it’s 12.4% among those who completed the trial.

That Foundayo figure comes from Eli Lilly’s press release rather than the published paper.

The difference in average weight loss between the two pills also widens when you compare them like for like: 2.4 percentage points across everyone enrolled, and 4.2 among people who stayed on treatment.

ATTAIN-1 tested a 36 mg capsule. The product licensed in the UK is a 17.2 mg tablet, which was not the formulation used in the trial.

Eli Lilly states that the 17.2 mg tablet delivers the same dose as the capsule, and the approval is based on that equivalence rather than on a separate trial of the tablet at 17.2 mg.⁶ That isn’t unusual in drug development, and it doesn’t mean the tablet works differently. It does mean the 11.2% figure comes from a capsule, not from the tablet that’s now on sale.

How many people reach 10%, 15%, and 20% of weight loss

Average weight loss is useful for comparing the two pills, but it doesn’t show the full range of results, nor the potential of these medications when we develop lifestyle habits alongside them.

In both trials, some people lost very little weight, and others lost much more than the average, so the researchers also reported the proportion who reached each level of weight loss.

ATTAIN-1 published the full breakdown for Foundayo at 36 mg:²

• 54.6% lost at least 10% of their body weight
• 36.0% lost at least 15%
• 18.4% lost 20% or more

OASIS 4 reports that people on the Wegovy pill were significantly more likely than those on placebo to reach each of the same thresholds, and that around 30% lost 20% or more.¹

The full breakdown at 10% and 15% for the Wegovy pill isn’t in the published paper, so a like-for-like comparison at those two levels isn’t possible from the evidence available.

In our experience, many people don’t need to lose 20% of their body weight. Even losing 5-10% of body weight, particularly if it supports a reduction in visceral fat, alongside developing healthy habits, will lead to significant health improvements.

On Foundayo’s highest dose, more than half the participants reached 10% and over a third reached 15%, while nearly a fifth lost more than 20%.

If you have a higher starting BMI, or a weight-related condition where your prescriber is aiming for a larger reduction, an injection may still be the better option. That’s a decision to make with your prescriber.

Side effects compared

Both medications cause similar side effects because both mimic the same hormone. The most common are gut-related and depend on the dose.

In OASIS 4, gut-related side effects occurred in 74% of people on the Wegovy pill compared to 42% on placebo.¹

The most common were nausea (46.6% on the pill against 18.6% on placebo) and vomiting (30.9% against 5.9%), followed by diarrhoea and constipation.¹

7% of people taking oral semaglutide stopped the medication because of side effects, compared with 6% taking placebo. This 1 percentage point difference is smaller than is usually seen in GLP-1 trials, where fewer people taking placebo stop treatment because of side effects.¹

In ATTAIN-1, the most common side effects on Foundayo were nausea, diarrhoea, constipation, vomiting, indigestion, and abdominal pain. Most were mild to moderate and happened while the dose was being increased.²

Stopping because of side effects ranged from 5.3% to 10.3% across the orforglipron doses, compared with 2.7% on placebo.²

Hair loss appears on the Foundayo label, reported in 4 to 5% of people on the medication against 2% on placebo, and more often in women (7%) than men (under 1%).⁶

Hair loss isn’t unique to Foundayo. It’s reported in other GLP-1 medications too, at around 3% with injectable Wegovy and 5 to 6% with injectable Mounjaro, and it’s usually a temporary response to rapid weight loss rather than a direct effect of the drug.

Hair loss can be avoided by losing weight slowly, while ensuring we’re eating a diet based on whole foods to provide our body with all of the essential nutrients it needs.

Serious side effects are rare with both medications. Contact your GP or prescriber urgently if you have severe, persistent stomach pain, as this can be a sign of pancreatitis (inflammation of the pancreas).

In the U.S., both medications carry a boxed warning about thyroid C-cell tumours seen in rodent studies.

UK product information records the same rodent findings as a precaution, and the European Medicines Agency reviewed the evidence in 2023 and found no causal link to thyroid cancer in humans.

Tell your prescriber if you have a personal or family history of medullary thyroid carcinoma (a rare thyroid cancer) or Multiple Endocrine Neoplasia syndrome type 2 (an inherited condition affecting the hormone glands).

The fasting rule on the Wegovy pill and what it means in practice

The Wegovy pill has to be taken on an empty stomach, first thing in the morning, with no more than 120 ml of plain water.

The UK product information also specifies a fasting period of at least 8 hours before the tablet, which a normal night’s sleep covers for most people.⁵

You can’t eat or drink anything else, or take any other oral medications, for at least 30 minutes after taking it.⁵

If you take the pill with food or a normal-sized drink, less of the semaglutide is absorbed, and the medication won’t work as well.

That routine is workable for many people, especially those already used to morning medications.

It may be more challenging with early-morning travel, irregular shifts, other tablets that need taking first thing, or simply not wanting to wait half an hour for breakfast and coffee.

Foundayo has none of those rules. You can take the tablet whenever it fits your routine, with food, with coffee, with a full glass of water, or alongside other medications.⁶

UK availability and who’s eligible

Both tablets are licensed for adults with a BMI of 30 or above, or a BMI between 27 and 30 with at least one weight-related condition, such as type 2 diabetes, high blood pressure, or high cholesterol.^4,5

Both licences cover weight maintenance as well as weight loss, so either can be prescribed to help maintain weight loss.^4,5

The MHRA approved the Wegovy pill on 11th June 2026, and it went on sale on 6th July.³

Foundayo was approved on 10th August 2026. The UK is the first country in Europe to license it.⁴

Foundayo isn’t on sale yet, because a newly approved medication takes time to reach pharmacies and providers. The Wegovy pill took around three and a half weeks.

You can pre-order Foundayo through Second Nature now, and your medication is dispatched once it goes on sale.

Neither pill is available on the NHS. NICE, the body that decides which medications the NHS funds, would need to recommend them first.

There’s no timeline on the Wegovy pill being approved by NICE for NHS approval, but Foundayo is expected to be recommended by NICE in November, potentially paving the way for NHS access in 2027.

The Wegovy pill costs from £74 a month through Second Nature (including introductory discount).

UK pricing for Foundayo hasn’t been announced, and while there are rumours the drug will be much cheaper than other GLP-1 medications, it’s likely to be similar to the Wegovy pill.

How the costs compare

Foundayo will cost less than the Wegovy pill at Second Nature at every dose.

Foundayo’s first three doses all cost £129 a month, rising to £149 at 9 mg and £179 at the two highest doses. The Wegovy pill starts at £149 and rises with each dose to £269 at its 25 mg maintenance dose.

Here’s the month-by-month cost if you increase your dose on the minimum schedule of a month per dose.

The difference in cost is greatest at the highest doses, where Foundayo costs £90 less.

Over a first year on the minimum dose increasing schedule, Foundayo comes to around £1,970 and the Wegovy pill around £2,970.

Both cost less on longer commitment plans. On our 12-month plan, the Wegovy pill costs £124 to £244 a month depending on the dose, and Foundayo £104 to £154.

These are Second Nature’s prices. Foundayo’s apply from when it goes on sale, and other providers will set their own, so check what’s included before comparing.

Our guides to the Wegovy pill’s cost and Foundayo’s cost cover each medication’s prices in more detail.

Which oral GLP-1 might suit you?

When the Wegovy pill’s morning routine doesn’t suit you

Foundayo can be taken at any time of day, with or without food. It doesn’t require a 30-minute gap before eating, drinking, or taking other tablets.

This can make it a better fit for people who work shift patterns, travel often, or need to take other medicine when they wake up.

If you have more weight to lose

The Wegovy pill produced more average weight loss in trials, at 13.6% compared with 11.2%, and the difference widens to 4.2 percentage points among people who stayed on treatment.^1,6

Semaglutide also has a longer track record in the UK, having been prescribed as injectable Wegovy since 2023 and as Rybelsus since 2020.

If you’re switching from injectable Mounjaro or Wegovy

Foundayo is the only oral weight-loss drug studied for maintaining weight loss after switching from injectable tirzepatide or semaglutide.

In ATTAIN-MAINTAIN, participants had already lost weight with an injectable medicine and reached a weight plateau before switching to Foundayo or placebo.

After 52 weeks, people switching from tirzepatide (the drug in Mounjaro) maintained 74.7% of their earlier weight loss with Foundayo, compared with 49.2% with placebo.¹¹

For people switching from injectable Wegovy, the figures were 79.3% with Foundayo and 37.6% with placebo.¹¹

No equivalent switching trial has been published for the Wegovy pill. Still, it’s licensed for weight maintenance as well as weight loss, so it can be prescribed for this purpose.

What we don’t yet know is how much weight people maintain when switching directly from an injectable treatment to the Wegovy pill.

Maintaining muscle mass on oral weight-loss medications

Weight loss with any GLP-1 medication usually includes some lean tissue as well as fat.

Lean tissue includes muscle, organs, body water, and other non-fat lean tissue, so a reduction in lean mass doesn’t represent muscle loss alone.

Losing weight more gradually may help preserve lean tissue. Eating enough protein and doing resistance exercise can also reduce muscle loss and help maintain strength.

During weight loss, a daily protein intake of around 1.2 to 1.6 g per kg of adjusted or target body weight is recommended, particularly alongside resistance exercise. For example, if you weigh 90 kg, this is about 110 to 145 g a day.

As a practical guide, we recommend a palm-sized serving of protein-rich food at each meal. This approach helps you portion your protein sizes without weighing or counting anything.

Resistance exercise at least twice a week can include bodyweight movements such as squats and press-ups, resistance-band exercises or lifting weights.

Frequently asked questions

Which is more effective for weight loss, the Wegovy pill or Foundayo?

The Wegovy pill produced an average weight loss of 13.6% over 64 weeks, and Foundayo 11.2% over 72 weeks at the highest tested dose.^1,2

No trial has compared them directly, so the figures come from separate studies with different populations.

Is Foundayo cheaper than the Wegovy pill?

Yes, at Second Nature. Foundayo will cost £129 to £179 a month, depending on the dose, compared with £149 to £269 for the Wegovy pill.

The difference in cost is largest at the highest doses, where Foundayo costs £90 a month less.

Are both pills available in the UK?

The Wegovy pill is on sale now through private providers, including Second Nature.

Foundayo was approved on 10th August 2026 and is expected to go on sale shortly.

You can, however, pre-order it with Second Nature in the meantime, where you’d complete the medical assessment now so your first month is dispatched as soon as it’s available (if you’re eligible).⁴

Why do I see two different weight-loss figures for the same pill?

Each trial reported one figure for everyone who enrolled and another for the people who stayed on treatment.

For the Wegovy pill, those figures are 13.6% and 16.6%, and for Foundayo they’re 11.2% and 12.4%.^1,2,6 We use the all-participants figures because they reflect what tends to happen across a real-world group.

Can you eat normally when taking Foundayo?

Yes. Foundayo can be taken at any time of day, with or without food, with no restrictions on what you drink.⁶

Why does the Wegovy pill have to be taken on an empty stomach?

Semaglutide is a peptide and would normally be broken down by stomach acid.

The pill includes an absorption enhancer (SNAC) that helps the drug cross the stomach lining, but it only works when the stomach is empty and with no more than 120 ml of water.⁷

Is the Wegovy pill the same as Rybelsus?

Both contain oral semaglutide, but they’re different products.

Rybelsus is licensed for type 2 diabetes at doses up to 14 mg. The Wegovy pill is a higher 25 mg dose licensed for weight loss.

Can I take Foundayo if I’m on injectable Wegovy or Mounjaro?

Switching between GLP-1 medications is a decision for you and your prescriber.

In ATTAIN-MAINTAIN, people who had already lost weight on injectable Mounjaro or Wegovy switched to Foundayo.

After 52 weeks, those previously taking Mounjaro had maintained 74.7% of their weight loss, compared with 79.3% among those previously taking Wegovy.¹¹

Are the tablets as good as the injections?

On average, weight-loss injections lead to more weight loss than pills.

Injectable Mounjaro produced 22.5% and the 7.2 mg Wegovy injection 20.7% in their trials, against 13.6% and 11.2% for the Wegovy pill and Foundayo.^1,2,9,10

Generally, the tablets suit people who want to avoid injections, don’t need to lose significant amounts of weight, or who are moving to maintenance after an injectable course.

Still, average weight loss outcomes often hide the potential of these medications for the individual.

For example, 1/5 participants taking Foundayo lost more than 20% of their body weight, similar to the average weight loss on Mounjaro and Wegovy 7.2 mg.

Is there a Mounjaro pill?

No. Tirzepatide, the drug in Mounjaro, hasn’t been developed as a tablet. Eli Lilly’s oral medication is Foundayo (orforglipron), a different drug.

Can I take other tablets at the same time as the Wegovy pill?

No. You need to wait at least 30 minutes after taking the Wegovy pill before taking any other oral medication.⁵ Foundayo has no such restriction.

Take home message

The Wegovy pill and Foundayo are both licensed in the UK. The pill is on sale now, and Foundayo is available to pre-order ahead of going on sale.

The Wegovy pill produces more weight loss, at 13.6% against 11.2% across everyone enrolled, and 16.6% against 12.4% among people who stayed on treatment.

Foundayo is easier to take, with no fasting, water, or timing rules, and it’s the only tablet with published evidence for maintaining weight loss after coming off an injection.

Still, the Wegovy pill is also approved for the use of weight maintenance.

Both produce less weight loss than injectable Mounjaro and the 7.2 mg Wegovy injection, so if you have a weight loss goal of over 20%, weight-loss injections may be a better option.

Second Nature’s programme combines either tablet with structured habit-change support from registered dietitians and nutritionists, built around a balanced plate of half vegetables, a quarter protein, a quarter complex carbohydrates, and a serving of fat.

In a study published in JMIR Formative Research, active subscribers on the programme lost an average of 19.1% of their body weight at 12 months, with 77.7% losing at least 10%.¹²

References

1. Wharton, S., Lingvay, I., Bogdanski, P., et al. (2025). Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity. New England Journal of Medicine, 393(11), 1077-1087. (OASIS 4 trial)
2. Wharton, S., Aronne, L.J., Stefanski, A., et al. (2025). Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment. New England Journal of Medicine, 393(18), 1796-1806. (ATTAIN-1 trial)
3. Medicines and Healthcare products Regulatory Agency. (2026). First GLP-1 tablet for weight loss approved in the UK. GOV.UK, 11 June 2026.
4. Medicines and Healthcare products Regulatory Agency. (2026). UK first in Europe to authorise orforglipron for weight management and type 2 diabetes. GOV.UK, 10 August 2026.
5. Electronic Medicines Compendium. (2026). Wegovy 25 mg tablets: Summary of Product Characteristics. Novo Nordisk Limited.
6. Eli Lilly and Company. (2026). FDA approves Lilly’s Foundayo (orforglipron), the only GLP-1 pill for weight loss that can be taken any time of day without food or water restrictions. Press release, 1 April 2026.
7. Buckley, S.T., Bækdal, T.A., Vegge, A., et al. (2018). Transcellular stomach absorption of a derivatized glucagon-like peptide-1 receptor agonist. Science Translational Medicine, 10(467).
8. Wilding, J.P.H., Batterham, R.L., Calanna, S., et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 384(11), 989-1002. (STEP 1 trial)
9. Jastreboff, A.M., Aronne, L.J., Ahmad, N.N., et al. (2022). Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine, 387(3), 205-216. (SURMOUNT-1 trial)
10. Wharton, S., Freitas, P., Hjelmesæth, J., et al. (2025). Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. Lancet Diabetes & Endocrinology, 13(11), 949-963. (STEP UP trial)
11. Aronne, L.J., Horn, D.B., le Roux, C.W., et al. (2026). Orforglipron for maintenance of body weight reduction: the double-blind, randomized phase 3b ATTAIN-MAINTAIN trial. Nature Medicine, 32(7), 2679-2687. (ATTAIN-MAINTAIN trial)
12. Richards, R., Whitman, M., Wren, G., Campion, P. (2025). A Remotely Delivered GLP-1RA-Supported Specialist Weight Management Program in Adults Living With Obesity: Retrospective Service Evaluation. JMIR Formative Research, 9(1), e72577.