Foundayo and Ozempic are approved for different uses
Foundayo is approved in the UK for weight management and type 2 diabetes. For weight management, it can be prescribed to eligible adults with a BMI of 30 or above, or a BMI of 27 to below 30 with at least one weight-related health condition.1
Ozempic is approved in the UK for type 2 diabetes. However, it isn’t approved for weight loss.2
Results below come from trials with different populations and durations, so they aren’t a direct comparison.
Foundayo vs Ozempic comparison
| Comparison |
Foundayo |
Ozempic |
| Drug |
Orforglipron |
Semaglutide |
| Medicine type |
Small-molecule GLP-1 receptor agonist |
Peptide GLP-1 receptor agonist |
| UK licensed uses |
Weight management and type 2 diabetes |
Type 2 diabetes only; not licensed for weight loss in the UK |
| How it’s taken |
One tablet every day, with no food or water restrictions |
One injection every week, at any time of day |
| UK dose range |
0.8 mg starting dose; increased through 2.5 mg, 5.5 mg, 9 mg and 14.5 mg to a maximum of 17.2 mg each day |
0.25 mg starting dose; increased to 0.5 mg, 1 mg or a maximum of 2 mg each week |
| Highest-dose weight-loss outcome |
An average weight loss of 11.2% after 72 weeks in ATTAIN-1; adults with obesity or overweight, without type 2 diabetes4 |
An average weight loss of 6.9 kg after 40 weeks in SUSTAIN FORTE, from an average starting weight of 100.1 kg; adults living with type 2 diabetes2 |
| Highest-dose HbA1c outcome |
A 1.9 percentage-point reduction after 52 weeks in ACHIEVE-35 |
A 2.2 percentage-point reduction after 40 weeks in SUSTAIN FORTE2 |
| Direct comparison trial |
No published trial against injected Ozempic |
No published trial against Foundayo |
| Serious heart-event evidence |
Events occurred in 0.94% with orforglipron and 1.04% with placebo across phase 3 trials; cardiovascular benefit hasn’t been established1 |
Events occurred in 6.6% with semaglutide and 8.9% with placebo over 2 years in SUSTAIN-6; a 26% relative risk reduction2 |
| Common side effects |
Nausea, diarrhoea, vomiting, constipation and indigestion1 |
Nausea, diarrhoea, vomiting, constipation and indigestion2 |
| Current NHS availability |
Not currently funded for weight management; NICE appraisal in progress |
Available for eligible people living with type 2 diabetes; not prescribed for weight loss |
| Second Nature weight-management price |
£129 to £179 per month on the monthly plan, depending on dose |
Not offered as a weight-management treatment because Ozempic isn’t licensed for weight loss |
No trial has compared Foundayo with the Ozempic injection
Comparing separate trials can still show the likely size of a difference, but the studies may recruit different people, last for different lengths of time and handle people who stop treatment differently. This makes it challenging to compare the drugs’ effectiveness like-for-like.
How much weight do people lose on Foundayo and Ozempic?
ATTAIN-1 followed 3,127 adults with obesity, or overweight plus a weight-related health condition, for 72 weeks. None were living with type 2 diabetes.4
The main analysis included everyone assigned to treatment, whether or not they stopped taking it. Average weight loss was 11.2% with the highest Foundayo trial dose and 2.1% with placebo.4
ATTAIN-1 produced a second average weight-loss figure because researchers also analysed what might have happened if everyone had stayed on the drug for the duration of the trial. In these individuals, average weight loss was 12.4%.1,4
Both figures are valid, but they answer different questions. We use 11.2% because it includes everyone assigned to Foundayo, whether or not they completed treatment, and is more likely to reflect real-world populations where people may stop taking the medication for various reasons.
However, averages don’t necessarily tell us the potential weight loss any individual might achieve. For example, 36% of participants on Foundayo lost at least 15% of their body weight, and 18.4% lost at least 20%.
ATTAIN-1 used a 36 mg capsule, while the Foundayo tablet sold in the UK has a maximum dose of 17.2 mg.
The UK prescribing information states that these doses have equal effects, so the 17.2 mg tablet is the marketed equivalent of the 36 mg trial capsule.1
SUSTAIN FORTE followed 961 adults living with type 2 diabetes for 40 weeks. Average weight loss was 6.0 kg with Ozempic 1 mg and 6.9 kg with Ozempic 2 mg, from mean starting weights of 98.6 kg and 100.1 kg.2
Still, the Foundayo and Ozempic weight-loss outcomes can’t be used to rank the medications directly.
ATTAIN-1 excluded people with type 2 diabetes and lasted 72 weeks, while SUSTAIN FORTE included people with type 2 diabetes and lasted 40 weeks.
Research shows that people living with type 2 diabetes typically lose less weight on GLP-1 medications than those not living with type 2 diabetes.8
Ozempic isn’t licensed for weight loss, so Wegovy provides a more relevant comparison with Foundayo for weight-loss outcomes.
Wegovy 2.4 mg produced an average weight loss of 14.9% over 68 weeks, while Wegovy 7.2 mg produced 20.7% over 72 weeks.3
These separate trials suggest semaglutide at Wegovy doses produces more weight loss than Foundayo on average. They don’t show the exact difference that would occur if both medications were tested under the same conditions.
Our guide to the Wegovy pill vs Foundayo compares the two tablets in detail.
Second Nature has worked with the NHS since 2017. If you’re deciding whether a tablet or injection is a better fit, take our 3-minute eligibility quiz, and a clinician will review your health, current medicines, and treatment preferences.
Does Foundayo or Ozempic control type 2 diabetes better?
No trial has compared Foundayo with the Ozempic injection for type 2 diabetes. ACHIEVE-3 is the closest evidence, but it tested orforglipron against oral semaglutide rather than Ozempic.5
ACHIEVE-3 followed 1,698 adults living with type 2 diabetes that wasn’t well controlled with metformin for 52 weeks.5
In the analysis that included everyone assigned to treatment, the highest orforglipron dose reduced HbA1c by 1.9 percentage points, compared with 1.5 percentage points for oral semaglutide 14 mg. HbA1c measures average blood sugar over the previous 2 to 3 months.5
Average weight loss was 8.2% with orforglipron and 5.3% with oral semaglutide in the same analysis.5
The UK prescribing information also reports outcomes for participants who remained on treatment: 2.2 versus 1.4 percentage points for HbA1c, and 9.2% versus 5.3% for weight.1
In SUSTAIN FORTE, Ozempic 1 mg reduced HbA1c by 1.9 percentage points, and Ozempic 2 mg reduced it by 2.2 percentage points after 40 weeks.2
These figures come from separate trials and can’t be used to conclude that Foundayo or Ozempic controls diabetes better. The studies tested different groups of people over different periods and didn’t directly compare the medicines.
Still, at face value, the outcomes suggest that Foundayo and Ozempic reduce blood sugar levels to a similar degree in patients living with type 2 diabetes.
Semaglutide has stronger evidence for reducing serious heart events
Ozempic has been tested in people living with type 2 diabetes who had a high risk of heart disease.
In SUSTAIN-6, heart attacks, strokes or deaths from heart disease occurred in 6.6% of the semaglutide group and 8.9% of the placebo group over 2 years.2
Semaglutide also reduced serious heart events in SELECT, which tested the 2.4 mg Wegovy dose in adults with heart disease and overweight or obesity, but without diabetes. Events occurred in 6.5% of the semaglutide group and 8.0% of the placebo group.6
The Foundayo trials weren’t designed to prove that it prevents heart attacks or strokes. Across its phase 3 trials, serious heart events occurred in 0.94% of participants taking orforglipron and 1.04% taking placebo.1
Of the two drugs, we only have evidence showing that semaglutide reduces serious heart events.
Anyone taking Ozempic partly because of heart or kidney risk should discuss this evidence with their prescriber before considering Foundayo.
Foundayo caused more gut-related side effects than oral semaglutide in ACHIEVE-3
Foundayo and semaglutide can both cause nausea, vomiting, diarrhoea, constipation and indigestion. These symptoms are most common while the dose is increasing and usually reduce over time.1,2
ACHIEVE-3 compared the highest orforglipron trial dose of 36 mg, which is equivalent to the marketed Foundayo 17.2 mg tablet, with oral semaglutide 14 mg. This was the Rybelsus diabetes dose available when the trial was conducted, not the 25 mg Wegovy pill used for weight management.1,5
Gut-related side effects affected 58% of people taking orforglipron and 45% taking oral semaglutide 14 mg. Side effects caused 10% of the orforglipron group and 5% of the oral semaglutide group to come off the medication.5
Average pulse rate increased by 4.7 beats per minute with orforglipron and 1.5 beats per minute with oral semaglutide.5
The 45% figure from ACHIEVE-3 can’t be applied to the higher-dose Wegovy pill; it applies only to the Rybelsus dose of 14 mg.
In OASIS 4, gut-related side effects affected 74% of people taking oral semaglutide 25 mg, compared with 42.2% taking placebo.9
Still, a 2026 population-adjusted indirect comparison used data from OASIS 4 and ATTAIN-1 to compare oral semaglutide 25 mg with orforglipron 36 mg.
Orforglipron was associated with 4.1 times the odds of coming off the medication because of any side effect and 13.9 times the odds of stopping because of gut-related side effects.10
The results suggest Foundayo may be harder to stay on than the 25 mg Wegovy pill, despite Wegovy using a higher semaglutide dose. However, this was an indirect analysis and doesn’t tell us how Foundayo compares with the Ozempic injection.
Foundayo has different medicine interactions
The UK Foundayo prescribing information includes several precautions that don’t appear in the same form for Ozempic:1,2
- Oral contraception: use a non-oral contraceptive or add a barrier method such as condoms for 30 days after starting Foundayo and for 30 days after every dose increase
- Strong CYP3A4 inhibitors, medicines that slow one of the enzymes involved in processing Foundayo: these include clarithromycin and some antifungal medicines, and the maximum Foundayo dose is 9 mg
- Strong CYP3A4 inducers, medicines that speed up the same enzyme: these include phenytoin, rifampicin and St John’s wort, and the UK prescribing information advises avoiding Foundayo
- Simvastatin: the simvastatin dose should be halved while taking Foundayo
This isn’t the full list of interactions. Tell your prescriber or pharmacist about every prescription medicine, over-the-counter treatment, and supplement before starting Foundayo.
Both medications slow digestion, which can change how quickly some tablets are absorbed.
The Foundayo prescribing information says a clinically important effect isn’t expected for most commonly used medications, but the specific precautions above still apply.1,2
Foundayo is a daily tablet and costs less at Second Nature than Wegovy
Foundayo is taken once a day, at any time, without food or water restrictions. Ozempic is injected once a week and can also be taken at any time of day.1,2
Second Nature’s monthly Foundayo plan costs £129 at 0.8 mg, 2.5 mg and 5.5 mg; £149 at 9 mg; and £179 at 14.5 mg and 17.2 mg.
On a 12-month plan, the ongoing monthly prices are £104, £124 and £154 across the same dose groups. A one-off £50 discount reduces the first month at the 0.8 mg starting dose to £54.
At the highest doses, Foundayo costs £179 on the monthly plan, compared with £249 for Wegovy 2.4 mg and £329 for Wegovy 7.2 mg at Second Nature. Our guide to Foundayo costs in the UK covers every plan and dose.
The NHS doesn’t currently fund Foundayo. NICE is assessing it for weight management, while Ozempic is available through the NHS for eligible people living with type 2 diabetes.
Foundayo is not a dose-for-dose replacement for Ozempic
There’s no equivalent Ozempic dose for each Foundayo dose. The medications contain different drugs, so their doses can’t be matched milligram for milligram.
The 36 mg figure for Foundayo appears because ATTAIN-1 used an earlier orforglipron capsule.
The UK prescribing information states that this capsule has the same effect as the marketed Foundayo 17.2 mg tablet. This only helps translate the trial results and can’t be used to calculate a dose when switching from Ozempic.1
Before changing treatment, a prescriber should consider current HbA1c, other diabetes medicines, side effects, heart and kidney history, and the risk of low blood sugar.
Doses of insulin (a hormone treatment that lowers blood sugar) or sulfonylurea tablets may need adjustment when starting Foundayo.1
Ozempic shouldn’t be used with another GLP-1 receptor agonist, so it shouldn’t be combined with Foundayo.2
Take home message
In separate trials, Foundayo’s highest dose produced average weight loss of 11.2% over 72 weeks. Ozempic 2 mg produced an average loss of ~7% over 40 weeks in people living with type 2 diabetes.2,4
No direct trial has compared these medications. The Foundayo trial excluded people with type 2 diabetes and lasted longer, so it doesn’t prove that Foundayo produces more weight loss than Ozempic.
Ozempic isn’t licensed for weight loss in the UK. Wegovy is the licensed semaglutide weight-management treatment, and separate trials suggest its 2.4 mg and 7.2 mg doses produce more average weight loss than Foundayo.3,4
For type 2 diabetes, orforglipron reduced HbA1c and weight more than oral semaglutide in ACHIEVE-3. No trial has compared it with the Ozempic injection, so we can’t say that Foundayo controls diabetes better than Ozempic.5
Still, at face value, Foundayo and Ozempic seem to reduce blood sugar levels – as measured by HbA1c – to a similar degree.
Foundayo offers a daily tablet with no fasting rules and lower Second Nature prices. Semaglutide has a longer record of use, stronger evidence for preventing serious heart events and caused fewer side effects than orforglipron in their oral comparison.
While GLP-1 medications can support significant weight loss by reducing hunger and food noise, it’s essential to develop healthy habits alongside these medications to maintain overall health and prevent regain in the future.
At Second Nature, registered dietitians and nutritionists help members build eating habits they can continue alongside medication.
A peer-reviewed service evaluation found that active subscribers on Second Nature’s semaglutide-supported programme lost an average of 19.1% of their body weight at 12 months, with 77.7% losing at least 10%.7
Second Nature's Mounjaro and Wegovy programmes
Second Nature provides Mounjaro or Wegovy as part of our Mounjaro and Wegovy weight-loss programmes.
Why choose Second Nature over other medication providers, assuming you're eligible?
Because peace of mind matters.
We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
Frequently asked questions
Which is better, Foundayo or Ozempic?
Foundayo produced average weight loss of 11.2% over 72 weeks in a trial without diabetes.
Ozempic 2 mg produced a 6.9 kg loss over 40 weeks in a trial involving type 2 diabetes. No direct trial has compared them, so these figures don’t show which is better.2,4
Is Foundayo stronger than Ozempic?
We don’t know. Foundayo’s reported weight loss was larger, but its trial lasted longer and tested people without type 2 diabetes.
Ozempic isn’t licensed for weight loss, and no trial has tested the two medicines under the same conditions.2,4
Which produces more weight loss, Foundayo or Wegovy?
Semaglutide at Wegovy doses produced higher average weight loss in separate trials: 14.9% at 2.4 mg and 20.7% at 7.2 mg, compared with 11.2% for Foundayo.3,4
Does Foundayo control type 2 diabetes better than Ozempic?
We don’t know because the medicines haven’t been compared directly.
In separate trials, the highest orforglipron dose reduced HbA1c by 1.9 percentage points over 52 weeks, while Ozempic 2 mg produced a 2.2-point reduction over 40 weeks, suggesting the drugs lower blood sugar to a similar degree.2,5
Can I switch from Ozempic to Foundayo?
A switch may be possible, but there’s no dose conversion between the medicines.
A prescriber needs to review diabetes control, other medicines, heart and kidney history, and side effects before planning the change.
Can Foundayo and Ozempic be taken together?
No. Ozempic shouldn’t be used with another GLP-1 receptor agonist, which includes Foundayo.2
Does Foundayo affect oral contraception?
Yes, it may reduce how well oral contraception works. Use a non-oral method or add a barrier method such as condoms for 30 days after starting Foundayo and for 30 days after every dose increase.1
Which causes more side effects?
In ACHIEVE-3, side effects caused 10% of people taking the highest orforglipron dose and 5% taking oral semaglutide 14 mg to stop treatment. This trial didn’t test the Ozempic injection.5
How much does Foundayo cost?
Second Nature’s monthly plan costs £129 for the first three doses, £149 for 9 mg, and £179 for the two highest doses. The 12-month plan costs £104, £124 and £154 a month across the same dose groups.
Can I get Foundayo or Ozempic for weight loss on the NHS?
Ozempic isn’t prescribed for weight loss because it isn’t approved for that use. Foundayo is approved for weight management, but NICE hasn’t yet recommended it for NHS funding.
