Foundayo: The New Weight Loss Pill Approved in the UK

On 10 August 2026, the Medicines and Healthcare products Regulatory Agency authorised Foundayo (orforglipron), making the UK the first country in Europe to license the tablet for both weight management and type 2 diabetes. It is the second oral GLP-1 medicine to reach the UK this year, and the questions arriving fastest are the simplest ones: what is it, how is it different, and when can people actually get it.

What is Foundayo?

Foundayo is the brand name for orforglipron, a once-daily tablet made by Eli Lilly. It belongs to the same class of medicines as the injectable GLP-1 treatments already familiar to UK patients: it mimics glucagon-like peptide-1, a hormone the gut releases after eating, acting on appetite-regulating areas of the brain to reduce hunger, slow stomach emptying and increase fullness after meals.

What separates it from every GLP-1 before it is chemistry. Orforglipron is a small-molecule, non-peptide GLP-1 receptor agonist. Semaglutide and tirzepatide are peptides, which the gut breaks down, and that is why they are injected or, in the case of the Wegovy pill, formulated with an absorption enhancer and strict fasting rules. Orforglipron is absorbed like an ordinary tablet, so it can be taken at any time of day, with or without food, and with no water restriction. The molecule was discovered by Chugai Pharmaceutical and licensed by Lilly in 2018.

The MHRA Foundayo approval, in plain terms

The MHRA authorisation covers two separate indications. For weight management, Foundayo is licensed for adults with a BMI of 30 or above, or a BMI between 27 and 30 with at least one weight-related condition, alongside a reduced-calorie diet and increased physical activity. It is licensed for both weight loss and weight maintenance. Separately, it is authorised to improve blood sugar control in adults whose type 2 diabetes is insufficiently controlled.

Julian Beach, executive director of healthcare quality and access at the MHRA, said the decision followed a rigorous assessment of the medicine's safety, quality and effectiveness, and confirmed that, as with all GLP-1 receptor agonists, it remains a prescription-only medicine kept under close review.

The UK decision follows the US Food and Drug Administration, which approved orforglipron in April 2026. 

Foundayo vs Wegovy pill

The UK's other oral GLP-1, the Wegovy pill (oral semaglutide 25 mg), was authorised on 11 June 2026. Both are once-daily tablets licensed for weight management in the same BMI groups, but they are taken very differently.

The Wegovy pill has to be taken on an empty stomach, first thing in the morning, with no more than a small sip of plain water, and nothing else by mouth for at least 30 minutes. Absorption depends on it. Foundayo has no such window. For anyone taking morning thyroid medication, working night shifts or travelling regularly, that is the most practically significant difference between the two.

How each one is taken

A note on the dose figures. Orforglipron was studied in capsules at doses up to 36 mg. The approved product is a tablet with a highest strength of 17.2 mg, which the manufacturer reports as pharmacokinetically equivalent to the capsule doses used in trials. That is why the licensed dose ladder above does not match the trial doses quoted below. Always follow the schedule your prescriber gives you.

On efficacy, the honest answer is that the two have never been compared head to head in obesity. ATTAIN-1, published in the New England Journal of Medicine, followed 3,127 adults for 72 weeks. Measured regardless of whether participants stayed on treatment, mean weight reduction was 7.5% at 6 mg, 8.4% at 12 mg and 11.2% at the 36 mg dose, against roughly 2% on placebo. Among those who adhered, the highest dose averaged 12.4%. In the same trial, 54.6% on the highest dose lost 10% or more of their body weight, and among participants with prediabetes at baseline, up to 91% reached near-normal blood sugar compared with 42% on placebo.

OASIS 4, the Wegovy pill trial, followed 307 adults for 64 weeks and reported 13.6% mean reduction regardless of adherence, and 16.6% among those who adhered, against 2.2% and 2.7% on placebo.

Compared like for like that puts oral semaglutide numerically ahead. But OASIS 4 enrolled 307 people and ATTAIN-1 enrolled 3,127, over different durations and designs, so cross-trial comparison is not evidence of superiority. Individual results vary, and no trial predicts what any one person will experience.

Foundayo vs Mounjaro and tirzepatide

This is the comparison most people are actually searching for, and the framing matters. Mounjaro is tirzepatide, a weekly injection. There is no Mounjaro pill. In the SURMOUNT-1 trial, tirzepatide produced mean weight reduction of around 20.9% at the 15 mg dose over 72 weeks, which remains ahead of both oral GLP-1 tablets on the published numbers.

So the trade is straightforward: injectables currently deliver the larger average reduction, tablets deliver convenience. The relevant clinical question is not which number is biggest, but which regimen a patient can realistically sustain for a year or more, because adherence is what turns trial figures into real-world ones.

Orforglipron does have one dataset with no direct oral equivalent. The ATTAIN-MAINTAIN trial, published in Nature Medicine in May 2026, followed people who had completed 72 weeks of injectable tirzepatide or semaglutide and then switched to orforglipron or placebo. Those on orforglipron maintained 74.7% of their earlier weight reduction, against 49.2% on placebo, and 43.7% held on to at least 80% of it. For patients who have done well on injections but want to move away from needles, that is clinically relevant, though outcomes still differ between individuals.

There is also one head-to-head trial, ACHIEVE-3, published in The Lancet in February 2026, in which orforglipron outperformed oral semaglutide on blood sugar control and weight across 1,698 adults with type 2 diabetes. The caveat is important: it used the 7 mg and 14 mg diabetes doses of oral semaglutide, not the 25 mg weight management dose, so it does not settle the weight loss question.

Foundayo side effects

The safety profile is consistent with the GLP-1 class, and gastrointestinal effects dominate. The most commonly reported side effects are nausea, constipation, diarrhoea, vomiting, indigestion and abdominal pain, with headache, bloating, fatigue, reflux, flatulence and hair loss also recorded.

US labelling carries a boxed warning regarding the risk of thyroid C-cell tumours, and warnings covering acute pancreatitis, severe gastrointestinal reactions, acute kidney injury from fluid loss, hypoglycaemia, serious hypersensitivity reactions, diabetic retinopathy complications in type 2 diabetes, gallbladder disease, and aspiration risk under general anaesthesia. The dose is stepped up gradually, through 0.8 mg, 2.5 mg, 5.5 mg, 9 mg, 14.5 mg and 17.2 mg with a minimum of one month at each level, specifically to limit these effects.

Anyone who suspects a side effect should speak to a doctor, pharmacist or nurse and report it through the MHRA Yellow Card scheme.

"The interesting question is no longer whether a tablet can work. Both oral GLP-1s clearly can. The question is which routine a patient can sustain, and whether they meet the clinical criteria in the first place. That is an assessment, not a purchase."

Dr Abdullah, Medical Lead at Rightangled

At Rightangled, every weight management consultation is reviewed by GPhC-registered independent prescribers as soon as the consultation is submitted. Treatment is supplied only where it is clinically appropriate, and outcomes depend on the individual, on adherence, and on the diet and activity changes made alongside any medicine. The MHRA has been explicit that GLP-1 medicines obtained from unregulated sources carry significant risk, and Foundayo should only ever be supplied by a registered pharmacy against a valid prescription.

Foundayo is not yet in UK supply. Add your name to the waiting list and we will let you know as soon as it becomes available, along with confirmed UK pricing.

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References

1. MHRA. UK first in Europe to authorise orforglipron for weight management and type 2 diabetes. GOV.UK, 10 August 2026.
2. Eli Lilly and Company. FDA approves Lilly's Foundayo (orforglipron). 1 April 2026.
3. Wharton S, et al. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment (ATTAIN-1). N Engl J Med 2025;393:1796-1806.
4. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity (OASIS 4). N Engl J Med, 2025.
5. Orforglipron for maintenance of body weight reduction: the phase 3b ATTAIN-MAINTAIN trial. Nature Medicine, May 2026.