Foundayo vs Wegovy Pill: Orforglipron vs Oral Semaglutide for Weight Loss
The short answer
No weight-loss trial has compared them. In their own trials the Wegovy pill (oral semaglutide 25 mg) took off 13.6% of body weight in 64 weeks and Foundayo (orforglipron 17.2 mg) 11.1% in 72 weeks. Foundayo can be taken with or without food; the Wegovy pill needs an empty stomach and a 30-minute wait. Both start at $149 a month self-pay.
The Wegovy pill (oral semaglutide 25 mg, Novo Nordisk) and Foundayo (orforglipron, Eli Lilly) are the two GLP-1 pills approved for weight loss in the US. No trial has put them against each other for weight, so the numbers below come from each drug's own label and trial.
Foundayo vs Wegovy pill side by side
| Foundayo | Wegovy pill | |
|---|---|---|
| Drug | Orforglipron, a small molecule | Semaglutide 25 mg, a peptide |
| Approved for weight | 1 April 2026 | 22 December 2025 |
| How taken | Once a day, with or without food, any time | Once a day on an empty stomach in the morning, with up to 4 ounces of water, then wait 30 minutes |
| Doses | 0.8, 2.5, 5.5, 9, 14.5, 17.2 mg | 1.5, 4, 9, then 25 mg maintenance |
| Weight trial | Trial 1 (ATTAIN-1), 72 weeks | OASIS 4, 64 weeks |
| Mean weight change, top dose | -11.1% | -13.6% |
| Placebo in the same trial | -2.1% | -2.4% |
| Lost at least 20%, top dose | 18.4% | 27.9% |
| Stopped for side effects | 10% at 17.2 mg | 6.9% at 25 mg |
| Self-pay per month | $149 to $349 | $149 to $299 |
Sources: Foundayo label; Wegovy label and OASIS 4, NEJM 2025; approvals from FDA and Novo Nordisk; prices from LillyDirect and TrumpRx.
Weight loss
The Wegovy pill took off 13.6% of body weight at 64 weeks against 2.4% on placebo; Foundayo's top dose took off 11.1% at 72 weeks against 2.1%. One published indirect comparison of the two trials put oral semaglutide 25 mg 3.2 points ahead (Diabetes Obes Metab 2026); Lilly has published indirect comparisons claiming the opposite in diabetes. Indirect comparisons are weak evidence in either direction.
The daily routine is the real difference
The Wegovy label says to take the tablet "on an empty stomach in the morning with water (up to 4 ounces)" and to "wait at least 30 minutes before eating food, drinking beverages or taking other oral medications". Foundayo's label says "with or without food", with no water limit and no wait. A missed Wegovy tablet is skipped; a missed Foundayo tablet is taken as soon as possible, and 7 missed days in a row restart the dose steps.
Orforglipron vs oral semaglutide in type 2 diabetes
The one head-to-head trial, ACHIEVE-3, used the diabetes doses of oral semaglutide (7 and 14 mg, not 25 mg). Over 52 weeks orforglipron 12 and 36 mg lowered A1C by 1.71 and 1.91 points against 1.23 and 1.47, and body weight by 6.7% and 9.2% against 3.7% and 5.3% (ACHIEVE-3, Lancet, posted results). More people stopped orforglipron for side effects, 9% and 10% against 4% and 5%.
Cost
Both start at $149 a month self-pay. The Wegovy pill tops out at $299 for 9 mg and 25 mg; Foundayo at $299 for the top doses if refilled within 45 days, otherwise $349. Both are on Medicare's $50 GLP-1 Bridge. Details: orforglipron price and oral semaglutide.
Not sure which of these you actually need?
Answer five questions about your goal, experience and budget and the Stack Builder shows you a matched research protocol on screen, with the compounds, cycle shape and vendor picks from the six vendors we score.
Build your stack, 2 minutesFrequently asked questions
Which pill works better, Foundayo or the Wegovy pill?
No head-to-head weight trial exists. The Wegovy pill took off 13.6% of body weight in OASIS 4 and Foundayo 11.1% in ATTAIN-1, trials of different length and populations. One indirect analysis favoured oral semaglutide 25 mg by 3.2 points.
Has orforglipron been tested against semaglutide?
Yes, in type 2 diabetes. In ACHIEVE-3, orforglipron 12 and 36 mg lowered A1C by 1.71 and 1.91 points against 1.23 and 1.47 for oral semaglutide 7 and 14 mg over 52 weeks. It did not test the 25 mg weight-loss dose.
Do you need an empty stomach for Foundayo?
No. Foundayo is taken once daily with or without food. The Wegovy pill must be taken on an empty stomach with up to 4 ounces of water, then 30 minutes before food, drink or other pills.
Which is cheaper, Foundayo or the Wegovy pill?
Both start at $149 a month self-pay. At the top doses the Wegovy pill is $299 and Foundayo $299 if refilled within 45 days, otherwise $349, as read on 8 November 2026.
Sources (checked 8 November 2026)
- Foundayo (orforglipron) US prescribing information, revised 7/2026. Checked 8 November 2026.
- Wegovy (semaglutide) injection and tablets US prescribing information, revised 06/2026. Checked 8 November 2026.
- FDA approval letter, NDA 220934, 1 April 2026. Checked 8 November 2026.
- Novo Nordisk: FDA approves Wegovy pill, 22 December 2025. Checked 8 November 2026.
- Novo Nordisk: Wegovy pill available nationwide, 5 January 2026. Checked 8 November 2026.
- Oral semaglutide 25 mg in adults with overweight or obesity (OASIS 4). N Engl J Med 2025;393(11):1077-1087. Checked 8 November 2026.
- Orforglipron for obesity treatment (ATTAIN-1). N Engl J Med 2025;393(18):1796-1806. Checked 8 November 2026.
- Orforglipron vs oral semaglutide in type 2 diabetes (ACHIEVE-3). Lancet 2026;407(10534):1147-1160. Checked 8 November 2026.
- ClinicalTrials.gov NCT06045221, posted results. Checked 8 November 2026.
- Indirect comparison of oral semaglutide 25 mg and orforglipron 36 mg. Diabetes Obes Metab 2026. Checked 8 November 2026.
- LillyDirect, Foundayo self-pay pricing. Checked 8 November 2026.
- TrumpRx, Wegovy pill listing. Checked 8 November 2026.
Cross-trial comparison from each US label; prices as read on 8 November 2026. Labels and trial records change; the leaflet in your box and your prescriber come first. Educational content, not medical advice.