If you’ve been following the world of weight loss medicine, you’ve probably heard of Ozempic, Wegovy, and Zepbound. These medications have helped a lot of people lose significant weight. But they all have one thing in common — they require a weekly injection. For many of my patients, that’s a dealbreaker and the Wegovy pill is too complicated to take.
Good news: there’s finally a second new pill for weight loss.
In 2026, the FDA approved a new weight loss medication called orforglipron (brand name Foundayo). It’s the first pill of its kind — a once-daily tablet that works the same way as injectable GLP-1 medications, without the needles.
How Does It Work?
Your body makes a natural hormone called GLP-1. This hormone helps control blood sugar, slows digestion, and tells your brain that you’re full. GLP-1 medications copy this signal. That’s why they help people eat less and lose weight.
Ozempic, Wegovy, and Zepbound are all injectable GLP-1 medications. Orforglipron does the same job, but it’s a small pill you swallow. Unlike the older oral diabetes medication semaglutide (Rybelsus), you don’t have to fast before taking it or limit how much water you drink. You just take it once a day — simple as that.
How Much Weight Can You Expect to Lose?
In a large clinical study of people with obesity (but without diabetes), people taking orforglipron lost about 11% of their body weight over 72 weeks. For someone who weighs 220 pounds, that’s roughly 24 pounds.
Here’s what that looked like for real patients in the study:
- More than half (55%) lost at least 10% of their body weight
- About 1 in 3 (36%) lost at least 15%
- About 1 in 5 (18%) lost at least 20%
For people who also have type 2 diabetes, the results were slightly lower — about a 9.6% reduction in body weight — which is still very meaningful.
It’s also worth noting that weight loss hadn’t fully leveled off by the end of the study. That means longer-term use could lead to even greater results.
How Does It Compare to Injections?
I want to be upfront with you — orforglipron is not quite as powerful as the injectable options. Here’s a simple comparison:
| Medication | How It’s Taken | Average Weight Loss |
| Orforglipron (Foundayo) | Daily pill | ~11% |
| Semaglutide (Wegovy) | Weekly injection | ~16% |
| Tirzepatide (Zepbound) | Weekly injection | ~21% |
So yes — if maximum weight loss is the goal and you’re comfortable with injections, tirzepatide is still the most effective option we have. But for many people, a pill that delivers 11% weight loss without needles is exactly what they’ve been waiting for.
There’s also an exciting possibility on the horizon. Researchers are studying whether people can start on an injectable medication like tirzepatide to get maximum weight loss, then switch to orforglipron as a daily pill for long-term maintenance. This could be great for people who want to avoid injections for the rest of their life.
What Are the Side Effects?
Like all GLP-1 medications, the most common side effects involve the stomach — especially in the first few weeks as your body adjusts:
- Nausea
- Diarrhea
- Constipation
- Upset stomach
- Vomiting (less common)
Most of these side effects are mild and tend to improve over time. The medication is started at a low dose and gradually increased to help your stomach get used to it. In clinical trials, only about 3 to 7 out of every 100 people stopped taking it because of these side effects.
No liver damage was seen with orforglipron — which is important because some earlier experimental pills in this class did cause liver problems.
Who Is This For?
The FDA approved orforglipron for adults who:
- Have obesity (BMI ≥ 30), or
- Are overweight (BMI ≥ 27) and have at least one weight-related health condition — such as high blood pressure, type 2 diabetes, or high cholesterol
This is also a great option for those taking Synthroid (levothyroxine) and want a weight loss pill. This is because the Wegovy pill requires a different amount of water you drink than the levothyroxine making my patients take one in the morning and one in the evening. This can be quite inconvenient. This is where this new medication shines and isn’t an issue.
If you’ve been on the fence about weight loss medication because of the needle, or if you tried an injectable and couldn’t tolerate it, this pill could be worth a conversation.
My Take
One of the most common things I hear from patients is, “I just can’t bring myself to do the injection.” I completely understand that. Phentermine and Qsymia were the old options and weren’t that great.
Orforglipron isn’t going to replace injections for everyone — if you need the most aggressive results possible, tirzepatide is still the gold standard. But for the right person, a once-daily pill with no food restrictions, no needles, and real clinical results is a major step forward and better than the Wegovy pill.
As always, weight loss medication works best when it’s part of a bigger plan — one that includes what you eat, how you move, how you sleep, and how you manage stress (Lifestyle Medicine). That’s what we focus on here at Jacksonville Concierge Medicine.
If you’d like to talk about whether orforglipron might be right for you, reach out and schedule a visit. I’m happy to walk through your options and help you find the approach that fits your life.
Dr. Kyle Mikals is a board-certified Internal Medicine physician and co-owner of Jacksonville Concierge Medicine. He specializes in primary care and lifestyle medicine for adults in Jacksonville, Nocatee, the Beaches, and St. Johns County.
References
1. FDA Orange Book. FDA Orange Book. 2026.
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3. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment. The New England Journal of Medicine. 2025. Wharton S, Aronne LJ, Stefanski A, et al.New
4. Efficacy and Safety of Once-Daily Oral Orforglipron Compared With Oral Semaglutide in Adults With Type 2 Diabetes (ACHIEVE-3): A Multinational, Multicentre, Non-Inferiority, Open-Label, Randomised, Phase 3 Trial. Lancet. 2026. Rosenstock J, Yabe D, Cox D, et al.New
5. GLP-1 Receptor Agonists. The New England Journal of Medicine. 2026. Rosen CJ, Ingelfinger JR.New
6. Glucagon-Like Receptor Agonists and Next-Generation Incretin-Based Medications: Metabolic, Cardiovascular, and Renal Benefits. Lancet. 2026. Nauck MA, Tuttle KR, Tschöp MH, Blüher M.New
7. Medications for Obesity: A Review. The Journal of the American Medical Association. 2024. Gudzune KA, Kushner RF.
8. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes. The New England Journal of Medicine. 2025. Rosenstock J, Hsia S, Nevarez Ruiz L, et al.New
9. Daily Oral GLP-1 Receptor Agonist Orforglipron for Adults with Obesity. The New England Journal of Medicine. 2023. Wharton S, Blevins T, Connery L, et al.
