Self-pay via LillyDirect starts at $149/month for the lowest dose. Eligible commercially insured patients may pay as low as $25/month with the Foundayo savings card. Medicare Part D patients may access it for roughly $50/month starting July 2026.

Coverage is expected to vary sharply by plan and employer policy, consistent with the broader pattern for branded obesity medications. Prior authorization is likely to be common.

Approved for adults with BMI of 30 or higher, or BMI of 27 or higher with at least one weight-related condition such as hypertension, dyslipidemia, obstructive sleep apnea, or cardiovascular disease, when used alongside reduced-calorie diet and increased physical activity.

Adults with BMI of 30 or higher (obesity), or BMI of 27 or higher (overweight) with at least one weight-related comorbidity such as hypertension, dyslipidemia, obstructive sleep apnea, or cardiovascular disease.

Self-pay pricing through LillyDirect starts at $149/month for the lowest dose. The Foundayo savings card may bring the cost to $25/month for eligible patients with commercial insurance. Eligible Medicare Part D enrollees may be able to access Foundayo for about $50/month starting in July 2026. Foundayo became available via LillyDirect in early April 2026, with broad retail pharmacy availability expected shortly after.

Foundayo is the first GLP-1 weight-loss medication that does not require injection. Unlike Novo Nordisk's oral semaglutide (Rybelsus), there are no fasting requirements, no restrictions on food or water before or after dosing, and no mandatory waiting period. The five-step titration from 0.8 mg to the maintenance dose takes about five months, which gives patients and clinicians room to manage side effects by adjusting the pace of escalation.

Foundayo is the first oral GLP-1 approved for weight loss without food or water restrictions. Average weight loss in the ATTAIN-1 trial (12.4% at the highest trial dose over 72 weeks) is meaningful but lower than what injectable tirzepatide (Zepbound) achieved in the SURMOUNT trials (roughly 20% at the highest dose) and lower than injectable semaglutide (Wegovy) in the STEP trials (roughly 15%). For many patients, the convenience of an oral pill with no injection and no fasting requirement will outweigh the smaller weight-loss numbers. Novo Nordisk's oral Wegovy pill (higher-dose oral semaglutide) showed greater weight loss in indirect comparison, but requires an empty stomach and a 30-minute post-dose fast.

The ATTAIN clinical program led to orforglipron becoming the first oral small-molecule GLP-1 approved for obesity. The approval relied primarily on the ATTAIN-1 trial in adults without type 2 diabetes.

ATTAIN-1 enrolled adults with obesity or overweight plus a weight-related comorbidity, without type 2 diabetes. At 72 weeks, participants on the highest trial dose (36 mg) lost an average of 12.4% of body weight compared with 0.9% for placebo. Lower doses showed a clear dose-response: 7.8% at 6 mg, 9.3% at 12 mg. The trial also showed improvements in waist circumference, non-HDL cholesterol, triglycerides, and systolic blood pressure. The 36 mg trial dose is higher than the current highest approved maintenance dose of 17.2 mg.

Carries a boxed warning about thyroid C-cell tumors observed in rodent studies. Additional warnings include pancreatitis, gallbladder disease, hypoglycemia when combined with insulin or secretagogues, acute kidney injury, hypersensitivity reactions, and suicidal behavior or ideation. Contraindicated in patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.

nausea, constipation, diarrhea, vomiting, indigestion, abdominal pain, headache, bloating, fatigue, belching, heartburn, gas, hair loss

Gastrointestinal events are the most common reason patients stop taking orforglipron. At the highest approved maintenance dose (17.2 mg), nausea occurred in about 35% of patients, constipation in 24%, diarrhea in 25%, and vomiting in 24%, compared with 10%, 9%, 11%, and 4% for placebo. About 60% of GI events were mild, 36% moderate, and 4% severe. Most GI symptoms peaked during dose escalation and decreased over time. Hair loss was reported in about 5% of patients at the highest dose. Discontinuation due to adverse events ranged from 5-10% depending on dose.

Once-daily oral tablet with step-up dosing: 0.8 mg starting dose, then 2.5 mg, 5.5 mg, 9 mg, 14.5 mg, and up to 17.2 mg maintenance. Each dose increase occurs after at least 30 days.

Oral tablet taken once daily at any time, with or without food, and without water restrictions.