SharpyWegovy Pill vs Foundayo: Weight Loss, Side Effects, Cost
The Wegovy pill (oral semaglutide, Novo Nordisk) and Foundayo (orforglipron, Eli Lilly) are the two daily GLP-1 pills for weight loss in the US. In their main trials, people lost 13.6% of body weight on average with the Wegovy pill at 64 weeks and 11.1% with top-dose Foundayo at 72 weeks, but the pills have never been tested head to head. The Wegovy pill has a strict empty-stomach routine and a heart-risk indication; Foundayo can be taken any time, with or without food. Both start at $149 a month self-pay, and on either one Sharpy helps you keep muscle with one protein target and one 20-minute workout a day.
Wegovy pill vs Foundayo: which daily weight loss pill works better, and how are they different? In their main trials, the Wegovy pill led to 13.6% average weight loss over 64 weeks and Foundayo led to 11.1% over 72 weeks, but the two have never been tested against each other. The biggest everyday difference is the routine. The Wegovy pill must be taken on an empty stomach with a sip of water and a 30-minute wait. Foundayo can be taken any time, with or without food. Both start at $149 a month if you pay cash.
The question is louder this week. On November 4, 2026, Novo Nordisk raised its yearly forecast for the third time because Wegovy pill sales beat expectations, while Lilly's Foundayo keeps gaining new prescriptions. Below is a plain-English, side-by-side read of the two FDA labels.
This guide explains the labels. It is not medical advice, and the choice of pill belongs to you and your prescriber.
Wegovy pill vs Foundayo at a glance
| Wegovy pill | Foundayo | |
|---|---|---|
| Drug | Semaglutide (a peptide) | Orforglipron (a small molecule) |
| Maker | Novo Nordisk | Eli Lilly |
| FDA approval | December 22, 2025 | April 1, 2026 |
| How you take it | Once a day, empty stomach, up to 4 oz water, wait 30 min | Once a day, any time, with or without food |
| Dose steps | 1.5, 4, 9, 25 mg | 0.8, 2.5, 5.5, 9, 14.5, 17.2 mg |
| Average weight loss, main trial | 13.6% at 64 weeks (placebo 2.4%) | 11.1% at 72 weeks (placebo 2.1%) |
| Approved uses | Weight loss and lowering heart attack and stroke risk in adults with heart disease | Weight loss |
| Self-pay price | $149 to $299 a month | $149 to $299 a month |
Both are for adults with obesity, or with overweight plus at least one weight-related health problem, together with a lower-calorie diet and more activity. Both carry the boxed warning about thyroid C-cell tumors that all GLP-1 drugs have.
Wegovy pill vs Foundayo efficacy: how much weight do people lose?
Here are the top-dose results from each label. These numbers include everyone who started, even people who stopped the pill.
| Result | Wegovy pill 25 mg (64 weeks) | Foundayo 17.2 mg (72 weeks) |
|---|---|---|
| Average weight change | -13.6% | -11.1% |
| Placebo average | -2.4% | -2.1% |
| Lost 5% or more | 76.3% | 71.5% |
| Lost 10% or more | 59.8% | 54.5% |
| Lost 15% or more | 47.0% | 35.9% |
The Wegovy pill looks stronger on average. But keep three things in mind:
- Different trials. The Wegovy pill trial had about 300 people. The Foundayo trial had about 3,100. Different people, lengths and sites change results.
- Neither trial included people with type 2 diabetes. In a separate Foundayo trial of people with type 2 diabetes, top-dose weight loss was 9.6%.
- Your result is personal. In both trials, some people lost far more than average and some lost little.
For the full story on each pill, see our Foundayo guide and our Wegovy pill dosage chart.
How you take each pill
This is where most people feel the difference day to day.
Wegovy pill. Very little semaglutide gets through the stomach, so the label is strict. Take one tablet first thing in the morning on an empty stomach with no more than 4 ounces of plain water. Swallow it whole. Wait at least 30 minutes before you eat, drink anything else or take other pills. If coffee is part of your morning, our coffee on GLP-1 guide shows how to plan around the wait.
Foundayo. Orforglipron is a small-molecule drug, closer to a regular pill. The label says take it once a day at any time, with or without food. Swallow it whole, and take only one tablet a day.
How long the dose climb takes. The Wegovy pill steps up every 30 days and reaches the 25 mg maintenance dose on day 91. Foundayo steps up after at least 30 days on each dose and can go up to 17.2 mg, based on how you respond and how well you tolerate it. Never change a dose on your own; that call belongs to your prescriber.
Wegovy pill vs Foundayo side effects
The side effects are the same type: mostly stomach and gut. They show up most when you start or when the dose goes up.
| Side effect data from the labels | Wegovy pill 25 mg | Foundayo 17.2 mg |
|---|---|---|
| Any stomach or gut side effect | 74.0% (placebo 42.2%, OASIS 4) | 69% (placebo 37%, pooled trials) |
| Nausea | Similar to the Wegovy shot (44% on the shot) | 35% (placebo 10%) |
| Vomiting | Similar to the Wegovy shot (24% on the shot) | 24% (placebo 4%) |
| Stopped because of side effects | 6.9% (placebo 5.9%) | 10% (placebo 3%) |
The Wegovy label says side effects in the pill trial were similar in type and rate to the weekly shot, so it does not list separate pill rates. That is why the table points to the shot numbers.
Other label points that differ:
- Birth control pills. The Foundayo label says to switch to a non-oral method or add a barrier method for 30 days after starting and after each dose increase. See our Mounjaro and birth control guide for how this rule works with tirzepatide.
- Other medicines. Foundayo levels can rise or fall with some drugs that affect a liver enzyme called CYP3A4, such as the antibiotic clarithromycin or the seizure drug carbamazepine, and the label says the dose may need to change. The Wegovy pill raised levels of levothyroxine (a thyroid pill) by 33% in a study. Give your prescriber your full medicine list.
- Serious warnings on both: pancreatitis, gallbladder problems, dehydration and kidney problems, low blood sugar with insulin or sulfonylureas, and risk during anesthesia.
- Blood pressure. On the Foundayo label, low blood pressure was more common in people also taking BP medicine (4% vs 1%). Our Foundayo blood pressure guide covers the details.
If nausea is your main worry, our nausea guide has food tips that work on either pill.
Protect your muscle on either pill
Both pills cut your appetite. When you eat much less, your body can lose muscle along with fat. A pill cannot stop that. Two habits do:
- Hit a daily protein target. Our protein target guide shows how to find your number.
- Lift 2 to 3 times a week. Short strength sessions tell your body to keep its muscle.
Sharpy makes this simple on the Wegovy pill or Foundayo. You get one protein target sized for you, one 20-minute workout and one Shape Score each day, so you can see whether you are losing fat, not muscle.
Foundayo vs Wegovy pill cost
Prices checked on the makers' sites on November 4, 2026. Both companies can change them.
| Self-pay price per month | Wegovy pill (NovoCare) | Foundayo (LillyDirect) |
|---|---|---|
| Starting dose | $149 (1.5 mg) | $149 (0.8 mg) |
| Second dose | $199 (4 mg) | $149 (2.5 mg, reduced through Dec 31, 2026) |
| Middle doses | $299 (9 mg) | $199 (5.5 mg, reduced through Dec 31, 2026), $299 (9 mg) |
| Top dose | $299 (25 mg) | $299 (14.5 mg or 17.2 mg, if you refill within 45 days) |
| Commercial insurance with coverage | As low as $25 | As low as $25 |
| Medicare GLP-1 Bridge | $50 | $50 |
So for the first few months, Foundayo is a little cheaper while Lilly's temporary prices last. At the top doses, both list $299 a month. Novo also sells a 3, 6 or 12-month Wegovy subscription through telehealth partners, with the pill at $249 a month on the 12-month plan. Our Wegovy pill cost guide has the details.
Wegovy pill vs Foundayo sales
On November 4, 2026, Novo Nordisk reported Wegovy pill sales of 5.39 billion Danish crowns (about $810 million) for the third quarter, up 53% from the second quarter, according to Reuters. US prescriptions reached about 3.6 million in the quarter and more than 8 million since the January launch. Reuters also reported that Foundayo is winning a growing share of new prescriptions. More prescriptions do not mean one pill is better for you; they mostly show how fast both are spreading.
Pill or shot instead?
If neither pill fits your routine, weekly shots are another option, and the strongest shots lead to more average weight loss than either pill. Our GLP-1 pill vs shot guide compares all four.
The bottom line
The Wegovy pill has the higher average weight loss in its trial and an approved heart-protection use. Foundayo is easier to take, with no food or water rules, and is a bit cheaper at the low doses right now. Neither has been tested against the other. Bring this comparison to your prescriber, along with your medicine list and your budget. Whichever pill you choose, the muscle work is on you, and Sharpy gives you one protein target and one 20-minute workout a day to make it easy.
Sources
- Wegovy (semaglutide) injection and tablets prescribing information, DailyMed (revised June 2026)
- Foundayo (orforglipron) prescribing information, DailyMed (August 2026)
- Wharton S, et al. Oral semaglutide at a dose of 25 mg in adults with overweight or obesity (OASIS 4). NEJM, 2025 (PubMed)
- Price your Wegovy, NovoCare (Novo Nordisk)
- Foundayo self-pay pricing, LillyDirect (Eli Lilly)
- Novo Nordisk lifts 2026 outlook as Wegovy pill surges, Reuters via TimesLIVE, November 4, 2026
- Novo Nordisk launches multi-month subscription program for Wegovy, PR Newswire, March 31, 2026
Questions people ask
Which is better, the Wegovy pill or Foundayo?
Neither has been proven better, because they have not been compared in the same trial. In separate trials, the Wegovy pill 25 mg led to 13.6% average weight loss at 64 weeks and Foundayo 17.2 mg led to 11.1% at 72 weeks. Foundayo is easier to take because it has no food or water rules. Your prescriber can help you weigh results, side effects, your other medicines and cost.
Is Foundayo as effective as the Wegovy pill?
On paper, the Wegovy pill shows more average weight loss: 13.6% versus 11.1%. The trials had different lengths, people and designs, so the gap is not a clean comparison. In each trial, about 1 in 2 people on the top dose lost 10% or more of their weight (59.8% on the Wegovy pill, 54.5% on Foundayo).
Does the Wegovy pill have fewer side effects than Foundayo?
Both mostly cause stomach side effects like nausea, diarrhea, vomiting and constipation. In the trials, 6.9% of people on the Wegovy pill 25 mg stopped because of side effects versus 5.9% on placebo. For Foundayo, 10% stopped at the 17.2 mg dose versus 3% on placebo. Different trials, so treat this as a rough guide.
How much do the Wegovy pill and Foundayo cost?
As of November 4, 2026, NovoCare lists the Wegovy pill at $149 a month for 1.5 mg, $199 for 4 mg and $299 for 9 mg and 25 mg. LillyDirect lists Foundayo at $149 for 0.8 mg and 2.5 mg, $199 for 5.5 mg and $299 for 9 mg, 14.5 mg and 17.2 mg (the top two when you refill within 45 days). Both can be as low as $25 with commercial coverage and $50 on the Medicare GLP-1 Bridge.
Can I take Foundayo with coffee?
Yes. The Foundayo label says to take it once a day at any time, with or without food. The Wegovy pill is different: take it on an empty stomach with up to 4 ounces of plain water, then wait 30 minutes before coffee, food or other pills.
Can I switch from the Wegovy pill to Foundayo?
Only with your prescriber. The two labels do not give a switching plan between these two pills, and the Foundayo label says not to use it with another GLP-1 drug. Your prescriber decides the starting dose and timing for any switch.
Which pill is selling more?
Novo Nordisk reported on November 4, 2026 that Wegovy pill sales were 5.39 billion Danish crowns in the third quarter, with about 3.6 million US prescriptions in the quarter, according to Reuters. Reuters also noted Foundayo is winning a growing share of new prescriptions. Sales do not tell you which pill will work best for you.