GLP-1 tablets for weight loss

There are 2 GLP-1 tablets licensed for weight loss in the UK. They are the Wegovy pill, which contains the active ingredient semaglutide and Foundayo, which contains orforglipron. They are both prescription-only medications that suppress your appetite and slow your digestion alongside a reduced-calorie diet and increased physical activity. Rybelsus is another GLP-1 tablet available in the UK that contains semaglutide, but it is licensed only for treating type 2 diabetes, not for weight loss.

Wegovy pill

The Wegovy pill is a once-daily weight loss tablet that contains semaglutide. Although it contains the same active ingredient as the injection, the tablet is taken differently as it’s absorbed through your stomach and follows its own dosing schedule.

How do Wegovy pills work?

Wegovy pills work like other GLP-1 medications. They mimic the natural GLP-1 hormone that your body releases after eating.

Wegovy pills help you lose weight by:

• reducing your appetite
• helping you feel fuller after meals
• slowing down how quickly food leaves your stomach, so you stay satisfied for longer
• making it easier to reduce your calorie intake without feeling as hungry

How do you take Wegovy pills?

Unlike the weekly Wegovy injection, you take Wegovy tablets once a day.

To help your body absorb the medication properly, you should:

• take 1 tablet first thing after waking up, after fasting for at least 8 hours
• swallow the tablet whole with no more than 120ml of plain water
• wait at least 30 minutes before eating, drinking anything other than plain water, or taking any other oral medication
• take your tablet at around the same time every day

Wegovy pill dosage

Wegovy tablets are started at a low dose and increased gradually, which is called titration. This helps your body adjust to the medication and reduces the chance of side effects.

The usual Wegovy pill dosage schedule is:

If you're getting side effects, your doctor will recommend staying on your current dose for longer before increasing it. You can also stick to a lower dose if you do not want to reach the maximum dose, as long as you’re happy with your results and this is still causing weight loss.

What are the side effects of Wegovy pills?

Like all medications, Wegovy pills can cause side effects, although not everyone gets them. Most are mild and improve as your body gets used to treatment.

The most common side effects include:

• feeling sick (nausea)
• being sick (vomiting)
• diarrhoea
• constipation
• stomach pain
• headache
• indigestion
• tiredness or weakness

These side effects are usually most noticeable when you first start treatment or after increasing your dose. Eating smaller meals, drinking plenty of water, and avoiding greasy or spicy foods can often help.

If you get severe stomach pain, symptoms of an allergic reaction, or any side effect that worries you, speak to a doctor or call 999 in an emergency. A full list of side effects can be found in the patient information leaflet.

Who can take Wegovy pills?

You may be eligible for Wegovy pills if you have:

• a body mass index (BMI) of 30 or above
• a BMI of 27 or above with a weight-related health condition, such as high blood pressure or type 2 diabetes

In some cases, a doctor may be able to prescribe the Wegovy pill off-label if they believe it would be beneficial for you.

Wegovy pills may not be suitable if you're pregnant, breastfeeding, have certain medical conditions such as a severe gastrointestinal disorder, or have an allergy to semaglutide. Your doctor will check your medical history before prescribing treatment.

Foundayo

Foundayo is a once-daily weight loss pill that contains orforglipron. It is licensed in the UK for weight loss and weight maintenance in overweight or obese adults. It can also be used to treat type 2 diabetes. Foundayo is made by Eli Lilly and can be taken at any time of the day without food or water restrictions.

How does Foundayo work?

Foundayo is a GLP-1 receptor agonist, which mimics the effects of the naturally produced hormone GLP-1 that is released after eating to control your appetite and blood sugar levels.

Foundayo works in the same way as the Wegovy pill to support weight loss by:

• lowering your appetite
• slowing digestion to help you feel fuller after eating
• reducing hunger and food cravings
• making it easier to eat less and lower your calorie intake

Foundayo must be taken alongside a reduced-calorie diet and increased exercise for you to get the full benefit.

How do you take Foundayo?

Foundayo is a non-peptide pill, which means it remains stable in stomach acid and has no dietary restrictions. You should take 1 tablet per day, at a time that is most convenient for you. You do not need to take it on an empty stomach or wait before eating, drinking, or taking other oral medications. You should swallow the Foundayo pill whole. Do not break, crush, or chew it.

Foundayo dosage

You will start taking Foundayo on a low dose to help your body adjust and reduce the chance of digestive side effects. Foundayo is available in 6 doses:

1. Starting dose – 0.8mg
2. Month 2 – 2.5mg
3. Month 3 – 5.5mg
4. Month 4 – 9mg
5. Month 5 – 14.5mg
6. Month 6 – 17.2mg

You will need to stay on each dose for at least 30 days before your doctor will suggest increasing it. After reaching 5.5mg, your doctor may gradually raise your dose through 9mg and 14.5mg to a maximum of 17.2mg once daily, depending on how well the treatment works and whether you experience side effects.

What are the side effects of Foundayo?

Foundayo can cause side effects, but not everyone will get them. Gastrointestinal side effects are the most common and are most noticeable at the start of your treatment and after each dose increase.

Very common Foundayo side effects are:

• feeling sick (nausea)
• constipation
• diarrhoea
• being sick (vomiting)
• indigestion
• stomach pain

These side effects usually become more manageable or improve over time, and are often mild. It’s important to stay hydrated, especially if you are being sick or have diarrhoea because dehydration can sometimes lead to kidney problems.

If you get any Foundayo side effects that are difficult to manage, get worse, or are causing you concern, contact your doctor for advice.

Who can take Foundayo?

Foundayo may be suitable for you if you are aged 18 or over and you have a body mass index (BMI) of:

• 30 or above
• between 27 and 30 and at least 1 weight-related health condition, such as high blood pressure, type 2 diabetes, abnormal blood fat levels, or obstructive sleep apnoea

Foundayo may not be suitable for you if you are pregnant or breastfeeding, are allergic to orforglipron, or have a serious digestive issue. You should tell your doctor before taking Foundayo if you have any other health conditions or are taking any prescribed, over-the-counter, or herbal medications.

Comparing GLP-1 tablets

Wegovy pills and Foundayo are both once-daily GLP-1 tablets licensed for weight loss, but they contain different active ingredients and have different instructions about how to take them. Rybelsus is also a GLP-1 tablet, but it is only available to treat type 2 diabetes.

GLP-1 tablets and injections work in similar ways to reduce appetite and support weight loss. The main differences are how often you take them, how convenient you find them, and their active ingredients. One form is not automatically better than the other and the right option depends on your preferences, health, and response to treatment.

GLP-1 tablet pros and cons

Pros:

• no needles or injections
• easy to take discreetly
• Foundayo can be taken with or without food
• may suit people who dislike injections
• can be easier to travel with

Cons:

• must be taken every day
• Wegovy pills have strict fasting and drinking instructions
• fewer tablet options are currently available
• digestive side effects can still occur

GLP-1 injection pros and cons

Pros:

• most are taken only once a week
• several established weight loss treatments and doses are available
• no daily tablet routine
• some injections have produced greater average weight loss in separate clinical trials
• can be taken with or without food

Cons:

• involve using a needle
• can cause injection-site reactions
• pens may require more careful storage
• can be difficult to travel with
• some people find injections difficult or uncomfortable

How does their effectiveness compare?

Both forms can produce clinically meaningful weight loss, but effectiveness depends more on the active ingredient and dose than on whether the medication is a tablet or injection.

No, currently tirzepatide is only available as an injection medication. This is either under the brand name Mounjaro for weight loss in the UK or Zepbound in the US.

There are also no current plans to create tirzepatide tablets. The reason for this is that tirzepatide is broken down too quickly during digestion, so not enough medication would be absorbed by the body. This issue does not exist in the same way for other GLP-1 agonists, which is why GLP-1 agonist tablets with other active ingredients do exist.

Yes, Wegovy tablets exist with the same active ingredient as Ozempic. Like Wegovy, Ozempic contains the active ingredient semaglutide. These tablets are not technically ‘Ozempic tablets’ but Wegovy tablets, as they are for weight loss rather than diabetes.

Rybelsus tablets are also available and are more closely related to Ozempic, as both are used to treat diabetes. Rybelsus is a GLP-1 semaglutide tablet for type 2 diabetes, with a lower maintenance dose and different dosage schedule than Wegovy tablets.

What's the difference between Wegovy pills and Rybelsus?

Although Wegovy pills and Rybelsus have the same active ingredient, semaglutide, there are a few differences, including:

• what they are licensed for – Wegovy pills are for weight loss, while Rybelsus is for type 2 diabetes
• dosage schedule – Wegovy pills have a maintenance dose of 25mg, while Rybelsus has a highest dose of 9mg and a maintenance dose of 1.5mg, 4mg, or 9mg, and your doctor will keep you on the lowest dose needed to manage your blood sugar

Both tablets are taken the same way, daily and on an empty stomach, but are used to manage different conditions.

Is there oral GLP-1?

Yes, there are oral GLP-1 medications. The only one licensed in the UK for weight loss is the Wegovy pill, which is a semaglutide tablet. Foundayo, a new GLP-1 pill containing the active ingredient orforglipron, has been approved in the US but is awaiting approval in the UK and is not available as of yet.

There are also oral GLP-1s for diabetes, rather than weight loss, such as Rybelsus. These should only be used if you have type 2 diabetes.

Are over-the-counter GLP-1 capsules effective?

There are no GLP-1 agonist medications available over the counter. GLP-1 medications are prescription-only and must be approved by a doctor. Any product claiming to be an over-the-counter GLP-1 agonist medication is either lying, unsafe, or both.

Are there compounded versions of GLP-1 pills?

They may exist but are strongly discouraged by regulatory bodies like the Medicines and Healthcare products Regulatory Agency (MHRA). Compounded medications are custom-made medications produced by compounding pharmacies. Compounding pharmacies are legal in the UK, but they are heavily regulated. Compounding pharmacies still require you to have a legitimate prescription before buying medications.

If you need to use a compounding pharmacy due to allergies, make sure they are registered with the General Pharmaceutical Council.

Do I have to take GLP-1 tablets on an empty stomach?

No, while the Wegovy pill and Rybelsus must be taken on an empty stomach to ensure they are properly absorbed, Foundayo can be taken with or without food. The reason for this is that Foundayo is a non-peptide pill, so it does not need a special coating to help it pass through the stomach and into the bloodstream. If you find taking tablets on an empty stomach difficult or find the instructions around taking the Wegovy pill too restrictive, Foundayo may be a more suitable option. For example, if you are taking the Wegovy pill you must follow fasting instructions otherwise the medication will not be effective.

Will I gain the weight back when I stop taking GLP-1 weight loss pills?

It’s possible. If you’re taking Wegovy or Foundayo tablets, once you stop taking them, you may put weight back on. This is because GLP-1 tablets reduce your appetite, so when you stop taking them, your appetite comes back, and you digest food faster, so you will not feel as full between meals.

It helps to keep the weight off if you stick to a diet and exercise plan after you stop your medication, but if this is something you have not been able to manage in the past, you can take Wegovy or Foundayo tablets for maintenance. This is where you keep taking GLP-1 medication to maintain your weight, perhaps at a lower dose than before, so you do not lose more weight but can avoid weight gain. Speak to your doctor about staying on Wegovy or Foundayo tablets for maintenance.