Orforglipron (Foundayo): A new oral treatment for medical weight management. Translating science into practice.

Prof Steve Davies

Consultant Endocrinologist and Medical Director

The MHRA has authorised Eli Lilly’s orforglipron (Foundayo), making the UK the first European country to approve this once-daily oral GLP-1 receptor agonist for weight management and type 2 diabetes.[1]

Orforglipron is a non-peptide, GLP-1 receptor agonist through its binding mechanism is distinct from endogenous GLP-1. Its molecular design enables oral administration without the fasting, food or water restrictions associated with other oral peptide formulations.[2]

The clinical programme provides compelling evidence of efficacy. In the landmark phase 2 trial involving 272 adults with obesity or overweight without diabetes, mean weight reduction at 36 weeks ranged from 9.4% to 14.7%, compared with 2.3% with placebo.[3] This was subsequently confirmed in ATTAIN-1, a phase 3 trial involving 3,127 adults without diabetes. At 72 weeks, average weight loss was 7.5% – 11.2% across the three Orforglipron doses, versus 2.1% with placebo. At the highest studied dose, average weight loss is around 12% which is similar to that of other oral weight loss agents (4,5). The tablet is taken once daily and can be taken at any time of day with no food or water restrictions. Treatment begins at 0.8 mg, escalating through 2.5 mg, 5.5 mg, 9 mg, 14.5 mg, and 17.2 mg, with a minimum of one month at each dose level.

For You Can Clinic practitioners, the authorisation represents more than an additional prescribing option. It has the potential to broaden the addressable patient population, encourage new enquiries and support longer-term engagement with people who may previously have discounted GLP-1 treatment. It also creates opportunities to develop comprehensive care pathways incorporating which should help support patient retention to the service that you offer.

The drug is typically well tolerated and the side effect profile is similar to that of GLP-1 agonist class and include nausea, constipation and indigestion.

The medicine is not currently available through the NHS, with any future NHS use subject to NICE evaluation. This may generate early demand within appropriately governed private services. Practitioners who prepare now—through product education, robust protocols and compliant patient communications—will be well placed to respond.

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