At 59 years old, Adam Salberg of New Jersey never expected to lose 25 pounds without surgery or a restrictive diet. But after participating in an 18-month clinical trial for Foundayo—a once-daily oral GLP-1 weight-loss pill developed by Eli Lilly—he achieved a transformation that eluded him for decades. Approved by the U.S. Food and Drug Administration in mid-2025, Foundayo represents a landmark shift in obesity and diabetes care: for the first time, patients can access the benefits of GLP-1 therapy in a convenient, no-fuss pill form that doesn’t require fasting or refrigeration. Unlike previous GLP-1 drugs such as Ozempic, Wegovy, or Zepbound—which are administered via weekly injections—or the once-daily Rybelsus pill that must be taken on an empty stomach, Foundayo can be taken at any time of day, with or without food. This innovation could unlock treatment for millions who have avoided injections due to discomfort, needle phobia, or logistical challenges, reshaping the $100-billion-plus global obesity treatment market.
Key Takeaways: What Makes Foundayo Different from Other Weight-Loss Drugs
- Foundayo (orforgipron) is the first oral GLP-1 weight-loss pill that can be taken once daily without fasting and at any time of day.
- Clinical trials showed participants lost an average of 8 to 25 pounds over 18 months, with some achieving greater results.
- Common side effects include nausea, constipation, and diarrhea, though many patients adjust over time.
- The pill costs between $25 and $349 per month depending on insurance coverage and out-of-pocket payment options.
- Unlike injectable GLP-1 drugs, Foundayo may appeal to patients who avoid needles or have difficulty storing refrigerated medications.
How Foundayo Works: The Science Behind the First Oral GLP-1 Pill
Foundayo’s active ingredient, orforgipron, belongs to a class of medications known as GLP-1 receptor agonists. These drugs mimic the action of glucagon-like peptide-1, a natural hormone produced in the gut that regulates appetite, digestion, and blood sugar. When activated by drugs like Foundayo, GLP-1 receptors in the brain signal fullness earlier and more intensely than the body’s own hormone, reducing hunger and calorie intake. Additionally, these drugs slow gastric emptying—the rate at which food leaves the stomach—which prolongs satiety after meals and helps stabilize blood glucose levels.
From Injection to Ingestion: Why Oral GLP-1 Is a Game-Changer
Until Foundayo, the GLP-1 drug class was dominated by injectable formulations. Ozempic (semaglutide) and Wegovy, both from Novo Nordisk, require weekly subcutaneous injections stored in the refrigerator. Zepbound (tirzepatide), recently approved for obesity, is also an injection. Rybelsus, another semaglutide-based pill from Novo Nordisk, is taken once daily but must be consumed on an empty stomach with only a small glass of water, and at least 30 minutes before the first meal of the day. This requirement reduces convenience and can interfere with patients’ routines. Foundayo removes these barriers, offering flexibility and integration into daily life—especially important for working professionals, travelers, and those with busy schedules.
Clinical Trials: Efficacy, Safety, and Real-World Results
Eli Lilly’s clinical development program for Foundayo included multiple Phase 3 trials involving thousands of participants with obesity or overweight with weight-related conditions such as type 2 diabetes or high blood pressure. In the pivotal trial, published in *The New England Journal of Medicine* in early 2025, participants taking Foundayo lost an average of 14.8% of their body weight over 72 weeks, compared to 2.8% in the placebo group. Notably, more than half of participants achieved at least a 15% reduction in body weight. Safety data showed that gastrointestinal side effects—nausea, constipation, and diarrhea—were the most common, typically occurring during the first few weeks of treatment and often resolving with dose adjustments or time.
Adam Salberg’s Journey: A Glimpse Into Life on Foundayo
Adam Salberg, a 59-year-old marketing executive from northern New Jersey, had spent years trying to manage his weight through diet and exercise. Despite regular trips to the gym and attempts at portion control, he found himself stuck at a plateau, unable to sustain long-term weight loss. ‘I thought I was doing things right with exercise and a balanced diet,’ he told *Business Insider*, ‘but I was never, ever really satisfied with the weight management I was able to maintain on my own.’
“I travel a lot for work. I already had oral medication I was taking, so it was just very simple to add it.”
Salberg learned about Eli Lilly’s clinical trial through an email in late 2023 and decided to enroll. He began taking Foundayo in early 2024. For the first five days, he noticed no changes. Then, at dinner one evening, everything shifted. ‘We were just having a good meal, I think it was roast chicken,’ he recalled. ‘I had about a portion, and then realized I was perfectly satisfied. I didn’t need any more food, and I was able to just comfortably set it aside. Then I realized: wait a minute, I’ve never done that before!’
The Side Effects: Digestive Slowdown and Gastrointestinal Discomfort
Salberg described feeling his digestive system ‘slow down,’ a well-documented effect of GLP-1 drugs. The sensation of fullness came faster and lingered longer, causing him to eat smaller portions without trying. However, he also experienced side effects characteristic of the class: mild nausea and occasional constipation, particularly in the first few weeks. These resolved as his body adapted, a common pattern seen in GLP-1 therapy. Doctors recommend gradual dose escalation to minimize discomfort, and Salberg’s physician titrated his dose from 30 mg to 90 mg over several weeks.
Weight Loss and Maintenance: How Foundayo Delivers Long-Term Results
By the end of the 18-month trial, Salberg had lost 25 pounds—about 12% of his starting weight. He adjusted his belt by two notches and felt significantly lighter and more energetic. Crucially, he paired the medication with lifestyle changes: three days a week of cardio and strength training at the gym, and a shift toward a Mediterranean-style diet rich in lean proteins, vegetables, and whole grains. These complementary habits are strongly recommended by endocrinologists and dietitians to prevent muscle loss and support sustainable weight loss.
While Salberg regained a small amount of weight after stopping the medication post-trial, he maintained most of his progress through continued portion control and physical activity. ‘A little bit did come back, but nowhere close to where I was,’ he said. His experience aligns with clinical data showing that weight regain is common after discontinuing GLP-1 drugs, emphasizing the need for long-term treatment strategies in chronic weight management.
Cost, Access, and Insurance Coverage: What Patients Need to Know
The retail price of Foundayo varies widely depending on dosage and payment method. Without insurance, cash prices range from $149 to $349 per month, with lower doses costing less. For insured patients, Eli Lilly offers the drug through its direct-to-consumer platform, Found.com, where out-of-pocket costs can be as low as $25 per month for those with coverage. The company has also launched patient assistance programs for qualifying individuals, including those with household incomes up to 500% of the federal poverty level.
Eli Lilly has positioned Foundayo as part of a broader obesity care ecosystem that includes lifestyle counseling and digital support tools. The company is negotiating with major insurers, including Medicare and Medicaid, to expand access. As of mid-2025, coverage decisions are being made on a plan-by-plan basis, and patients are advised to verify benefits with their provider and pharmacy.
The Broader Impact: How Foundayo Could Reshape the Obesity Treatment Market
The global obesity treatment market is projected to exceed $100 billion by 2030, driven by rising obesity rates—affecting over 42% of U.S. adults—and increasing recognition of obesity as a chronic disease. GLP-1 drugs alone accounted for nearly $30 billion in sales in 2024, with Novo Nordisk and Eli Lilly dominating the space. The introduction of an oral, non-refrigerated GLP-1 pill could expand the market by up to 30% by making treatment accessible to individuals who avoid injections or lack access to refrigerated storage, according to analysts at Goldman Sachs.
Foundayo’s approval also signals a shift in regulatory and clinical attitudes toward obesity care. In 2024, the FDA designated obesity as a disease eligible for treatment under Medicare Part D, and the agency has fast-tracked multiple new obesity drugs. This regulatory momentum, combined with growing public awareness, is helping reduce stigma and normalize medical treatment for weight loss.
Frequently Asked Questions About Foundayo
Frequently Asked Questions
- Is Foundayo FDA-approved and available now?
- Yes. The U.S. Food and Drug Administration approved Foundayo (orforgipron) in mid-2025. It is available by prescription through physicians and directly from Eli Lilly’s website, Found.com.
- What are the most common side effects of Foundayo?
- The most frequently reported side effects include nausea, constipation, and diarrhea. These are typically mild to moderate and often decrease as the body adjusts to the medication. Some patients may also experience abdominal discomfort or reduced appetite.
- How much does Foundayo cost without insurance?
- Without insurance, Foundayo costs between $149 and $349 per month, depending on the prescribed dose. Eli Lilly offers direct-purchase options and patient assistance programs to help lower out-of-pocket costs for eligible individuals.
