Foundayo (orforglipron): guide to the obesity pill

By Dr. Asnat Raziel, bariatric surgeon specializing in obesity treatment, metabolic health and healthy longevity; Director of the Multidisciplinary Center for Obesity Treatment, Assia Medical, Assuta Ramat HaChayal, Tel Aviv

Foundayo (orforglipron): the complete guide to the new obesity pill

Foundayo (orforglipron) is the first non-peptide GLP-1 pill approved for the treatment of obesity. You take it once a day, at any time, with or without food. At the highest dose, it produced an average weight loss of 11.1% of body weight in people without diabetes.

Foundayo is the brand name of orforglipron, and it is the name that appears on the patient information leaflet in Israel. Eli Lilly developed the drug. The US Food and Drug Administration (FDA) approved it on April 1, 2026, for the long-term treatment of obesity and of overweight with at least one weight-related condition. I have written about the approval before, including a piece on Camoni about the pill that marks a new era (in Hebrew) and one on MedPage about the next stage of the obesity revolution (in Hebrew). In this guide I have gathered everything you need to know before you start. It is based on the prescribing information, the Hebrew patient leaflet and the studies published through October 2026.

Where Foundayo (orforglipron) stands in Israel and worldwide

In Israel, Foundayo (orforglipron) reached pharmacies on September 15, 2026. However, as of October 2026 it still lacks Israeli registration; an application for registration is now pending at the Ministry of Health. In the meantime, it is available through the “29C” pathway, at the sole discretion of the treating physician. This pathway allows a doctor to prescribe, on their own responsibility, a drug that lacks Israeli registration but holds registration in a recognized reference country. The doctor fills out a dedicated form, and a pharmacy then supplies the drug. You will find a detailed explanation in the article Form 29C: what you need to know on the Camoni website (in Hebrew).

The Israeli importer is Salomon, Levin and Elstein (SLA) Ltd., and patients receive an information leaflet in Hebrew. Its indication, doses and warnings match the FDA-approved labeling. The national health basket does not cover unregistered drugs, so for now patients pay for treatment themselves. According to reports, the full price ranges from ILS 691.59 a month for the 0.8 mg dose to ILS 1,146.46 for the 17.2 mg dose. I have written separately about access to Foundayo and Mounjaro, about the cost of obesity medication, and about Foundayo’s arrival in Israel.

Around the world, the picture is expanding quickly:

United States: approved in April 2026 for weight management. An application to approve it for type 2 diabetes as well is under review.
United Kingdom: the UK medicines regulator (MHRA) approved it in August 2026, both for weight management and for type 2 diabetes.
European Union: the scientific committee of the European Medicines Agency recommended approval for both indications on October 16, 2026. We expect the European Commission’s final decision in the coming weeks.

What is orforglipron, and what makes it different?

Orforglipron is a GLP-1 receptor agonist (GLP-1, glucagon-like peptide-1, is a natural satiety hormone that the gut releases after a meal). It activates the same receptor targeted by Wegovy, Ozempic and Mounjaro. The difference lies in its structure. Semaglutide and tirzepatide are peptides, chains of amino acids that the digestive tract breaks down easily. Orforglipron, by contrast, is a small, non-peptide molecule built for good absorption through the gut. That is why you can take it as an ordinary tablet. According to the prescribing information, you do not need to take it on an empty stomach, and there is no need to wait before eating, drinking or taking other medications.

Key pharmacological features

Relatively high bioavailability: about 77% of the dose reaches the bloodstream (measured at a 0.8 mg dose).
Blood levels peak 4 to 8 hours after a dose.
The half-life is 29 to 49 hours. Blood levels become steady after about a week of daily dosing.
The liver breaks it down, mainly through the enzyme CYP3A4 (cytochrome P450 3A4, a liver enzyme that metabolizes many drugs).
The body excretes about 87% of the drug and its breakdown products in the stool, and less than 1% in the urine.
You can store it at room temperature; it does not need refrigeration.

How Foundayo (orforglipron) works in the body

Foundayo (orforglipron) activates the GLP-1 receptor and acts on several mechanisms at once:

It increases the feeling of fullness.
It reduces hunger and the urge to eat, quieting what many patients call “food noise.”
It helps reduce calorie intake.
It slows stomach emptying. This effect is especially strong after the first dose and fades over time.
It increases insulin secretion only when blood sugar is high.
It reduces glucagon secretion when blood sugar is high.

Most of the lasting effect on weight does not come from slower stomach emptying. Rather, it comes from action on the hunger and satiety centers in the brain. I have written about this in more depth elsewhere, including the MedPage piece Why does our brain ask for food even when we’re not hungry? (in Hebrew).

Who is the drug for?

According to the indication in the prescribing information, doctors prescribe Foundayo (orforglipron) alongside a reduced-calorie diet and physical activity. Its goal is to reduce excess weight and maintain the loss over time. Candidates include:

Adults with obesity, meaning a body mass index (BMI: weight in kilograms divided by height in meters squared) of 30 or higher.
Adults with overweight, meaning a BMI of 27 or higher, with at least one weight-related condition.

Such conditions include high blood pressure, abnormal blood lipids, sleep apnea, cardiovascular disease or type 2 diabetes. Medication is especially appropriate when lifestyle change alone is not enough (in Hebrew), as the new professional recommendations (in Hebrew) also define it.

It is important to be precise: in the United States, the indication is for weight management only. In the United Kingdom, by contrast, regulators also approved the drug for type 2 diabetes. About 13% of trial participants were 65 or older, and researchers found no differences in safety or effectiveness in this group. I have written about obesity treatment in older age on MedPage (in Hebrew), and separately about the results in women during menopause. On the other hand, regulators have not approved the drug for children and adolescents, and its safety under age 18 remains unproven. I have written about the options available for teenagers on ynet (in Hebrew).

Foundayo (orforglipron) doses and dose escalation

According to the prescribing information, the drug comes in six strengths: 0.8, 2.5, 5.5, 9, 14.5 and 17.2 mg. Each bottle contains 30 tablets. The dose-escalation schedule is:

Start with 0.8 mg once a day for at least 30 days.
Increase to 2.5 mg once a day for at least 30 days.
Then increase to 5.5 mg once a day for at least 30 days.
Depending on response and tolerability, your doctor can raise the dose gradually to 9, 14.5 and 17.2 mg, with each step coming after at least 30 days on the previous dose.
The maximum dose is 17.2 mg once a day.

The gradual increase aims to reduce nausea, vomiting and other digestive side effects. There is no obligation to reach the maximum dose. The right dose is the lowest one that provides good control of hunger, weight loss or weight maintenance, and good tolerability. I have expanded on this principle in a separate article, “Does every patient need the maximum dose?”, and in my step-by-step guide to Foundayo treatment.

Why the numbers in the trials are different

The phase 3 trials used an investigational formulation at doses of 6, 12 and 36 mg. The company developed the commercial tablets after adjusting the bioavailability. As a result, the 6, 12 and 36 mg doses in the trials correspond to 5.5, 9 and 17.2 mg in the commercial tablets. In other words, you cannot compare the numbers directly.

How to take the drug

Take one tablet once a day, with or without food.
Choose a fixed, convenient time of day to help you stay consistent.
Swallow the tablet whole. Do not split, crush or chew it.
Do not take more than one tablet a day.
Store at room temperature, 20 to 25°C, out of the reach of children.
According to the Israeli patient leaflet, the drug is sensitive to light. Keep the tablets in the original bottle and package, and close the cap after each use.

The big practical advantage is flexibility. The Wegovy pill (oral semaglutide), for example, requires an empty stomach, a limited amount of water and a wait before eating. Foundayo requires none of this. For anyone who is afraid of injections or finds it hard to keep pens refrigerated, that is a meaningful difference. I have also written an overview of all the oral options for obesity treatment.

What to do if you miss a dose

If you miss a dose, take it as soon as you remember. However, do not take two doses on the same day, and do not double the next dose. If you miss seven or more consecutive days, the patient leaflet advises contacting your doctor. According to the prescribing information, your doctor should then restart treatment at a lower dose and increase it gradually again.

How much weight do people lose with Foundayo (orforglipron)?

The two main phase 3 trials, ATTAIN-1 and ATTAIN-2, lasted 72 weeks. Together they included 4,740 participants with obesity or overweight. All participants received guidance on a reduced-calorie diet and advice to do at least 150 minutes of physical activity a week.

People without diabetes: the ATTAIN-1 trial

The ATTAIN-1 trial, published in the New England Journal of Medicine, included 3,127 adults without diabetes. Average body weight at the start of the trial was about 103 kg. In the analysis that included all participants, including those who stopped treatment, the average weight loss after 72 weeks was:

5.5 mg a day: 7.4%.
9 mg a day: 8.3%.
17.2 mg a day: 11.1%.
Placebo: 2.1%.

At the highest dose, out of every 100 participants:

About 72 lost at least 5% of their body weight (71.5%).
About 55 lost at least 10% of their body weight (54.5%).
About 36 lost at least 15% of their body weight (35.9%).
About 18 lost at least 20% of their body weight (18.4%).

For comparison, in the placebo group only 13 out of 100 lost at least 10% of their body weight.

People with type 2 diabetes: the ATTAIN-2 trial

The ATTAIN-2 trial, published in the Lancet, included 1,613 adults with overweight or obesity and type 2 diabetes. The average weight loss after 72 weeks was:

5.5 mg a day: 5.1%.
9 mg a day: 7.0%.
17.2 mg a day: 9.6%.
Placebo: 2.5%.

At the highest dose, 67 out of 100 participants lost at least 5% of their body weight, and about 46 lost at least 10% (45.6%). In addition, glycated hemoglobin (HbA1c, a measure of average blood sugar over the past three months) fell by an average of 1.7 percentage points, compared with 0.4 on placebo. The average value at the start of the trial was 8%. At the highest dose, 75.5% of participants reached a value below 7%, the usual target for good control. Losing weight is generally harder for people with diabetes, which is why the averages here are slightly lower. I have written more about the link between obesity and diabetes in my guide to obesity and type 2 diabetes.

Two ways to read the results

The numbers above are based on all participants assigned to treatment, including those who stopped it. This is the stricter and more realistic analysis. By contrast, in the ATTAIN-1 efficacy analysis, which estimates what happens to those who stay on treatment, weight loss at the high dose was 12.4%, compared with 0.9% in the placebo group. In ATTAIN-2, weight loss in this analysis was 10.5%, compared with 2.2% on placebo. Keep in mind that these are averages. Some patients lost more, some lost less, and some will not achieve an adequate response. I have written separately about why the same drugs work for one person and not for another.

Maintaining weight and switching from injections: the ATTAIN-MAINTAIN trial

Regulators approved Foundayo (orforglipron) not only for weight loss but also for maintaining that loss over time. The ATTAIN-MAINTAIN trial, published in Nature Medicine in May 2026, looked at a question many patients ask me: can you switch from an injection to a pill without losing what you have achieved? The trial included 376 adults who had completed 72 weeks of treatment with tirzepatide or semaglutide injections. Researchers then randomly assigned them to orforglipron or placebo for another 52 weeks. The results:

Those who switched from tirzepatide maintained, on average, 74.7% of their weight loss on orforglipron, compared with 49.2% on placebo.
Those who switched from semaglutide maintained, on average, 79.3% of their weight loss, compared with 37.6% on placebo.

What this means: switching to the pill preserved most of the weight loss, but not all of it. Over the year, people who switched from tirzepatide regained an average of about 5 kg, and those who switched from semaglutide only about 1 kg. The finding reinforces an important principle: obesity is a chronic disease, and continuing treatment is part of maintaining the result. I have written more about this trial on this site, on Camoni (in Hebrew) and on MedPage (in Hebrew).

How it compares with injections and other pills

Foundayo is effective, but the average weight loss in its trials is more modest than with the most powerful injections. In the SURMOUNT-1 trial, for example, tirzepatide at 15 mg produced an average weight loss of 20.9% over 72 weeks. However, comparisons between separate trials can be misleading. The populations, treatment duration, analysis methods and dropout rates are not the same. There is currently no basis for deciding that the pill is better or worse for a particular patient without considering their preferences, other health conditions and response to previous treatments.

In type 2 diabetes, there is also a head-to-head comparison with another pill. In the ACHIEVE-3 trial, orforglipron lowered glycated hemoglobin more than oral semaglutide (Rybelsus) over 52 weeks. On the other hand, digestive side effects, discontinuations due to side effects and increases in heart rate were more common with orforglipron. Foundayo’s main advantage is convenience. I have written about the considerations in choosing between a pill and an injection, and about how the two new pills compare in Wegovy pill vs. Foundayo. I also recommend the ynet articles Pills instead of weight-loss injections? and The weight-loss pill: the next big thing? (both in Hebrew).

Foundayo (orforglipron) and the heart: metabolic benefits and safety

Alongside weight loss, the trials showed additional metabolic improvements:

A smaller waist circumference: about 10 cm at the highest dose in people without diabetes. Waist circumference reflects, among other things, visceral (abdominal) fat.
A drop of about 6.4 mmHg in systolic blood pressure at the highest dose in people without diabetes.
A drop of about 20% in triglycerides at the highest dose.
Lower non-HDL cholesterol, that is, total blood cholesterol minus “good” cholesterol.
Better blood sugar control in people with type 2 diabetes.

On the other hand, heart rate rose by an average of 4 to 5 beats per minute, similar to other GLP-1 drugs.

Cardiovascular safety: the ACHIEVE-4 trial

The ACHIEVE-4 trial included 2,749 people with type 2 diabetes, overweight or obesity, and increased cardiovascular risk. It compared orforglipron with insulin glargine over a median follow-up of about two years. The researchers published the full results in the Lancet and presented them at the European diabetes conference in September 2026. The drug met its safety goal: the rate of major adverse cardiovascular events (MACE: heart attack, stroke, cardiovascular death or hospitalization for angina) was no higher than with insulin (HR 0.84).

In addition, according to the company, after 52 weeks glycated hemoglobin fell by 1.6 percentage points, compared with 1.0 on insulin. Weight fell by 8.8%, whereas on insulin it rose by 1.7%. A further analysis showed a lower death rate (HR 0.43), but the researchers did not test this finding with rigorous statistical methods, so we should interpret it with caution. In other words, the trial demonstrates cardiovascular safety, but no study has yet proven that the drug reduces heart attacks, strokes or deaths. We should not automatically assume that it shares the heart benefits of Wegovy (the SELECT trial, on Camoni, in Hebrew) or Mounjaro. I have written about Foundayo’s cardiovascular safety in more depth elsewhere, and about the protective effect of GLP-1 drugs after a heart attack on Camoni (in Hebrew).

Side effects of Foundayo (orforglipron)

The common side effects involve the digestive system. They appear mainly during the adjustment period and after dose increases, and they ease over time. In the pooled data from the two trials, the rates were as follows (placebo / 5.5 / 9 / 17.2 mg):

Nausea: 10% / 26% / 34% / 35%.
Constipation: 9% / 20% / 27% / 24%.
Diarrhea: 11% / 21% / 23% / 25%.
Vomiting: 4% / 13% / 21% / 24%.
Indigestion: 4% / 12% / 16% / 13%.
Abdominal pain: 7% / 13% / 14% / 14%.

Other common side effects included abdominal bloating, belching, reflux and heartburn, gas, fatigue, headache and hair loss. Most digestive side effects were mild. Of the patients who reported them, 60% described them as mild, 36% as moderate and 4% as severe. About 8 out of 100 patients stopped treatment because of side effects, compared with 3 out of 100 on placebo. Hair loss mainly affected women: 7% of women compared with less than 1% of men, and researchers linked it to weight loss. I have written separately about GLP-1 drugs and hair loss. For an overview of side effects across all obesity medications, see my guide to side effects.

How to reduce side effects

Gradual adjustment allows most patients to continue treatment comfortably. I recommend that you:

Eat small portions, slowly, and stop at the first feeling of fullness.
Temporarily cut back on fatty, fried or heavy foods.
Drink enough fluids throughout the day.
Add dietary fiber gradually and stay active every day.
Postpone a dose increase when there is significant nausea, vomiting, constipation or diarrhea.
Consider, under your doctor’s guidance, going back to the previous dose if symptoms persist.

Having no side effects does not mean the treatment is not working, and nausea is not a requirement for weight loss. You can read more about 8 steps to support weight loss on ynet (in Hebrew).

When to seek medical evaluation

See a doctor if any of the following appear:

Severe, persistent abdominal pain, especially if it radiates to the back.
Prolonged vomiting or difficulty drinking.
Signs of dehydration: reduced urine output, significant dizziness or weakness.
Pain in the upper right abdomen, fever, jaundice or pale stools.
Severe constipation with pain, bloating, or no bowel movements or gas.
Swelling of the face, lips, tongue or throat, a widespread rash or shortness of breath.
A lump or swelling in the neck, persistent hoarseness or difficulty swallowing.
A sudden change in vision in a person with diabetes.

In Israel, you can report side effects to the Ministry of Health through the online side-effect reporting form.

The pancreas, gallbladder and thyroid

Pancreatitis: doctors have reported acute pancreatitis with GLP-1 drugs, and it appears among Foundayo’s warnings as well. In the two ATTAIN trials, investigators confirmed 6 cases among patients taking the drug, compared with one patient in the placebo group. It is a rare event, but an important one to recognize. Severe, persistent pain in the upper abdomen, sometimes radiating to the back and accompanied by vomiting, requires stopping treatment and seeking urgent evaluation. For people who have had pancreatitis in the past, the decision needs careful, individual consideration, because there is little experience in this population.

Gallbladder: gallstones and gallbladder inflammation can occur with any rapid weight loss. In the two trials, gallstones occurred in 1% of patients compared with 0.7% on placebo, and acute gallbladder inflammation in 0.4% compared with 0.3%.

Thyroid: as with all GLP-1 drugs, Foundayo’s prescribing information includes a boxed warning about thyroid C-cell tumors. Studies found such tumors in rats and mice given other drugs in this class. Orforglipron is not active in rodents, so this test is not suitable for it. The relevance to humans is unknown. In practice, doctors do not give the drug to anyone with a personal or family history of medullary thyroid cancer.

Who should not take the drug

Do not use the drug if any of the following apply:

A personal or family history of medullary thyroid carcinoma.
MEN 2 syndrome (multiple endocrine neoplasia type 2, a genetic syndrome of tumors in the endocrine glands).
A previous serious hypersensitivity reaction to orforglipron or to any of the tablet’s ingredients.

In addition, the prescribing information advises against the drug:

In severe gastroparesis, a marked slowing of stomach emptying.
In severe liver impairment.
While breastfeeding.
In combination with another GLP-1 drug, such as Wegovy, Ozempic, Rybelsus, Saxenda or Mounjaro.

Kidneys, liver, blood sugar and blood pressure

Kidney function: impaired kidney function did not change blood levels of the drug, so the prescribing information does not call for a dose adjustment. However, nausea, vomiting and diarrhea can cause dehydration and acute kidney injury. In the two trials, such injury occurred in 0.2% of patients, compared with 0.05% on placebo. For people with kidney disease or those taking diuretics, it is therefore important to monitor fluid intake and kidney function.

Liver function: in moderate liver impairment, exposure to the drug rose about 1.7-fold, and in severe liver impairment 4.6-fold. The prescribing information therefore advises against it in severe liver impairment (Child-Pugh C, the most severe grade on the scale used to rate liver disease). With the approval, the FDA asked Eli Lilly for additional liver-safety data as part of post-marketing follow-up. This is a standard requirement for a new drug, not an unusual warning. I have written more about this in a separate article on the new weight-loss pill under the FDA’s magnifying glass. For people with fatty liver, weight loss is a central part of treatment.

Blood sugar, eyes and blood pressure

Low blood sugar: on its own, the drug usually carries a low risk of hypoglycemia. In the ATTAIN-2 trial, significant hypoglycemia occurred in 2% of patients, compared with 0.2% on placebo. The risk rises, however, when patients combine it with insulin or a sulfonylurea. In the trial, 7% of patients who also took a sulfonylurea had hypoglycemia, compared with 0.5% of those who did not. Doctors sometimes need to reduce the doses of these medications.

Diabetic retinopathy: rapid improvement in blood sugar control may be accompanied by a temporary worsening of damage to the blood vessels of the retina. Patients with existing retinopathy need regular eye follow-up.

Low blood pressure: in the two trials, low blood pressure occurred in 2% of patients, compared with 0.5% on placebo. It was more common in people taking blood pressure medication (4%). I have written more about this in my guide to treating high blood pressure through weight loss.

Pregnancy, contraception and breastfeeding

Doctors do not recommend intentional weight loss during pregnancy. If you become pregnant, stop treatment and contact your doctor. Human data are limited, and the prescribing information notes a possible risk to the fetus based on animal studies. Women of childbearing age should therefore use effective contraception during treatment.

Important guidance for women taking birth control pills: switch to a non-oral method of contraception, or add a barrier method such as a condom. This applies for 30 days after starting treatment and for 30 days after each dose increase. The reason is that slower stomach emptying may reduce absorption of the pill. A vaginal ring, patch or hormonal IUD, on the other hand, should work as usual.

Breastfeeding: the prescribing information and the Hebrew patient leaflet advise against breastfeeding during treatment. I have written about the new international guidelines for women of childbearing age on Camoni (in Hebrew), on this site, and on MedPage (in Hebrew), and also about what happens to weight when GLP-1 drugs are stopped ahead of pregnancy.

Foundayo (orforglipron) interactions with other drugs

Unlike the peptide drugs, orforglipron relies mainly on the enzyme CYP3A4 for its breakdown. In addition, the protein OATP1B (organic anion transporting polypeptide 1B, a carrier protein that moves drugs into liver cells) carries it into the liver. As a result, it has more important drug interactions, and I recommend reviewing all regular medications before starting treatment. I have written more about this in a separate article on obesity and polypharmacy.

Strong CYP3A4 inhibitors (for example, clarithromycin): maximum dose of 9 mg a day.
Strong CYP3A4 inhibitors that also inhibit OATP1B (for example, ritonavir): avoid the combination.
Strong CYP3A4 inducers (for example, carbamazepine, rifampin): avoid the combination.
Moderate CYP3A4 inducers (for example, efavirenz): monitor effectiveness and increase the dose as needed.
Simvastatin: do not exceed 20 mg a day.
Insulin and sulfonylureas: consider a dose reduction and monitor blood sugar.
Birth control pills: an alternative or additional contraceptive method for 30 days at each step.

To illustrate: clarithromycin increased exposure to orforglipron 3.5-fold, and carbamazepine reduced it by 82%. Combining it with simvastatin doubled exposure to simvastatin’s active compound. With atorvastatin and rosuvastatin, by contrast, studies found no clinically meaningful change. Acid-reducing drugs such as esomeprazole did not affect the drug’s level. In addition, slower stomach emptying may affect the absorption of other oral medications, mainly at the start of treatment. Any combination is worth checking in an up-to-date interaction database or with a pharmacist.

Surgery, anesthesia and invasive procedures

Foundayo (orforglipron) slows stomach emptying. With GLP-1 drugs, doctors have reported rare cases of food remaining in the stomach and aspiration into the lungs during general anesthesia or deep sedation, even when patients fasted as instructed. It is therefore important to inform the surgeon, the anesthesiologist and the team performing a gastroscopy or colonoscopy in advance. According to the prescribing information, the available data are not sufficient to determine whether temporarily stopping the drug reduces the risk. The decision depends on the type of procedure, the dose, digestive symptoms and local anesthesia guidelines.

How to switch from an injection to Foundayo (orforglipron)

There is no agreed conversion table between this drug and semaglutide, tirzepatide or liraglutide. The milligram amounts in the different products are not comparable. The ATTAIN-MAINTAIN trial showed that such a switch is possible and preserves most of the weight loss. However, the trial used an investigational formulation and its own protocol, so doctors should not copy its dosing. A switch needs to take into account:

The previous drug and dose, and the timing of the last dose.
How sensitive the person is to side effects.
Hunger levels and weight response.
Blood sugar levels and any other diabetes treatment.
The length of the break between treatments.
Regular medications and possible interactions.

A reasonable safety principle is to start conservatively and progress according to tolerability. This is especially important after a long break or in people who have previously suffered from nausea and vomiting. The prescribing doctor sets the exact protocol, on their own responsibility, as the 29C pathway requires. I have written more about switching from an injection to a pill in a separate article.

Recommended monitoring

Before starting treatment, it is worth checking:

Weight, height, BMI and waist circumference.
Blood pressure and heart rate.
Glycated hemoglobin or fasting blood sugar.
Kidney and liver function, and a lipid profile.
A list of regular medications and a check for interactions.
Any history of pancreatic, gallbladder or digestive disease.
Any personal or family history of thyroid tumors.
Pregnancy plans and contraception.
Eating habits, protein intake, physical activity and sleep.

I have also written a step-by-step guide to starting weight-loss medication.

During treatment, it is important to monitor effectiveness, tolerability, fluid intake, muscle mass and diet quality. It is also necessary to check whether diabetes and blood pressure medications need adjusting. It is best to assess response after an adequate period on a well-tolerated therapeutic dose. I have written at length about tests for personalizing treatment, about the importance of a multidisciplinary team, and about the document that redefines treatment with weight-loss drugs (in Hebrew).

How to preserve muscle mass

Any significant weight loss includes some loss of lean body mass. According to the prescribing information, the weight lost with this drug included more fat than lean mass. Still, the drug reduces appetite, and patients sometimes eat too little protein. A good plan includes:

A personalized amount of protein.
Strength training two to three times a week.
Aerobic activity and daily movement.
Enough sleep.
Tracking strength, function and body composition, when possible.
Checking for nutritional deficiencies, such as iron deficiency, when there is fatigue, weakness or hair loss.

Further reading: Preserving muscle mass in the era of weight-loss drugs and The seeds that build muscle on ynet, and Preserving muscle mass and the new issues in GLP-1 treatment on MedPage (all in Hebrew).

What happens when you stop Foundayo (orforglipron)?

Obesity is a chronic disease, and it is not laziness but physiology (in Hebrew). Stopping an effective treatment can bring hunger back and lead to weight regain. Real-world studies show this clearly with GLP-1 drugs. That is why regulators approved Foundayo (orforglipron) for maintaining weight loss as well, not only for achieving the initial loss. The decision to continue treatment, use a maintenance dose or switch to another drug should be based on effectiveness, tolerability, availability and cost. Stopping is not a personal failure, and the stigma around obesity (in Hebrew) only does harm. The right way to prepare for stopping starts at the very beginning of treatment.

The bottom line on Foundayo (orforglipron)

Foundayo (orforglipron) is the first non-peptide GLP-1 pill approved for weight management. You take it once a day, regardless of meals. At the highest dose, it produced an average weight loss of 11.1% in people without diabetes and 9.6% in people with type 2 diabetes. It also preserved most of the weight loss in people who switched to it from injections, and it demonstrated cardiovascular safety. The drug may be especially suitable for people who prefer a pill to an injection. The keys to safe treatment are choosing the right patients, increasing the dose gradually, reviewing interactions, and combining the drug with good nutrition, strength training and medical follow-up.

Medication is not a magic solution but a professional medical tool (in Hebrew), and it works best when you don’t face this alone (in Hebrew).

The information in this article is general and does not replace personal medical advice. Make the decision to start medication with a doctor who knows your medical history. This information is accurate as of October 22, 2026. If and when the drug receives Israeli registration, follow the leaflet approved in Israel and the Ministry of Health guidelines.