It’s the pharmacological equivalent of doing a crossword puzzle: you wake up, take a tablet with half a glass of water (never more than 120ml) and sit down to wait. Half an hour without breakfast, without coffee, without taking any other medicine. And all this so that only 1-2% of the oral semaglutide you take reaches your blood.
For years, our go-to pill for weight loss was Rybelsus, and taking it, as we see it, required almost monastic discipline. That is, bioavailability ended up being limited and few people did really well.
Therefore, the European Medicines Agency has recommended the approval of Foundayo (orforglipron) as a factor that goes beyond another GLP-1. It’s a decision that changes (almost) everything.
What exactly happened? The European Medicines Agency’s Committee for Medicinal Products for Human Use has approved orforglipron for two uses: weight management and poorly controlled type 2 diabetes. It is true that the committee cannot approve the drug (which is done by the commission), but for practical purposes it is the key initial step.
And all the fuss over a pill? As I said, Rybelsus has been in Europe since 2020 and the tablet version of Wegovy was approved in July 2026. The problem is, until now, all we had were peptides.
That is, chains of amino acids that mimic GLP-1, but are highly sensitive to stomach acid. So the injection was given in the traditional route. Attempts have been made to overcome the problem with enhancers (such as SNAC, a compound that facilitates absorption), but absorption remains minimal.
Orforglipron is something else: A molecule that activates the same receptor via a different route and is absorbed like any regular drug.
The fact of the matter is that such small molecules are manufactured through synthesis, do not require a cold chain, and scale better. It’s not just a format change, it’s a complete industry change. That’s why Lilly, the company that makes it, has $1.5 billion in inventory at the end of 2025. Before anyone approves the drug.
And does it work? In principle and as far as we know, yes. In weight trials evaluated by EMA, loss at 72 weeks was between 5% and 11% depending on dose, compared with 2 and 2.5% for placebo. These are slightly worse numbers than injectables, it’s true; But the advantages we mentioned make it very competitive and attractive.
The toll, so to speak, is digested (nausea, vomiting and diarrhea). In fact, between 3% and 6% of participants in clinical trials (depending on dose) discontinued because of it.
Are we going to take the next leap in the world of medicine? It’s what we all ask ourselves. If we pay attention to what happened in England, where it has been sold since August, the price will be around 100-120 pounds per month. That sounds pretty good, considering what has been said about its possible positive effects on the heart.
Especially for Lily. We just got a GLP-1 bigger than a stomach, what’s not clear is that it will survive the budget.
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