Foundayo, Wegovy and how GLP-1 weight-loss pills compare to shots

Corrections: This story was updated to clarify the findings of clinical trials and out-of-pocket cost information.

As the GLP-1 weight-loss drug market continues to grow, consumers weary of needles now have two options in pill form instead.

Eli Lilly, the makers of Zepbound, gained FDA approval for its drug orforglipron, sold under the brand name Foundayo, on April 1, 2026, following Novo Nordisk, which received approval for the Wegovy pill in December 2025.

Unlike the injectable forms of the drugs, the pills are taken daily, not weekly, don't need to be refrigerated, and generally come at a much lower price tag. As GLP-1s become more ubiquitous, leading many to scramble after insurance rejections, both manufacturers are looking to draw in more customers who either prefer to avoid a needle or were unable to swing the out-of-pocket price.

Lilly's drug, marketed under the brand name Foundayo, began shipping to customers on April 6. On April 8, Amazon announced it would stock the new weight-loss pill at U.S. kiosks, offering same-day shipping. Lilly also said it would begin selling Foundayo directly ​to cash-paying customers through LillyDirect at $149 per month for the lowest dose.

Amid growing access to GLP-1 drugs, here's what to know about injections versus pills.

What are GLP-1 drugs? How they work.

GLP-1 agonists are FDA-approved drugs used to help lower blood sugar in people with type 2 diabetes. These drugs are also used to help people lose weight, and different versions and doses have been approved by the FDA for both purposes.

GLP-1 stands for glucagon-like peptide-1, a naturally occurring hormone that regulates metabolism, or how the body uses energy, as previously reported by USA TODAY. After you eat, GLP-1 increases insulin, stops blood sugar from entering the bloodstream, slows stomach emptying, and makes you feel full. People taking GLP-1s may experience fewer blood sugar spikes, less hunger, and quicker, longer-lasting fullness after meals.

The two most well-known GLP-1 agonists are semaglutide (Ozempic and Wegovy) and tirzepatide (Zepbound and Mounjaro). Studies show that Tirzepatide generally results in greater weight loss because it is dual-acting: not only does it suppress hunger signals, but it also improves how the body handles glucose and insulin at the same time, as reported by USA TODAY.

Are the GLP-1 pills as effective as injections? What trials found.

In its third and final clinical trial phase (including 3,127 adults), Eli Lilly's weight loss pill resulted in a 12.4% weight loss at 72 weeks for obese participants without type 2 diabetes who took the highest dose of the medication. Participants also incorporated an improved diet and exercise during the trial. On average, the participants lost 7.8% to 12.4% of their body weight, and 59.6% of people on the highest dose lost more than 10%, Eli Lilly reported. That comes out to an average of about 27 pounds, compared with about 2 pounds for patients on a placebo.

In Novo Nordisk's clinical late-phase trial for obesity without type 2 diabetes, which included more than 300 adults, the participants who took the pill once daily lost an average of 16.6% of their body weight, or 39 pounds, compared with 2.7%, or 6 pounds, for those on a placebo. The trial was shorter than Eli Lilly's, 64 weeks, and the company noted that the pill was used with a reduced-calorie diet and increased physical activity. Novo Nordisk said 60% of participants lost 10% or more of their body weight, compared with 14% in the placebo group.

Injectable semaglutide, sold by Novo Nordisk under the brand name Wegovy for weight loss, and tirzepatide, sold by Eli Lily as Zepbound for weight loss, generally cap out at a 15-20% body weight loss for the highest doses and 5-10% on the lower end. Tirzepatide has come out on top in multiple literature reviews and trials.

What are side effects of GLP-1 medications?

The most commonly-reported side effects of GLP-1 pills are consistent with GLP-1 injections and include gastrointestinal issues such as nausea, vomiting and diarrhea, according to the trials.

Other common side effects associated with GLP-1s include constipation, loss of muscle mass or bone density, and, less commonly, abdominal pain, according to the Obesity Action Coalition. Patients and health care providers should also keep an eye out for signs of improper nutrition, such as hair loss or fatigue.

Five to 10% of patients discontinued Eli Lilly's pill due to side effects across doses, the company said. For Novo Nordisk, 6.9% of participants dropped out of the trial due to the side effects.

According to Harvard Health, rarer but more serious side effects can include inflammation of the pancreas, called pancreatitis; gastroparesis, or the slowing or stopping of movement of food through the stomach; bowel obstruction or blockage; and gallstone attacks or bile duct blockages.

GLP-1s have also drawn broader scrutiny over unknown long-term health risks and reports of patients regaining weight once they stop the medication.

How much do GLP-1 pills cost versus injections?

Many insurance companies have opted out of covering GLP-1s for weight loss only, meaning you are likely to have to pay out-of-pocket for the drugs.

When paying out of pocket, prices vary wildly across medications and doses. You can expect to pay anywhere from $199 to $1,500 for a month’s worth of injections, depending on which GLP-1 medication you’ve chosen and where you get it.

Out-of-pocket, injectable Wegovy can cost $200-$350 monthly out of pocket versus $140-$300 a month for the pill, according to a Wegovy cost guide. Pharmacy and manufacturer coupons and offers can significantly lower the price, at least for a time. With insurance, both can cost as little as $25 a month.

The Zepbound injection can cost $300-$450 per month through LillyDirect without insurance, versus $150-$350 a month for Foundayo, USA TODAY previously reported. Again, pharmacy and manufacturer coupons and offers can significantly lower the price, and the cost can be as low as $25 a month with insurance.

On March 31, Novo launched a subscription plan for Wegovy's self-pay patients. Customers will get discounts of nearly 30% if they subscribe to the medications through telehealth partners Ro, Weight Watchers ​and LifeMD.

Under the subscription plan, the Wegovy pill will have monthly costs of $289 for a three-month subscription, $269 for a six-month subscription and $249 for a 12-month subscription. Those discounts range from 3% to 17% of the Wegovy pill's $299 monthly price.

Contributing: Ken Alltucker, USA TODAY; Reuters