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. 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 turn down hunger signals, but it also improves how the body handles glucose and insulin at the same time.
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 nearly 12.4% weight loss at 72 weeks for obese participants without type 2 diabetes who took the highest dose. On average, 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, participants who took the pill once daily lost an average of 14% of their body weight, or 33 pounds, compared with 2.4%, or 6 pounds, for those on a placebo. The trial was shorter — 64 weeks — and the company noted the pill was used alongside 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 (Wegovy) and tirzepatide (Zepbound) generally cap out at 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 the 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 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 watch 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. For Novo Nordisk, 18% of trial participants dropped out due to side effects.
According to Harvard Health, rarer but more serious side effects can include pancreatitis, gastroparesis, bowel obstruction, and gallstone or bile duct complications. GLP-1s have also drawn scrutiny over unknown long-term health risks and reports of patients regaining weight after stopping 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 most patients are paying out of pocket.
When paying out of pocket, prices vary widely. You can expect to pay anywhere from $199 to $1,500 for a month’s worth of injections, depending on which medication you’ve chosen and where you fill it.
Out-of-pocket, injectable Wegovy can cost up to around $1,619 per month, versus $140–$300 a month for the pill. Pharmacy and manufacturer coupons can significantly lower the price. With insurance, both can cost as little as $25 a month.
The Zepbound injection can cost up to $1,281 per month without insurance, versus $149–$349 a month for Foundayo. Again, coupons can significantly reduce the cost, and insurance can bring it down to as little as $25 a month.
On March 31, Novo Nordisk launched a subscription plan for Wegovy’s self-pay patients. Customers will get discounts of nearly 30% if they subscribe through telehealth partners Ro, Weight Watchers, and LifeMD. Monthly costs under the plan run $289 for a three-month subscription, $269 for six months, and $249 for a 12-month subscription — discounts ranging from 3% to 17% off the $299 monthly price.
Contributing: Ken Alltucker, USA TODAY; Reuters
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