Which Weight Loss Tablets Are Licensed in the UK? Foundayo, the Wegovy Pill and Rybelsus
Three GLP-1 tablets are talked about for weight loss in the UK—but only two are licensed for it. What each one is actually approved for, how they differ, and how they compare with the injections.
Part of the Overweight and Obesity condition guide.
The headline: Foundayo and Wegovy tablets are licensed in the UK for weight management. Rybelsus contains the same active ingredient as the Wegovy pill but is licensed only for type 2 diabetes—that distinction is the single most important thing on this page, and the thing most often got wrong.
Not Sure Which Tablet Fits You?
Access Doctor supplies the licensed GLP-1 tablets following a GPhC-regulated online consultation with our pharmacist independent prescribers. We don't supply medicines outside their UK licence for weight loss.
Compare Weight Loss Treatments →The short version
All three medicines discussed here are prescription-only and require assessment by a registered prescriber. None of the three is available on the NHS for weight management. This page is general information, not a recommendation.
| Foundayo | Wegovy pill | Rybelsus | |
|---|---|---|---|
| Active ingredient | Orforglipron | Semaglutide | Semaglutide |
| Licensed in the UK for | Weight management and type 2 diabetes | Weight management | Type 2 diabetes only |
| UK approval for weight management | 10 August 2026 | 11 June 2026 | Not licensed for this |
| Strengths | 0.8–17.2 mg | 1.5, 4, 9, 25 mg | 3, 7, 14 mg (or the bioequivalent 1.5, 4, 9 mg) |
| Food and water rules | None | Empty stomach, up to 120 ml water, wait 30 min | Empty stomach, up to 120 ml water, wait 30 min |
| Typical weight change in trials | ~11–12% at highest dose | ~13.6–16.6% at 25 mg | ~3–4 kg (secondary finding in diabetes trials) |
| NHS availability | No | No | Yes, for type 2 diabetes where criteria are met |
Rybelsus isn't a weight loss medicine in the UK
Rybelsus contains semaglutide—the same active ingredient as the Wegovy pill—and it's a tablet. That similarity generates a lot of confusion, and some of it is actively unhelpful.
Rybelsus is licensed in the UK for the treatment of type 2 diabetes in adults. It isn't licensed for weight management. Three things follow from that.
1. The doses are much lower
Rybelsus tops out at 14 mg. The Wegovy pill goes to 25 mg. These aren't interchangeable products under different brand names—the dose is central to the effect.
There's a wrinkle here that trips people up. Rybelsus is supplied in two bioequivalent formulations: oval tablets of 3 mg, 7 mg and 14 mg, and round tablets of 1.5 mg, 4 mg and 9 mg. The round 9 mg tablet delivers the equivalent of the oval 14 mg—the numbers differ, the exposure doesn't. The Wegovy pill uses the same newer round formulation, which is why its strengths run 1.5, 4, 9 and then 25 mg. So the meaningful difference isn't "9 mg versus 14 mg" but that only the Wegovy pill has a 25 mg step at all.
2. The weight loss is modest
In diabetes trials, Rybelsus produced average reductions of roughly 3–4 kg as a secondary outcome. That's a real effect, but it's a different order of magnitude from the 10–17% seen in dedicated weight-management trials.
3. Prescribing it purely for weight loss is off-label
That isn't automatically wrong—off-label prescribing is lawful and sometimes appropriate—but it requires a documented clinical rationale and properly informed consent. A service offering Rybelsus as a weight-loss product without explaining that it's unlicensed for that purpose isn't giving you the information you need.
If you're looking at Rybelsus for weight loss, ask directly: is this licensed for what I want it for, and if not, why is it being recommended over something that is?
The two licensed options
Foundayo (orforglipron)
Foundayo is chemically different from the others. It's a small-molecule, non-peptide GLP-1 receptor agonist—a molecule robust enough to survive digestion without help. That has one large practical consequence: no food or water restrictions. You take it once a day, at any time, with or without food.
- Strengths: 0.8, 2.5, 5.5, 9, 14.5, 17.2 mg
- Titration: monthly steps, at least 30 days at each dose
- Trial result: ATTAIN-1, 3,127 adults, 72 weeks—−11.1% versus −2.1% placebo at the highest dose (treatment-policy estimand); the manufacturer reports −12.4% under the efficacy estimand
- Also licensed for type 2 diabetes, which none of the others combine with a weight-management licence in the UK
Full detail is in our Foundayo guide and dosage schedule.
The Wegovy pill (oral semaglutide 25 mg)
The Wegovy pill is a peptide, like the injection, and needs an absorption enhancer plus a strict routine to work.
- Take it in the morning on an empty stomach, with no more than 120 ml of water, then wait 30 minutes before eating, drinking or taking other oral medicines
- Strengths: 1.5, 4, 9, 25 mg
- Titration: monthly steps
- Trial result: OASIS-4, 307 adults, 64 weeks on treatment—approximately −13.6% versus −2% placebo; the manufacturer reports −16.6% when treatment was adhered to
- People on 2.4 mg weekly Wegovy injections can transition to the 25 mg tablet
See what Wegovy tablets are and what they cost.
Comparing the trial results honestly
These three medicines have never been tested against each other. The figures come from separate trials with different designs, sizes, durations and populations, so they describe each medicine on its own terms rather than ranking them.
Trap 1: estimands
Each trial reports two numbers. The treatment-policy estimand counts everyone as randomised, including those who stopped. The efficacy estimand estimates the effect in people who take the medicine as intended. Comparing one drug's efficacy figure to another's treatment-policy figure inflates the difference.
Trap 2: trial size
ATTAIN-1 enrolled 3,127 people. OASIS-4 enrolled 307. The larger trial gives a more precise estimate, with narrower uncertainty around the average.
What can reasonably be said: oral semaglutide 25 mg produced greater average weight loss in its trial than orforglipron did in its own, and both produced substantially more than Rybelsus does at diabetes doses. How much greater, and whether it holds for any individual, the evidence doesn't establish. Response varies widely, and there's no way to predict in advance where you'll fall.
Side effects and safety
All three are GLP-1 receptor agonists and share a profile. The commonest effects are gastrointestinal—nausea, constipation, diarrhoea, vomiting, indigestion—worst after each dose increase and easing with time. Every one of them uses slow monthly titration for this reason.
All three carry a boxed warning for thyroid C-cell tumours and are contraindicated in anyone with a personal or family history of medullary thyroid carcinoma or with MEN 2 syndrome. All carry warnings about pancreatitis, gallbladder disease, dehydration and kidney injury, hypoglycaemia when combined with insulin or sulfonylureas, and aspiration risk under anaesthesia—tell any surgeon, anaesthetist, endoscopist or dentist well before a procedure. None should be used in pregnancy, and none should be combined with another GLP-1 receptor agonist.
Where they differ:
- Foundayo has CYP3A4-related interactions: maximum 9 mg daily with a strong inhibitor, avoid strong inducers including St John's wort, and limit simvastatin to 20 mg daily
- The two semaglutide tablets require a 30-minute window clear of all other oral medicines, which is its own kind of interaction problem if you take anything else in the morning
- All three can reduce absorption of oral contraceptives—raise this specifically with your prescriber
The full picture for orforglipron is in the Foundayo side effects and safety guide.
Which of these are on the NHS?
Foundayo and the Wegovy pill aren't available on the NHS. MHRA authorisation establishes that a medicine is safe, effective and of adequate quality; NHS funding is a separate decision made by NICE, and neither has completed an appraisal. Access is by private prescription only.
Rybelsus is available on the NHS—but for type 2 diabetes, where prescribing criteria are met, not for weight management.
A UK price for Foundayo hadn't been confirmed by the manufacturer at the time of writing. When comparing services, compare the total annual cost at a realistic maintenance dose, including consultations and monitoring—not the entry price at the lowest strength. More detail is in Foundayo UK cost and access.
What about the injections?
Tablets aren't the whole picture, and it would be misleading to present them as the best available option.
Injectable semaglutide 2.4 mg sits between the two. Tirzepatide is also available on the NHS under NICE TA1026, on a phased rollout, for adults with a BMI of at least 35—or 32.5 for some ethnic backgrounds—plus at least one weight-related condition.
For many people, the honest position is that the tablets trade some effectiveness for convenience. Whether that trade is worth making is exactly the sort of thing a consultation is for. See Foundayo vs Mounjaro, what Mounjaro is and Saxenda injections.
Order Foundayo or Wegovy Tablets
Free online consultation, reviewed by a GPhC-registered pharmacist independent prescriber. We only supply medicines within their UK licence, and we'll tell you if treatment isn't clinically appropriate for you.
Order Foundayo →Frequently Asked Questions
Is there a weight loss pill that works as well as the injections?
Not on current evidence. Both licensed tablets produced less average weight loss in their trials than injectable tirzepatide did in its own. Injectable tirzepatide averaged around 20.9% at 15mg over 72 weeks in SURMOUNT-1, against roughly 11 to 12% for orforglipron and 13.6 to 16.6% for oral semaglutide 25mg. The tablets trade some effectiveness for convenience.
Can I take Rybelsus for weight loss?
Rybelsus is not licensed for weight loss in the UK. It is licensed for the treatment of type 2 diabetes in adults. Prescribing it for weight loss alone is off label, which is lawful but requires a documented clinical rationale and properly informed consent. Two tablets are now licensed specifically for weight management, so there is usually a licensed alternative to consider first.
Is the Wegovy pill just a higher dose of Rybelsus?
They are different products with different licences. Both contain oral semaglutide and share strengths at 1.5mg, 4mg and 9mg, but only the Wegovy pill has a 25mg dose and only the Wegovy pill is licensed for weight management in the UK. They are not interchangeable, and a prescription for one is not a prescription for the other.
Why does Rybelsus come in two sets of numbers?
Rybelsus is supplied in two bioequivalent formulations: oval tablets at 3mg, 7mg and 14mg, and round tablets at 1.5mg, 4mg and 9mg. Each round tablet delivers the equivalent exposure of its oval counterpart, so a round 9mg tablet is equivalent to an oval 14mg tablet. Your pharmacy will tell you which formulation you have been supplied.
Which weight loss tablet is easiest to take?
Foundayo, by a clear margin. There is no fasting requirement, no water limit, no waiting period and no fixed time of day. Both semaglutide tablets must be taken in the morning on an empty stomach with no more than about 120ml of water, followed by a 30 minute wait before eating, drinking or taking any other oral medicine.
Do any of these tablets work without diet and exercise?
All are licensed as an adjunct to a reduced-calorie diet and increased physical activity. Every participant in every trial received lifestyle support alongside the medicine, so the published results describe the combination rather than the drug alone. A medicine makes the dietary change more achievable; it does not replace it.
Will I regain weight if I stop an oral GLP-1?
Appetite typically returns and weight regain is common across this class of medicine, whether the treatment was a tablet or an injection. How long you stay on treatment is something to review with your prescriber over time, alongside the diet, activity and support that will carry the result if you do stop.
Are any weight loss tablets available on the NHS?
Neither Foundayo nor the Wegovy pill is available on the NHS, because NICE has not completed an appraisal for either. Rybelsus is available on the NHS but for type 2 diabetes where prescribing criteria are met, not for weight management. Injectable tirzepatide is available on the NHS under NICE TA1026, on a phased rollout with prioritised access.
How Access Doctor prescribes
Access Doctor is a GPhC-registered UK online pharmacy supplying licensed weight management medicines by private prescription. Our prescribers work within UK licensed indications, and where a medicine isn't licensed for the purpose you're asking about, we'll say so rather than supply it off-label without a clear rationale.
Weight Loss · Rx
Foundayo (Orforglipron)
The easiest of the tablets to take: any time of day, with or without food.
View product →Weight Loss · Rx
Wegovy Tablets
Oral semaglutide up to 25 mg, the larger average weight loss of the two tablets.
View product →See all licensed options, tablets and injections, on our weight loss treatments page.
References
- Medicines and Healthcare products Regulatory Agency. UK first in Europe to authorise orforglipron for weight management and type 2 diabetes. 10 August 2026. gov.uk
- The Pharmaceutical Journal. MHRA approves semaglutide oral tablets for weight loss. 2026. pharmaceutical-journal.com
- US Food and Drug Administration. FOUNDAYO (orforglipron) tablets — Prescribing Information. 2026. accessdata.fda.gov
- American College of Cardiology. OASIS 4 trial summary. 2025. acc.org
- electronic medicines compendium. Rybelsus Summary of Product Characteristics. medicines.org.uk
- NHS England. Interim commissioning guidance: NICE TA1026 tirzepatide. england.nhs.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.