Daily orforglipron pill aims to keep weight off after patients stop obesity injections
Eli Lilly's orforglipron, a once-daily oral tablet, has received US Food and Drug Administration approval and is now on sale. The drug is intended as a maintenance therapy to help people who come off injectable weight-loss treatments — chiefly semaglutide and tirzepatide — keep weight from returning.
Like existing obesity drugs, orforglipron is a GLP-1 receptor agonist. The difference is that it is a small molecule rather than a peptide, so it is not broken down in the stomach. That allows it to be taken as a daily tablet; current injectables are administered weekly or twice-weekly.
In the phase 3 ATTAIN-3 trial, orforglipron produced an average weight loss of 11.2% against placebo, the FDA briefing document says. It also reduced weight regain in patients who came off injectables by about five percentage points on average. The trial ran over 72 weeks in roughly 1,500 adults.
Dr Daniel Skovronsky, the Lilly clinical lead who worked on the programme, said: "Most patients want to come off the injections at some point, but they worry the weight will come back. Orforglipron is designed to be the bridge."
The monthly US list price for the new tablet starts at about $250, around two-thirds less than the average $950 monthly price tag of the injectables. US insurance coverage is not yet settled, although the drug is expected to fall within the new Medicare $2,000 annual out-of-pocket cap for prescription medicines.
The UK path depends on the Medicines and Healthcare products Regulatory Agency. Lilly's UK arm said it had filed its application this weekend. A subsequent review by the National Institute for Health and Care Excellence (NICE) could take six months before NHS prescription eligibility is decided.
Safety data submitted include the side-effect profile. In the phase 3 trial the most common adverse events were nausea (21%), constipation (12%) and headache (8%). Existing GLP-1 injectables show nausea rates as high as 30%, so the tablet appears modestly better tolerated.
Professor John Wilding, an obesity specialist at the Royal College of Physicians, told the BBC: "This is an important development because many of our patients know they can't be on the injections forever. But we still need more data on the long-term safety profile of orforglipron."
The global market for weight-loss injectables reached $90 billion in 2025. Orforglipron's manufacturing footprint is simpler: tablet form can be made at Lilly's existing plants in Indianapolis and Cork. That could ease the periodic shortages seen with the injectables.
The UK NHS currently prescribes Wegovy and Mounjaro for obesity, but only to about 30,000 people a year. Orforglipron, if it secures a NICE recommendation and an acceptable price, could expand that pool meaningfully. A NICE decision is expected in autumn 2026.