GLP-1 Weight Loss Pill Side Effects: Foundayo and Wegovy

With the U.S. Food and Drug Administration (FDA) approving pill versions of orforglipron (Foundayo) and semaglutide (Wegovy) for weight management, you might wonder how the side effects of glucagon-like peptide-1 (GLP-1) receptor agonist pills compare with weekly injectable versions.

The new pills haven’t been around long enough to establish their long-term safety. But their side effects do not seem significantly different from injectable versions of semaglutide and tirzepatide (Zepbound).

The side effect rates are fairly similar, but that doesn’t mean that each drug will affect everyone equally. Anthony Puopolo, MD, an internal medicine physician and the chief medical officer at the telehealth platform LifeMD, believes that Foundayo hits some people harder: “The types of symptoms are the same — the intensity and dropout rate are not.”

Preventing and Managing GI Problems

To prevent and manage GI side effects with GLP-1s, first be conscious about what you’re eating.

“Often, when patients start a GLP-1 medication, they are surprised that certain foods can cause significant side effects,” says Meghan Garcia-Webb, MD, a board-certified internal, lifestyle, and obesity medicine physician in private practice in Wellesley, Massachusetts.

High-fat foods such as pizza tend to cause side effects for many people, so stick to smaller meals with lean protein and plenty of fruits and vegetables, she suggests.

“For patients who are more sensitive to nausea, I may prescribe anti-nausea medication,” says Mir Ali, MD, a bariatric surgeon, bariatric medicine specialist, and the medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California.

• Fatigue
• Headaches
• Uncomfortable skin sensations (dysesthesia)

When you take a GLP-1, you may experience side effects because of weight loss rather than the medication itself. These include aesthetic changes to your face and body, commonly called “Ozempic face,” “Ozempic butt,” and “Ozempic breasts.”

“Generally, the hair grows back after a plateau weight is reached,” says Sriram Machineni, MD, the director of the Fleischer Institute Medical Weight Center at Montefiore Einstein in New York City.

“The physical changes associated with these medications are more closely related to the total amount of weight lost rather than the speed of the loss,” Dr. Ali says. “Consequently, patients who lose more weight are more likely to notice these changes, regardless of which medication or delivery method is used.”

GLP-1 pills and injectables have about the same effect on weight loss, though Dr. Machineni says that losing less weight reduces your risk of these weight loss side effects.

• Pancreatitis, or inflammation of the pancreas
• Gallbladder issues, including gallstones
• Severe allergic reactions
• Vision changes in people with type 2 diabetes
• Thyroid tumors, including cancer
• Severe stomach problems
• Kidney damage from dehydration
• Low blood sugar in people with type 2 diabetes
• Increased resting heart rate
• Food or liquid getting into the lungs during surgery
• Gastroparesis (stomach paralysis)

While rare, these side effects are possible. Be sure to weigh the potential risks with your healthcare provider when deciding whether to take a GLP-1 in any form.

Ultimately, you may want to work with your doctor to decide if a daily oral pill or a weekly injection is best for you, Ali says, considering factors such as cost, insurance coverage, comfort with self-injection, and general convenience.

• GLP-1 weight loss medications orforglipron (Foundayo) and semaglutide (Wegovy) in pill form have similar side effects to their injectable versions, with gastrointestinal issues such as constipation and diarrhea being the most common.
• To help manage these side effects, stick to smaller meals with lean protein, fruits, and vegetables, and avoid high-fat foods that may trigger symptoms.
• While rare, GLP-1 pills carry serious risks such as pancreatitis, gallbladder issues, thyroid tumors, and kidney damage.
• Work closely with your doctor to determine if a GLP-1 pill or injection is the best option for you.