Orforglipron (Foundayo) is a GLP-1 pill and a small molecule, not a peptide, approved by the FDA in 2026 for weight management. Semaglutide (Ozempic, Wegovy) is a GLP-1 peptide approved in the US and EU for type 2 diabetes and weight management. This page compares their study results.
Comparing 2 records · Data version 308560
Swipe sideways to see every peptide.
| Peptide | Synthetic analog Semaglutide | |
|---|---|---|
| Identity | ||
| Kind | Small molecule | Synthetic analog |
| Area | Weight and metabolic | Weight and metabolic |
| Evidence | ||
| Amount of evidence | 340 | 4,624 |
| Evidence level | Has results from studies in people | Has results from studies in people |
| Safety | ||
| Safety results | 121 (119 in people) | 1,224 (1,221 in people) |
| Status | ||
| Approval | ||
| Sport (WADA) | ||
| Registered trials | 53 · 20 active1 more mentions it but does not test it | 663 · 284 active124 more mention it but do not test it |
Shared outcomes
From the regulatory data of each peptide.
The FDA label for Foundayo says: “With a reduced-calorie diet and increased physical activity: reduce excess body weight and maintain weight reduction long term in adults with obesity, or adults with overweight in the presence of at least one weight-related comorbid condition” No central EU authorisation (EMA).
The FDA label for Ozempic says: “Adjunct to diet and exercise for glycemic control in adults with type 2 diabetes; reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease; reduce the risk of sustained eGFR decline…”
Outcome groups with study results for at least two of these peptides. Counts include only results from studies that gave the peptide. Bar length is the number of results, on one scale. The bars show how much was studied, not how large an effect was. A peptide with more studies can look stronger here without being stronger. For results, see the randomized results above.
| Outcome group | Orforglipron | Semaglutide |
|---|---|---|
| Body weightMetabolic and weight | 66633 | 969954105 |
| Adverse eventsWhole body | 545211 | 7757723 |
| Glycemic controlMetabolic and weight | 54513 | 66866512 |
| Gastrointestinal adverse eventsGastrointestinal | 4646 | 345345 |
| Cardiovascular eventsCardiovascular | 211 | 2672634 |
| Liver fat and liver functionLiver | 99 | 17917441 |
| LipidsMetabolic and weight | 13121 | 1181171 |
| PharmacokineticsPharmacology | 383332 | 93894 |
| MortalityWhole body | 88 | 1041031 |
| Blood pressureCardiovascular | 66 | 9999 |
| Appetite and food intakeMetabolic and weight | 33 | 97952 |
| Heart functionCardiovascular | 66 | 67616 |
PepBank is a research reference. Talk to a doctor before you use any peptide.
For each outcome that two or more peptides have results for: the best result of a single randomized trial, on the same measure (the same kind of number, the same unit). When a trial has several dose arms, the cell shows the highest dose arm. The trials differ in people, length and dose, so a gap between two cells is not proof that one peptide works better.
| Outcome | Orforglipron | Semaglutide |
|---|---|---|
| Body weightMetabolic and weightCompared as: value in the arm that got the peptide, in % | −8.6 to −12.6% Weight change Placebo: −2% Dose studied: 12, 24, 36, or 45 mg once daily26 weeksn = 2722023 | −14.9% Mean weight change Placebo: −2.4% Dose studied: 2.4 mg once weekly68 weeksn = 1,9612021 |
| Glycemic controlMetabolic and weightCompared as: difference from placebo, in % | −1.08% Estimated treatment difference in HbA1c vs placebo Dose studied: 12 mg once daily40 weeksn not reported2026 | −1.6 to −0.4% Estimated treatment difference Dose studied: 2.5-40 mg once daily26 weeksn not reported2017 |
| Adverse eventsWhole bodyCompared as: value in the arm that got the peptide, in % | 81.5 to 92.5% 95% confidence interval for TEAE percentage · orforglipron 36 mg Dose studied: 36 mg once daily52 weeksn = 2692026 | 16.6% discontinuation due to adverse events Placebo: 8.2% Dose studied: 2.4 mg once weeklyn = 17,6042023 |
| Gastrointestinal adverse eventsGastrointestinalCompared as: value in the arm that got the peptide, in % | 3 to 11.3% Confidence interval (level not stated) for gastrointestinal discontinuation percentage · orforglipron 12 mg Dose studied: 12 mg once daily52 weeksn = 1352026 | 4.3% Discontinuation for GI AEs · semaglutide 2.4 mg Dose studied: 2.4 mg once weekly68 weeksn = 2,1172022 |
−8.6 to −12.6%
Weight change
Placebo: −2%
Dose studied: 12, 24, 36, or 45 mg once daily26 weeksn = 2722023
−14.9%
Mean weight change
Placebo: −2.4%
Dose studied: 2.4 mg once weekly68 weeksn = 1,9612021
−1.08%
Estimated treatment difference in HbA1c vs placebo
Dose studied: 12 mg once daily40 weeksn not reported2026
−1.6 to −0.4%
Estimated treatment difference
Dose studied: 2.5-40 mg once daily26 weeksn not reported2017
81.5 to 92.5%
95% confidence interval for TEAE percentage · orforglipron 36 mg
Dose studied: 36 mg once daily52 weeksn = 2692026
16.6%
discontinuation due to adverse events
Placebo: 8.2%
Dose studied: 2.4 mg once weeklyn = 17,6042023
3 to 11.3%
Confidence interval (level not stated) for gastrointestinal discontinuation percentage · orforglipron 12 mg
Dose studied: 12 mg once daily52 weeksn = 1352026
4.3%
Discontinuation for GI AEs · semaglutide 2.4 mg
Dose studied: 2.4 mg once weekly68 weeksn = 2,1172022
The other peptides have no randomized result on the same measure, so these results cannot be set side by side.
| Outcome | Orforglipron | Semaglutide |
|---|---|---|
| Cardiovascular eventsCardiovascularCompared as: value in the arm that got the peptide, in % | No comparable result 1 randomized-trial result measure it in another way or another unit. | 6.5% primary end-point event rate Placebo: 8% Dose studied: 2.4 mg once weeklyn = 17,6042023 |
| Blood pressureCardiovascularCompared as: difference from placebo, in mm hg | No comparable result 3 randomized-trial results measure it in another way or another unit. | −3.84 mm Hg SBP change at 13 weeks Dose studied: maximum 14 mg once dailyn = 9,6502026 |
| Inflammation markersImmune and inflammationCompared as: difference from placebo, in % | No comparable result 1 randomized-trial result measure it in another way or another unit. | −18.08% hsCRP change at 13 weeks Dose studied: maximum 14 mg once dailyn = 9,6502026 |
| LipidsMetabolic and weightCompared as: difference from placebo, in % | No comparable result 7 randomized-trial results measure it in another way or another unit. | −7% Total cholesterol change at 13 weeks Dose studied: maximum 14 mg once dailyn = 9,6502026 |
| Cardiometabolic risk factorsMetabolic and weightCompared as: value in the arm that got the peptide, in % | No comparable result 1 randomized-trial result measure it in another way or another unit. | −61.1% Relative risk score change Placebo: −12.9% Dose studied: 2.4 mg68 weeksn = 1,5832023 |
| PharmacokineticsPharmacologyCompared as: value in the arm that got the peptide, in h·nmol/l | No comparable result 14 randomized-trial results measure it in another way or another unit. | 233 h·nmol/L AUC0-24h,sema,SS · 3 mg oral semaglutide Dose studied: 3 mg12 weeksn = 322024 |
| Heart functionCardiovascularCompared as: value in the arm that got the peptide, in % | No comparable result 4 randomized-trial results measure it in another way or another unit. | −17% Loop diuretic dose decrease · Shown as a change. The study reports a loop diuretic dose decrease of this size. Dose studied: 2.4 mg once weekly52 weeksn not reported2024 |
| Liver fat and liver functionLiverCompared as: difference from placebo, in percentage points | No randomized trial result 9 results from other study designs. | 28.7 percentage points Estimated difference Dose studied: 2.4 mg once weekly72 weeks (interim analysis; planned 240 weeks)n = 8002025 |
No comparable result
1 randomized-trial result measure it in another way or another unit.
6.5%
primary end-point event rate
Placebo: 8%
Dose studied: 2.4 mg once weeklyn = 17,6042023
No comparable result
3 randomized-trial results measure it in another way or another unit.
−3.84 mm Hg
SBP change at 13 weeks
Dose studied: maximum 14 mg once dailyn = 9,6502026
No comparable result
1 randomized-trial result measure it in another way or another unit.
−18.08%
hsCRP change at 13 weeks
Dose studied: maximum 14 mg once dailyn = 9,6502026
No comparable result
7 randomized-trial results measure it in another way or another unit.
−7%
Total cholesterol change at 13 weeks
Dose studied: maximum 14 mg once dailyn = 9,6502026
No comparable result
1 randomized-trial result measure it in another way or another unit.
−61.1%
Relative risk score change
Placebo: −12.9%
Dose studied: 2.4 mg68 weeksn = 1,5832023
No comparable result
14 randomized-trial results measure it in another way or another unit.
233 h·nmol/L
AUC0-24h,sema,SS · 3 mg oral semaglutide
Dose studied: 3 mg12 weeksn = 322024
No comparable result
4 randomized-trial results measure it in another way or another unit.
−17%
Loop diuretic dose decrease · Shown as a change. The study reports a loop diuretic dose decrease of this size.
Dose studied: 2.4 mg once weekly52 weeksn not reported2024
No randomized trial result
9 results from other study designs.
28.7 percentage points
Estimated difference
Dose studied: 2.4 mg once weekly72 weeks (interim analysis; planned 240 weeks)n = 8002025
Each analog against its native parent, residue by residue. Substitutions, non-standard residues and modifications are marked. Calculated from the two sequences.
Semaglutide differs from Glucagon-like peptide 1 (7-37) at 2 positions and carries 1 added group.
What is different
Registered trials, ranked by phase (late phases first), then posted results and enrollment. Status is the registry status. Study results come from published studies. Results posted at ClinicalTrials.gov are shown on each trial page.
Top 3 of 53 trials, ranked by phase, then posted results and enrollment: 1 ongoing · 2 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)
Eli Lilly and Company3,127 participants5 Jun 2023 to est. Oct 2027
Obesity · Overweight · Overweight or Obesity
Eli Lilly and Company1,698 participants22 Sept 2023 to 22 Aug 2025
Type 2 Diabetes
Eli Lilly and Company1,613 participants5 Jun 2023 to 8 Aug 2025
Obesity · Overweight · Type 2 Diabetes
1 more mentions it but does not test it. They only measure it or name it in their text.
Top 3 of 663 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)
Novo Nordisk A/S17,604 participants24 Oct 2018 to 29 Jun 2023
Overweight · Obesity
Novo Nordisk A/S9,651 participants17 Jun 2019 to 23 Aug 2024
Diabetes Mellitus, Type 2
Novo Nordisk A/S3,533 participants17 Jun 2019 to 9 Jan 2024
Diabetes Mellitus, Type 2
124 more mention it but do not test it. They only measure it or name it in their text.
In PepBank now:147 peptides, 6 blends and 13 other compounds97,577 study results from 17,383 studies8,473 clinical trialsUpdated