Women experiencing menopause now have evidence that a new oral medication can help them lose significant weight, even as hormonal changes work against them. In clinical trials involving over 1,500 women, Foundayo (orforglipron) produced meaningful weight loss across pre-menopause, perimenopause, and post-menopause stages, with some women losing up to 30.4 pounds in just 72 weeks.

Why Does Menopause Make Weight Loss So Difficult?

Menopause is a major driver of weight gain that often goes unrecognized in obesity treatment. During this transition, hormonal shifts accelerate fat accumulation, particularly around the abdomen, and make weight loss significantly harder to achieve and maintain. Despite affecting tens of millions of women in the United States alone, menopausal status has rarely been evaluated as a factor in how well obesity treatments actually work.

"Menopause can be an incredibly frustrating time for many women, partly because weight gain often feels beyond their control, and the biology of menopause can undermine even the most determined efforts to manage weight," stated Rachel Batterham, OBE, MBBS, Ph.D., FRCP, Lilly senior vice president of medical innovation and external engagement.

Rachel Batterham, OBE, MBBS, Ph.D., FRCP, Lilly senior vice president of medical innovation and external engagement

What Were the Weight Loss Results Across Menopause Stages?

The research examined two major clinical trials called ATTAIN-1 and ATTAIN-2. In ATTAIN-1, which included women without diabetes, results varied by menopausal stage at the highest medication dose:

• Pre-menopausal women: Lost up to 28.0 pounds, or 12.8% of their body weight
• Perimenopausal women: Lost up to 30.4 pounds, or 14.4% of their body weight
• Post-menopausal women: Lost up to 28.2 pounds, or 14.1% of their body weight

In ATTAIN-2, which included women with type 2 diabetes, weight loss was also significant across all stages, ranging from 8.9% to 13.6% of body weight. Beyond total weight loss, women experienced meaningful reductions in waist circumference, losing up to 4.9 inches in ATTAIN-1 and up to 4.3 inches in ATTAIN-2. Reducing abdominal fat is particularly important because it's associated with lower cardiometabolic risk, meaning reduced risk for heart disease and metabolic complications.

How Many Women Achieved Significant Weight Loss Milestones?

The trials tracked how many participants reached different weight loss thresholds, which helps show how consistently the medication worked. In ATTAIN-1, at the highest dose:

• 5% weight loss or more: Between 80.3% and 82.7% of women across all menopause stages achieved this milestone
• 10% weight loss or more: Between 61.5% and 64.2% of women achieved this level
• 15% weight loss or more: Between 40.9% and 51.5% of women achieved this significant reduction
• 20% weight loss or more: Between 23.8% and 29.9% of women achieved this substantial loss

In ATTAIN-2, women with diabetes showed similar patterns, with 44.2% of post-menopausal women achieving at least 15% weight loss.

How Does Foundayo Differ From Other Weight-Loss Medications?

Foundayo is a glucagon-like peptide-1 receptor agonist, or GLP-1, a class of medications that has become increasingly popular for weight management. What sets Foundayo apart is its formulation: it's the only oral GLP-1 medication that can be taken without food or water restrictions. This means patients can take it any time of day, which may improve adherence compared to medications that require specific timing around meals.

The medication works by mimicking a natural hormone that helps regulate appetite and blood sugar. Unlike injectable GLP-1 medications like Ozempic and Wegovy, Foundayo is a small molecule taken as a tablet, making it more convenient for some patients who prefer oral medications over injections.

How to Maximize Weight Loss Results With This Medication

The clinical trials tested Foundayo as part of a comprehensive approach to weight management. Here's what the research shows works best:

• Combine with lifestyle changes: ATTAIN-1 was the first Phase 3 study to evaluate this medication as an adjunct to exercise and a balanced, healthy diet rather than a strict reduced-calorie diet, showing that sustainable lifestyle changes enhance results
• Start low and increase gradually: Participants began at a dose of 0.8 milligrams once daily and increased in steps every four weeks, reaching the highest dose of 17.2 milligrams, which minimizes side effects while building tolerance
• Maintain consistency: The 72-week trial period shows that sustained use of the medication, combined with ongoing diet and exercise efforts, produces the most meaningful weight loss

What Does This Mean for Women in Menopause?

These findings address a significant gap in obesity treatment. For decades, menopause has been overlooked as a factor affecting how well weight-loss treatments work. The research demonstrates that women don't need to accept weight gain as an inevitable part of menopause. With appropriate medical support and lifestyle modifications, meaningful weight loss is achievable even during this hormonally challenging time.

The medication is FDA-approved for adults with obesity or some adults with overweight who also have weight-related medical conditions. Beyond weight management, Foundayo is being studied for potential benefits in treating type 2 diabetes, obstructive sleep apnea, osteoarthritis knee pain, high blood pressure, peripheral artery disease, and stress urinary incontinence.