*Gulp*

Much to the relief of the needle-shy, the FDA has just approved a second oral GLP-1 drug, following the release of the semaglutide Wegovy pill in January. 

But this new tablet, from pharma giant Eli Lilly, promises to be even more convenient than its predecessor with similar, if slightly less drastic, weight-trimming results.

According to a press release from Lilly, orforglipron — which is being sold under the brand name Foundayo — punched above its weight in clinical trials. At the highest dose of Foundayo, participants lost an average of 27.3 pounds (12.4% of their body weight) compared to 2.2 pounds (0.9%) with a placebo.

The pill also led to noted reductions in cardiovascular risk factors like waist circumference, non-HDL cholesterol, triglycerides and systolic blood pressure, according to the press release.

In a head-to-head trial assessing its efficacy versus oral semaglutide (Wegovy) in patients with type 2 diabetes, the former outperformed the latter on all key metrics, including overall weight loss and blood sugar control. 

These medications are being released on the market at a dizzying speed, as the world’s pharmaceutical leaders race to develop the drug that will produce the most dramatic thinning results — sometimes against advice from doctors. 

And while it can be hard to keep it all straight, there are notable differences between the currently available options. Foundayo, for example, is the first GLP-1 that isn’t a peptide, but a synthetic small molecule, which is much stabler than the organic, biological alternative.

Unlike its Wegovy competitor — which comes with strict directions to be taken first thing in the morning with four ounces of water, and 30 minutes before any other medication, food or drink — the Foundayo pill can be taken at any time of day with or without food because of its small molecule composition. 

Additionally, NYU Langone obesity medicine specialist Dr. Holly Lofton explains that Wegovy tablets were formulated with an absorption enhancer, which changes the pH of the stomach so the medication can be optimally absorbed. 

“Because the Foundayo pill is a small molecule, it does not have that absorption enhancer and that’s what allows the administration to be more variable,” she told The Post.

“This is significant for certain patients who don’t have the most strict morning routine — but also for those who have to take other medications first,” she said, such as thyroid hormones or some osteoporosis meds, which also require morning administration and waiting 30 minutes before consuming anything else.

This pill now opens up GLP-1 access for other patients, too, who may not have been good candidates for injectables or the Wegovy pill, such as those who are overweight but not obese and need to lose slightly less weight, she said.

Whereas injectables lead to an average of 20% weight loss, and the Wegovy pill led to about 16% in studies, the Foundayo pill offers a more modest 12.4%.

And in general, it’s better for patients to have more choices, in case they’re unable to tolerate other GLP-1 drugs.

“We need to have options for those patients,” she says.

Foundayo may also become a go-to medication for long-term weight maintenance, as results from clinical trials found that patients who received Zepbound or Wegovy injections were able to keep most of that weight off when they later switched to Foundayo pills.

In a recent investor conference, Lilly’s chief medical officer David Hyman said that the company’s “mission is to launch this medicine in a volume, unrestricted way throughout the entire world,” which he said was “not possible with injectables, full stop.”

As with other GLP-1s, the list of possible side effects for the Foundayo pill is long. As of now, it comes with warnings of possible thyroid tumors and even cancer, plus pancreatitis, GI issues, dehydration and interference with oral birth control.

Also like other GLP-1s, however, it is less likely to have adverse interactions with heart disease and blood pressure drugs than non-GLP-1 weight loss drugs like Contrave and phentermine.

For her part, as a provider, Lofton feels optimistic about this new approval. 

“I’m excited about this medication,” she said. “This is an excellent option that provides flexibility in dosing, and also there were patients I was not able to prescribe Wegovy pills to because of aforementioned issues. So I think this will be a great addition to our toolbox.”

At 28st Graham Baalham faced leg amputation and severe breathing problems at night before his incredible 17st weight loss transformation

At 5ft 4in and 17st heavier than he is now, Graham Baalham’s nights were once frightening. The 55 year old window cleaner would wake suddenly up to seven times each night, struggling for air, alarmed as his airway appeared to constrict.

Instead of enjoying proper rest, he would find himself leaning out of the bedroom window or sitting upright in a chair for hours. His wife, Belinda, grew so concerned by his loud snoring and repeated pauses in breathing that she became certain he was suffering from sleep apnoea.

Reflecting back, Graham, from Bury St Edmunds, says: “I can honestly say that if I hadn’t joined Slimming World, I don’t believe I’d have lived to see 60.” Prior to shedding the pounds, Graham describes himself as perpetually worn out, sluggish and scarcely capable of walking a mile.

He told the Mirror: “I avoided the doctor for years because I knew what they’d say: ‘You have to lose weight’. Even though I’ve always worked in physical jobs – I was a groundsman and now I’m a window cleaner – and I always told myself I was fit for a big bloke, the reality was very different. As I got older, it became harder and harder to work the weight off. I was tired all the time.

“The real turning point came when I was in hospital for more than two weeks with a serious leg infection. The doctor drew a pen line around the infection and he told me it couldn’t spread past that mark. He said if the antibiotics didn’t work within 48 hours, they’d have to amputate my leg. That was it – that was the moment, I knew I’d run out of chances.”

Graham’s experience mirrors Slimming World research that demonstrates the strong correlation between sleep and weight. Slimming World’s ‘Snooze More to Lose More’ survey asked its members about their sleep habits over a week.

The study, which involved more than 3,000 members, found that nearly half of those who lost 15% or more of their body weight reported improved sleep. The survey indicated that the more weight members shed, the more likely they were to report enhancements in their sleep.

Before joining his local group, Graham admits that each Saturday watching his beloved Ipswich Town would see him regularly consume 10 pints. He says: “I always worked hard, I was active, but food and drink was my downfall”.

“Every afternoon around 2.30pm I’d have six bags of crisps back-to-back, followed by five or six chocolate bars. Belinda would cook a healthy meal every evening, but once everyone had settled down, they’d hear me back in the kitchen rustling the packets – it was like I couldn’t stop myself.”

Graham recalls: “Walking into a Slimming World group felt terrifying, but Belinda encouraged me to go and as soon as I walked through the doors, Shani, the Consultant, clocked me straight away. She was brilliant and made me feel welcome, which gave me confidence.”

He says the transformation has been life-changing: “Now, Belinda and I plan our meals together using the app. Our favourites include chicken risotto, pasta dishes, curries and the Slimming World Free Food range at Iceland.

“We recently went on an all-inclusive long weekend and I stayed on plan without feeling deprived or like I was missing out. That’s when I knew this is my new normal. The plan has become part of my everyday routine, so I ate well but stayed mindful about what I chose.

“For breakfast, instead of going straight for a full English, I leaned more towards fruit and if I did have bacon, I removed the fat. Lunch was usually chicken or tuna salad with fruit and I chose healthier dinner choices like fish or lean steak. I also kept alcohol low and it all felt natural – and showed me how much my habits have changed.

“Slimming World didn’t just help me lose weight – it taught me how to eat properly. I tried pills, exercise, everything. This is what worked. It’s given me my life back.

“Nowadays I feel like a 20-year-old. I walk up to 10 miles a day with my dog. Before, I was lucky if I managed one mile. I sleep through the night. No more gasping for air. No more sitting upright in the dark, terrified. I wake up feeling rested.”

He shared that some changes were drastic, stating: “I’ve ditched crisps and chocolate completely. Once I put my mind to it, I knew I could do it. I’m so proud knowing that I’ve inspired other people locally to join after seeing my journey on Facebook.

“Belinda and I have been married for 35 years and we have three adult children – Sian, Matthew and Bethany – and three grandsons aged eight, five and just seven months. I realised I didn’t just want to lose weight. I wanted to be here for them.

“At 55, I’ve been given a second chance. I’m not just lighter – I’m alive, awake and present. And I fully intend to be here, watching my grandchildren grow up, for many, many years to come.”

Shani Yates is Graham’s Slimming World Consultant. Shani says: “Supporting Graham has been an absolute joy. His determination has inspired every single member in our group and he’s become a bit of a local legend. Seeing him lose an incredible 17st and finally enjoy a full night’s sleep after struggling for so long makes me so proud.

“Graham brings energy, ideas and kindness to every session and the support he gives others is extraordinary. He’s a much‐loved member of our Slimming World family and a real example of what’s possible when you believe in yourself.”

Graham attends Shani Yates’ Slimming World group in Stanton, Bury St Edmunds. For more information or to find your nearest group, visit slimmingworld.co.uk.

Graham Baalham

• Start weight: 28st 12lbs
• Weight at group finals: 11st 13lbs
• Height: 5 ft 4 in
• Weight lost 16st 13lbs in 92 weeks

Graham’s day on a plate

Before

Breakfast: Nothing / Coffee with sugar

Lunch: White bread sandwich, packet of crisps, two or three chocolate bars, full sugar cola drink

Dinner: Roast beef with vegetables and new potatoes, full sugar cola, two to three bottles of beer

Snacks: Six packets of crisps, six chocolate bars, cheese biscuits, cream crackers with cheese and lashings of margarine, half a packet of custard creams, salted peanuts with a pint of full fat milk, coffee and tea with sugar

After

Breakfast: Overnight oats, Slimming World cooked breakfast at weekends, coffee without sugar

Lunch: Wholemeal bread sandwich, fruit, salad, water or low-calorie fruit squash

Dinner: Slimming World chicken and mushroom risotto or Slimming World pasta dishes, or a meal from the Slimming World Free Food range at Iceland with salad or vegetables, diet cola or water

Snacks: Fruit, two high fibre snack bars, low fat yoghurts, coffee or tea with no sugar