Can Foundayo® help manage menopausal weight gain? What new research says

If you’ve been trying to manage your weight during perimenopause or menopause, you may have noticed that the same strategies that worked in the past don’t seem as effective anymore. Hormonal changes during the menopause transition can affect appetite, body composition, fat distribution, and energy balance, making weight loss feel more challenging than it once did.

That’s one reason researchers have become increasingly interested in how newer weight-loss medications perform in women during menopause. In June 2026, Eli Lilly announced new findings from an analysis of two large clinical trials showing that women lost significant weight with Foundayo® regardless of whether they were premenopausal, perimenopausal, or postmenopausal.

The findings add to a growing body of research suggesting that GLP-1 medications can remain effective throughout the menopause transition. They also help answer a common question many women have: Does menopause make weight-loss medications work less well?

In this article, we’ll look at what the Foundayo® research found, why menopause can make weight management more difficult, and how Foundayo® compares with other GLP-1 medications that have been studied in menopausal women. Dr. Karen Mann, an OB-GYN and Noom’s Medical Director, shares her expertise on managing menopausal weight gain and what role hormone replacement therapy (HRT) may play. 

What is Foundayo® and what makes it different?

Foundayo® is a medication that contains the active ingredient orforglipron. It’s a once-daily medication in the GLP-1 family. It was FDA-approved in April 2026 for weight loss purposes.

What makes Foundayo® stand out in the GLP-1 category is the fact that it’s a pill you take by mouth and that it has no timing restrictions for taking it. It’s what’s called a non-peptide small molecule, which means its chemical structure is fundamentally different from injectable GLP-1s and the other oral option for GLP-1 weight loss, the Wegovy® pill.

That structural difference is what allows it to be taken any time of day, without food or water restrictions.

Read more: What is Foundayo®? New GLP-1 weight loss pill explained

How much weight can you lose with Foundayo®?

In studies, people taking higher doses of orforglipron lost about 11% of their body weight over 72 weeks.

That level of weight loss was seen in people who reached the higher doses and stayed on the medication throughout the study. Lower doses still led to weight loss, but results tended to build more gradually over time as the dose increased.

There were also improvements beyond weight. People saw changes in waist size, cholesterol, and blood pressure—all markers tied to overall metabolic health.

One important thing to keep in mind: people in these studies were also making changes to how they were eating and moving. Like other medications in this category, Foundayo® is designed to work alongside those habits—not replace them.

Why is weight loss harder during menopause?

Menopause is typically thought of in stages. Perimenopause is the time before your period ends and can be a time of fluctuating hormones, particularly estrogen. Once a woman has gone without a period for a year, she is officially post-menopausal. Estrogen is important because losing it can be associated with weight gain and weight redistribution.

“Declining estrogen is the central driver of weight gain during menopause,” explains Dr. Mann. Estrogen plays a role in regulating body fat distribution, and as levels drop, fat tends to shift from the hips and thighs toward the abdomen. At the same time, energy expenditure is reduced, muscle mass declines, and sleep disruption can increase hunger hormones while blunting the satiety signal.”

What this means is that weight gain becomes easier, and weight loss is harder. Abdominal fat in particular can be resistant to standard diet and exercise approaches during this phase. GLP-1s like Wegovy and Zepbound have both been associated with increased weight loss during menopause.

Read more: Menopause and weight gain: causes, solutions, and how to manage belly fat

Foundayo® and menopause weight loss: What the research says

Given the growing interest in GLP-1 medications for menopause-related weight gain, researchers wanted to know whether Foundayo® works differently depending on where someone is in the menopause transition.

To answer that question, Eli Lilly analyzed data from more than 1,500 women who participated in two different 72-week clinical trials of Foundayo®. The secondary analyses grouped women as premenopausal, perimenopausal, or postmenopausal to compare weight loss outcomes across the different stages.

The clearest menopause-specific findings came from ATTAIN-1, which included adults with overweight or obesity but not type 2 diabetes. At the highest available dose (which is equivalent to 17.2 mg), women lost an average of 12.8% to 14.4% of their body weight over 72 weeks. 

Menopause stage	Average weight loss (ATTAIN-1)
Premenopause	12.8%
Perimenopause	14.4%
Postmenopause	14.1%

Perimenopausal women experienced the greatest average weight loss, but the differences between groups were relatively small, suggesting that Foundayo® remained effective throughout the menopause transition and after menopause.

Researchers also observed meaningful reductions in waist circumference, a measure often associated with abdominal fat. In ATTAIN-1, waist measurements decreased by up to 4.9 inches, more than 80% of women at all 3 stages of menopause achieved at least 5% weight loss, and up to 51.5% achieved weight loss of 15% or greater.

Researchers saw a similar pattern in the new analysis of ATTAIN-2, which included adults with type 2 diabetes. At the highest dose, up to 44.2% of women achieved at least 15% weight loss, and waist circumference decreased by up to 4.3 inches.

It’s important to note that these findings come from a post-hoc analysis, meaning the original studies weren’t specifically designed to compare these differences.

Foundayo® worked regardless of menopause phase

Results were consistent across menopausal stages in both trials, which means the drug appeared to work regardless of where a woman was in the hormonal transition.

That’s important because menopause is often associated with changes that can make weight management more challenging, including increased abdominal fat, shifts in body composition, and changes in appetite and energy expenditure. Many women worry that weight-loss medications may be less effective once these hormonal changes begin. The reanalysis of the ATTAIN findings suggest that it wasn’t the case—women experienced meaningful weight loss before, during, and after menopause.

Read more: Foundayo® vs. Zepbound® for weight loss

Why Foundayo® helps with weight loss during menopause

“For women in menopause, the GLP-1 pathway may be particularly relevant because the metabolic effects of declining estrogen—including reduced insulin sensitivity and shifts in appetite regulation—are exactly what GLP-1 receptor activation helps address. It’s not a hormonal treatment, but it works on biology that’s disrupted during the menopausal transition,” notes Dr. Mann.

The waist circumference reductions seen in the ATTAIN menopause subgroup data are worth highlighting. During menopause, fat tends to shift toward the abdomen, and this visceral fat is associated with a higher risk of metabolic conditions such as type 2 diabetes and cardiovascular disease.

In the secondary analysis of the ATTAIN-1 trial, women experienced waist circumference reductions of up to 4.9 inches. While waist measurements don’t directly measure body fat, the findings suggest that Foundayo® may be affecting the abdominal fat accumulation pattern commonly seen during menopause, not just overall body weight.

What dose of Foundayo® was associated with weight loss during menopause?

The menopause-specific analysis highlighted results from the highest available dose of Foundayo®. The dose in the studies was equivalent to what is currently available as 17.2 mg and was associated with the greatest weight loss and reductions in waist circumference. But that doesn’t mean women experienced no benefit at lower doses.

In the original ATTAIN trials, weight loss generally increased as the dose increased, suggesting a dose-response relationship. What the menopause analysis showed is that women who reached the highest dose achieved significant weight loss regardless of whether they were premenopausal, perimenopausal, or postmenopausal.

One important consideration is that reaching the highest dose takes time. Foundayo® follows a gradual titration schedule designed to help minimize side effects. Most people begin at 0.8 mg and increase approximately every four weeks, meaning it can take at least five months to reach the maximum 17.2 mg dose.

Here’s a look at the most common dosing schedule: 

Weeks	Daily dose
Weeks 1–4	0.8 mg
Weeks 5–8	2.5 mg
Weeks 9–12	5.5 mg
Weeks 13–16	9 mg*
Weeks 17–20	14.5 mg*
Weeks 21+	17.2 mg*

Because Foundayo® is titrated gradually, weight loss tends to build over time rather than happen all at once. The women in the ATTAIN menopause analysis were followed for 72 weeks—more than a year—giving the medication time to reach its full effect.

“And it’s important to remember that not everyone reaches or tolerates the maximum dose. The prescribing information allows for dose adjustments based on individual tolerability and response, so some patients may remain on a lower maintenance dose if appropriate,” reminds Dr. Mann.

Read more: Foundayo® side effects

Can combining GLP-1s and HRT work together for menopause weight loss?

The ATTAIN data reflects what Foundayo® can do on its own. But for women who are also on hormone replacement therapy (HRT)—or considering it—the research on combining GLP-1 medications with HRT is worth knowing about.

A small study in the journal Menopause found that postmenopausal women taking semaglutide (the active ingredient in Wegovy) plus HRT lost around 16% of their body weight at 12 months, compared to 12% for those on semaglutide alone. It’s a small study, but the results are promising and leave room for further research about the role of HRT and GLP-1s. 

Another small study added to that picture, finding roughly 35% greater weight loss when tirzepatide was combined with hormone therapy in postmenopausal women. Again, we still need more research because it’s a small study. 

GLP-1 and HRT seem to work well together because they strengthen the benefits of each of the two medications. On its own, HRT works by replacing declining estrogen, which can help counter the hormonal shift toward abdominal fat storage. And GLP-1 medications like Foundayo® address appetite regulation and how the body processes food. These two medicines are working on the problem from different angles.

“In the right patient, a combined approach may offer more than either treatment alone—but it needs to be individualized based on each person’s health history and goals,” says Dr. Mann.

Read more: HRT and GLP-1 medications for menopause weight loss

How does Foundayo® compare to other GLP-1s for menopause weight loss?

There are no head-to-head trials comparing GLP-1 medications specifically in menopausal women, so direct comparisons are limited. What does exist are subgroup analyses looking at how semaglutide and tirzepatide perform across pre-, peri-, and post-menopause. There is no equivalent data for other oral GLP-1 medications.

Semaglutide (Wegovy® injection)

Researchers also looked at semaglutide in women at different stages of menopause. When researchers revisited a key trial, STEP UP, and analyzed the results by menopausal status, they found that women taking the highest 7.2 mg dose lost about 20% to 23% of their body weight over 72 weeks, regardless of menopausal status.

Specifically, average weight loss was 22.6% in premenopausal women, 19.7% in perimenopausal women, and 19.8% in postmenopausal women. While the numbers varied slightly, the overall pattern suggests that semaglutide remained effective throughout the menopause transition.

Tirzepatide (Zepbound®)

Researchers found similar results with tirzepatide. When researchers revisited the SURMOUNT trial, they found that women experienced substantial weight loss regardless of where they were in the menopause transition.

In that trial, women taking the highest dose of tirzepatide (15 mg) lost an average of 26% of their body weight in premenopause, 23% in perimenopause, and 23% in postmenopause. While premenopausal women lost slightly more weight on average, the differences between groups were relatively small.

The findings were also notable because nearly all participants responded to treatment. Across reproductive-stage subgroups, 97% to 98% of women achieved at least 5% weight loss, a benchmark often used to measure clinically meaningful weight loss.

Here’s how the three compare across the highest doses: 

Medication	Pre-menopause weight loss	Perimenopause weight loss	Post-menopause weight loss
Foundayo® 17.2 mg	12.8%	14.4%	14.1%
Wegovy® 7.2 mg injection	22.6%	19.7%	19.8%
Zepbound® 15 mg injection	26%	23%	23%

While the numbers can be helpful for understanding the range of weight loss seen in different studies, it’s important not to treat them as direct comparisons between medications. Foundayo®, Wegovy®, and Zepbound® were studied in separate clinical trials with different participants and study designs. The results shown here also reflect the highest doses evaluated in each analysis. 

“What the data suggest is that all three medications produced meaningful weight loss across premenopausal, perimenopausal, and postmenopausal groups, indicating that GLP-1-based treatments can remain effective regardless of a woman’s menopause status,” shares Dr. Mann.

FAQs about Foundayo® and menopause weight loss

Does Foundayo® work the same way for post-menopausal women as for women in perimenopause?

Based on the ATTAIN analysis, it appears so. Women lost significant amounts of weight regardless of whether they were premenopausal, perimenopausal, or postmenopausal.

At the highest dose (17.2 mg), women in postmenopause lost an average of 28.2 pounds (14.1% of their body weight) over 72 weeks, compared with 30.4 pounds (14.4%) among women in perimenopause. More than 80% of women at every menopausal stage achieved at least 5% weight loss.

While the study wasn’t specifically designed to compare menopause stages, the results suggest that Foundayo® remained effective throughout the menopause transition and after menopause. That’s notable because many women report that weight management becomes more challenging as hormone levels change, yet the weight-loss results were remarkably similar across groups.

Can I take Foundayo® with HRT?

In general, yes. There is currently no known contraindication that prevents Foundayo® and hormone replacement therapy (HRT) from being used together. In fact, researchers are increasingly interested in the combination because the two treatments work in different ways.

HRT helps address some of the hormonal changes that occur during menopause, while Foundayo® targets appetite regulation, food intake, and metabolic function. Emerging research on other GLP-1 medications suggests that combining a GLP-1 with HRT may lead to greater weight loss than either approach alone in some women.

That said, whether the combination is appropriate depends on factors such as your symptoms, medical history, cardiovascular risk factors, and treatment goals. If you’re considering either medication—or both—it’s important to discuss the options with a healthcare provider who can help determine the safest and most effective approach for your situation.

Read more about the side effects of Foundayo and who can take it.

Is Foundayo® safe for women in perimenopause?

Based on the available research, Foundayo® appears to have a similar safety profile in women in perimenopause as it does in other people who take the medication. The most common side effects are gastrointestinal and include nausea, vomiting, diarrhea, constipation, and stomach discomfort. These symptoms are often most noticeable when starting treatment or increasing the dose and tend to improve over time.

The menopause-specific ATTAIN analysis didn’t identify any new or unexpected safety concerns among women at different stages of menopause.

Remember, Foundayo® isn’t appropriate for everyone. It should not be used during pregnancy, and women in any stage of menopause who can still become pregnant should discuss contraception and pregnancy planning with their healthcare provider. The medication also shouldn’t be used by people with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

If you have a history of pancreatitis, gallbladder disease, kidney disease, or significant gastrointestinal conditions, your provider can assess whether Foundayo® is a good fit for you.

How do I get a prescription for Foundayo®?

The first step to getting a prescription for Foundayo is to see if you qualify. Foundayo® is approved for adults with a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related condition like high blood pressure or high cholesterol.

You can get a prescription through your primary care doctor, an obesity medicine specialist, or a telehealth platform, like Noom Med. If you qualify, a licensed clinician will review your health history, discuss your treatment options, and prescribe Foundayo® if it’s appropriate. 

You can check your eligibility by completing our intake questionnaire. Once you have a prescription, it can be filled through your choice of pharmacy.

Wondering about insurance coverage? Use Noom’s Insurance Checker to see if your plan covers it.

The bottom line: Foundayo® can help people at all menopausal stages lose weight

The new ATTAIN findings offer encouraging news for women who feel like weight management has become harder during perimenopause or after menopause. At the highest dose, women lost significant amounts of weight regardless of menopausal stage, with similar results in premenopausal, perimenopausal, and postmenopausal participants. Researchers also saw meaningful reductions in waist circumference, an important finding given that increased abdominal fat is one of the most common body-composition changes associated with menopause.

It’s worth keeping the findings in perspective. The menopause results come from a post-hoc analysis, meaning researchers went back and examined the trial data by menopausal status after the studies were completed. The results are promising, but the trials weren’t originally designed to answer menopause-specific questions.

It’s also important to remember that Foundayo® isn’t a quick fix. Participants were followed for 72 weeks, and it can take about five months to reach the highest dose. Like other GLP-1 medications, Foundayo® works best as part of a broader approach that includes nutrition, physical activity, and other healthy habits.

If you’re in menopause and weight management has felt harder than it used to, there are effective options worth exploring. If you qualify, Noom Med can connect with a clinician who can assess whether Foundayo® or another GLP-1 medication might make sense for you.