FDA-Approved Weight Loss Medications (2026)

Medically reviewed by Biljana Srbinovska, MPharm. Last reviewed July 2026.

There are now around eleven FDA-approved prescription weight loss medications, and the list changed substantially in the last year. Three new GLP-1 products arrived: a Wegovy pill in December 2025, a higher-dose Wegovy in March 2026, and Foundayo (orforglipron) in April 2026, the first small-molecule GLP-1 taken as a tablet. Just as importantly for cost, Medicare began a demonstration on July 1, 2026 that puts some of these drugs at a $50 monthly copay for the first time. Here is the current landscape.

What Is FDA-Approved Now

One number worth correcting, because it is being widely misquoted. Foundayo is often cited at 12.4% weight loss. That figure comes from a trial dose above what was actually approved. At the approved maximum the result was about 11.1%. It is the convenience of a daily tablet with no food or water restrictions that distinguishes it, not superior efficacy.

Beyond Weight Loss

Several of these now carry additional approved uses, which matters because insurance may cover a drug for one indication and not another.

Wegovy is approved for cardiovascular risk reduction and for MASH with moderate to advanced fibrosis. Zepbound is approved for moderate to severe obstructive sleep apnea in adults with obesity, the first medication ever approved for OSA. Imcivree was expanded in March 2026 to cover acquired hypothalamic obesity in children from age 4.

If you have one of these conditions alongside obesity, that route to coverage is often easier than a weight-loss-only request.

Cost and How People Actually Pay

List prices run roughly $1,000 to $1,350 a month. Almost nobody pays that, and the self-pay landscape has shifted quickly.

Manufacturers now sell direct. As of mid-2026, LillyDirect offered Zepbound vials from about $299 to $449 depending on dose, though the lower prices on higher doses require refilling within 45 days or the price rises sharply. NovoCare listed Wegovy around $349, Wegovy HD around $399, and the Wegovy pill from about $149. Foundayo self-pay started around $149, with commercial copays as low as $25.

These prices have changed repeatedly through 2026, so check the manufacturer’s own pricing page rather than relying on any published figure, including these.

Medicare: What Changed on July 1, 2026

The long-standing rule still stands: Part D is statutorily barred from covering drugs used solely for weight loss. That has not been repealed.

What is new is a workaround. CMS launched the Medicare GLP-1 Bridge demonstration running from July 1, 2026 through December 31, 2027, offering a $50 monthly copay for Foundayo, Wegovy injection and tablets, and Zepbound. Two details catch people out: for Zepbound only the KwikPen is included, with vials and single-dose pens excluded, and the programme sits outside the normal Part D benefit. A separate broader model, BALANCE, has been delayed indefinitely.

Coverage for the non-weight indications, meaning diabetes, cardiovascular risk, MASH, and sleep apnea, continues under normal Part D rules.

Commercial insurance typically requires prior authorisation, a BMI of 30 or above (or 27 with a related condition), documented lifestyle attempts, and often step therapy with re-authorisation tied to hitting weight loss milestones. Many employers have dropped or capped obesity drug coverage, so check your specific plan rather than assuming.

Compounded Semaglutide: Read This Before Buying

This is where people are getting hurt.

During the shortages, compounding pharmacies could legally produce copies of semaglutide and tirzepatide. Those shortages ended, tirzepatide in December 2024 and semaglutide in February 2025, which removed the legal basis for that exemption. In April 2026 the FDA proposed permanently excluding semaglutide, tirzepatide, and liraglutide from the list of drugs eligible for large-scale compounding, finding no clinical need. A final determination was still pending as of July 2026.

In practice, large-scale bulk compounding of these drugs is effectively barred. Smaller pharmacies may still prepare patient-specific formulations in narrow circumstances, such as a documented clinical need for a change, but not mass-marketed copies.

Telehealth operations still advertising cheap “generic semaglutide” are the risk. There is no generic semaglutide. The FDA has logged hundreds of adverse event reports connected to compounded versions of these drugs, including dosing errors. If an offer looks dramatically cheaper than the manufacturer’s own direct price, that is a warning rather than a bargain.

Side Effects and Safety

GLP-1 medications commonly cause nausea, vomiting, diarrhea, and constipation, usually worst when starting or increasing a dose.

They carry a boxed warning for thyroid C-cell tumours, based on rodent studies, and are contraindicated if you or a family member has had medullary thyroid carcinoma or MEN 2. Other risks include pancreatitis, gallbladder disease, kidney injury from dehydration during vomiting, and an aspiration risk under anesthesia, which is why you must tell a surgical team you are taking one.

Among the others: Qsymia can cause birth defects and has a risk management programme; Contrave carries a boxed warning for suicidal thoughts; orlistat causes oily stools and GI effects; phentermine is a stimulant and a controlled substance approved only for short-term use.

What Happens If You Stop

Regain is the norm rather than the exception, and this is the part least often explained before starting.

In the extension of the STEP 1 trial, participants regained about two thirds of the weight they had lost within a year of stopping, though roughly 48% still kept at least 5% off. In SURMOUNT-4, 82% regained more than a quarter of the weight they had lost, and the cardiometabolic improvements reversed alongside it.

The practical implication is that these are treatments for a chronic condition rather than a course you finish. That has real financial consequences, so factor ongoing cost into the decision rather than budgeting for a year.

FDA-Approved Weight Loss Medication FAQs

Which weight loss drug works best?

By average trial weight loss, higher-dose semaglutide (about 20.7%) and tirzepatide (about 18% to 21%) lead. Individual response varies, and tolerability and cost often decide the choice more than the headline figure.

Is there a weight loss pill instead of an injection?

Yes, two now. An oral semaglutide version of Wegovy was approved in December 2025, and Foundayo (orforglipron) in April 2026 as the first small-molecule GLP-1 tablet with no food or water restrictions.

Does Medicare cover weight loss drugs?

Part D still cannot cover drugs used solely for weight loss. However, the Medicare GLP-1 Bridge demonstration launched July 1, 2026 offers a $50 monthly copay for certain products through 2027. Coverage for diabetes, cardiovascular, MASH, or sleep apnea indications follows normal rules.

Is compounded semaglutide legal?

Largely not any more. The shortages that permitted it ended in 2024 and 2025, and the FDA has proposed permanently excluding these drugs from large-scale compounding. There is no generic semaglutide, and the FDA has logged hundreds of adverse event reports tied to compounded versions.

What are the main side effects?

Nausea, vomiting, diarrhea, and constipation are most common with GLP-1 drugs. They carry a boxed warning for thyroid C-cell tumours and are contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2. Tell any surgical team you are taking one, because of aspiration risk under anesthesia.

Will I regain the weight if I stop?

Usually a substantial portion. Trial follow-ups found roughly two thirds regained within a year in one study, and 82% regaining more than a quarter of lost weight in another. These treat a chronic condition rather than providing a permanent fix.