Educational information only. Not medical advice.
Compare compounds, understand the differences, and explore the original studies behind them.
Research reviewed October 15, 2026. Start with the overview, then explore the evidence and sources.
Stages summarize the study designs available for the identified material in this selection. Human stages require studies in which people received that material; measuring the body’s own peptide or testing a different analogue does not qualify. Controlled studies can measure hormone responses or other biological changes, as well as clinical outcomes. A higher stage can include unsuccessful trials; the adjacent summary explains the findings and limitations.
Multiple reports from one trial count as one study for this classification. The selected-report totals below describe library coverage. Outcome-specific certainty would require a separate assessment of study limitations, consistency, applicability, precision and publication bias.
Orforglipron is a synthetic nonpeptide small molecule that activates the human GLP-1 receptor. LY3502970 and OWL833 are development names for the same molecule. The approved Foundayo tablets contain its calcium salt, whose formula and molecular weight differ from those of neutral orforglipron.
Semaglutide is a modified, 31-amino-acid version of GLP-1, a gut hormone involved in blood-glucose regulation and appetite.
FDA approved Foundayo on April 1, 2026 for reduction of excess body weight and long-term maintenance in adults with obesity, or adults with overweight and at least one weight-related condition, alongside diet and activity measures. Trials also studied blood-glucose control in type 2 diabetes and retention of weight loss after injectable treatment. The July 2026 label checked on October 15, 2026 does not list a separate diabetes-treatment indication.
FDA-approved semaglutide formulations cover type 2 diabetes, weight management and cardiovascular risk reduction in specified populations. Ozempic injection also covers kidney outcomes in diabetes-associated chronic kidney disease. Wegovy injection has accelerated approval for adults with noncirrhotic MASH, a metabolic fatty-liver disease with inflammation, and moderate-to-advanced scarring. Indications differ between tablets and injections.
The categories describe the most advanced study designs selected for this library. Each summary explains what was measured and what remains uncertain.
Multiple controlled human studies
Large randomized trials show greater weight loss than placebo and improved blood-glucose control in defined adult populations. In ATTAIN-1, 3,127 adults without diabetes lost an average of 7.5–11.2% across orforglipron groups versus 2.1% with placebo over 72 weeks; adverse events led more people to stop orforglipron. In a separate trial of adults with diabetes and cardiovascular or kidney disease, major cardiovascular events were numerically less frequent than with insulin glargine, but uncertainty remained about whether orforglipron reduced them.
Multiple controlled human studies
Separate controlled trials established weight loss and fewer cardiovascular events. FLOW found fewer cases of serious kidney deterioration or death from kidney or cardiovascular causes in diabetic kidney disease. In metabolic fatty-liver disease with inflammation (MASH), liver inflammation and scarring improved; follow-up continues. Weight regain followed withdrawal in a selected extension. Oral SOUL recorded numerically fewer combined kidney complications and deaths from kidney or cardiovascular causes than placebo; that difference remained uncertain, while kidney filtration declined more slowly.
ACHIEVE-3 followed metformin-treated adults with type 2 diabetes for 52 weeks. Average starting HbA1c was 8.3%. HbA1c reflects glucose exposure over preceding weeks and months; the results below use the main analysis that included stopping and additional glucose-lowering treatment.
HbA1c fell by 1.71 percentage points with the 12-mg trial capsule and 1.91 points with the 36-mg capsule. Both groups had greater average reductions than both semaglutide groups under the prespecified tests.
HbA1c fell by 1.23 percentage points with the 7-mg oral tablet and 1.47 points with the 14-mg oral tablet. The comparison concerns these tablets and strengths.
These 52-week estimates come from the sponsor’s results table for the main treatment-regimen analysis of ACHIEVE-3. They describe the same diabetes population and oral trial treatments as the glucose comparison.
Average weight loss was 6.1% with the 12-mg trial capsule and 8.2% with the 36-mg capsule. The often-quoted 6.7% and 9.2% estimates instead assume continued treatment without additional glucose-lowering medication.
Average weight loss was 3.9% with the 7-mg oral tablet and 5.3% with the 14-mg oral tablet. Injectable semaglutide and the Wegovy tablet were not tested in this comparison.
The trial was open-label: participants knew their assignment. These are participants with at least one gastrointestinal adverse event over 52 weeks, most of which were mild or moderate.
Events were reported by 249 of 424 participants (59%) with the 12-mg trial capsule and 245 of 423 (58%) with the 36-mg capsule.
Events were reported by 157 of 426 participants (37%) with the 7-mg oral tablet and 193 of 425 (45%) with the 14-mg oral tablet.
These ACHIEVE-3 results concern stopping study treatment because of an adverse event. They do not count all reasons for stopping, and the events were not limited to digestive symptoms.
37 of 424 participants (9%) stopped at the 12-mg trial capsule strength and 41 of 423 (10%) at 36 mg.
19 of 426 participants (4%) stopped at the 7-mg oral tablet strength and 21 of 425 (5%) at 14 mg.
The product and formulation matter. These distinctions explain the evidence and are not instructions for selecting or changing a medicine. U.S. labels were checked on October 15, 2026.
ACHIEVE-3 used capsules. A separate blood-exposure study linked its 12-mg and 36-mg capsules to specified 9-mg and 17.2-mg tablets. The U.S. Foundayo label covers adult weight management and permits use with or without food.
ACHIEVE-3 used 7-mg and 14-mg oral diabetes tablets. Current oral diabetes products have fasting and timing requirements. Wegovy tablets and weekly injections have separate weight-management evidence and were not ACHIEVE-3 comparators.
Stomach and intestinal symptoms and treatment stopping were more common with orforglipron than placebo in the large weight-management trials. The FDA label carries a thyroid C-cell tumor warning and contraindications for a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. It also warns about pancreatic inflammation, severe stomach or intestinal reactions, fluid-loss kidney injury, low blood glucose, especially with insulin or insulin-releasing medicines, serious allergy, diabetes-related eye complications, gallbladder disease and stomach contents entering the lungs during anesthesia or deep sedation.
Nausea, vomiting, diarrhea, constipation and abdominal discomfort are common across approved semaglutide products. More serious concerns include pancreatitis, gallbladder disease, dehydration-associated kidney injury and severe gastrointestinal symptoms. Delayed stomach emptying matters around anesthesia because retained stomach contents can enter the lungs. Damage to the retina associated with diabetes, called diabetic retinopathy, requires attention in patients with a history of the condition, especially as glucose control improves. Combining semaglutide with insulin or medicines that stimulate insulin release increases the risk of low blood glucose, called hypoglycemia. These warnings appear in the current Ozempic injection label.
These are selected reports; several reports can come from one trial or cohort. Counts describe this library’s coverage.
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Read how the compounds differ, what direct studies found, and which questions remain open.
BPC-157 has been studied in several animal injury models and a few small human reports. Research on the defined acetylated TB-500 fragment is largely analytical or laboratory work. A small 2026 rat study tested BPC-157 alongside a TB-500-labeled preparation, but the paper did not fully identify that preparation or establish a clear difference between the two compounds.
CJC-1295 with DAC was designed to bind albumin and prolong growth-hormone signaling, and early studies measured its persistence and hormone effects in healthy volunteers. Modified GRF(1–29) shares the modified GHRH core but lacks that extension; most selected reports concern chemical identification, leaving much less human pharmacology to compare.
Direct trials found greater average weight and blood-glucose reductions with tirzepatide at the formulations tested. Receptor biology, available products, approved uses, cardiovascular outcomes and tolerability add context when comparing the two medicines.
Liraglutide and semaglutide activate the same GLP-1 receptor. Direct trials found larger average weight and blood-glucose reductions with semaglutide under the protocols tested. The comparison explains those trials, formulation differences, tolerability and separate cardiovascular evidence.
ACHIEVE-3 directly compared oral orforglipron capsules with oral semaglutide tablets in adults with type 2 diabetes taking metformin. Orforglipron lowered average blood glucose more. More participants reported stomach or intestinal adverse events or stopped treatment because of adverse events, and the average pulse increase was larger with orforglipron. The results concern the trial formulations and strengths; weight-management products need separate context.