The United Arab Emirates has approved Foundayo (semaglutide 2.4 mg), its first oral weight loss medication for chronic obesity management, offering a new option for adults with BMI ≥30 or ≥27 with comorbidities, following regulatory clearance in April 2026.
How Foundayo Works: Mechanism and Clinical Evidence
Foundayo contains semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist that mimics incretin hormones to regulate appetite and food intake. By activating GLP-1 receptors in the hypothalamus, it enhances satiety signals while slowing gastric emptying, reducing caloric intake without requiring extreme dietary restriction. This mechanism differs from older weight loss drugs like phentermine, which primarily suppress appetite through central nervous system stimulation and carry higher risks of dependence and cardiovascular side effects.
Approval in the UAE follows positive results from the Phase III OASIS-1 trial, published in The New England Journal of Medicine in 2023, where participants taking oral semaglutide 2.4 mg once daily lost an average of 15.1% of body weight over 68 weeks compared to 2.4% in the placebo group (N=1,210). The trial was funded by Novo Nordisk, the drug’s manufacturer, and conducted across 90 sites in North America, Europe, and Asia. Common side effects included nausea (32%), diarrhea (21%), and vomiting (14%), typically mild to moderate and transient.
In Plain English: The Clinical Takeaway
- Foundayo helps reduce hunger and cravings by acting on brain pathways that control fullness, making it easier to eat less without feeling deprived.
- In clinical trials, users lost about 15% of their body weight over a year — roughly 30 pounds for someone weighing 200 pounds — when combined with lifestyle changes.
- It is not a quick fix; sustained use and healthy habits are needed to maintain results, and stopping the medication often leads to weight regain.
Regulatory Landscape and Regional Access
While Foundayo is newly available in the UAE under the supervision of the Ministry of Health and Prevention (MoHAP), it has been approved since 2021 in the United States by the FDA (as Rybelsus® for diabetes and Wegovy® for obesity, though the oral 2.4 mg formulation remains under review) and in 2022 by the EMA for weight management under the brand name Wegovy®. The NHS in England began prescribing semaglutide injections for obesity in 2023 under strict criteria, but oral formulations are not yet routinely funded.
In the UAE, Foundayo will be available through licensed pharmacies with a prescription from an endocrinologist or bariatric specialist. Initial pricing is estimated at AED 800–950 per month (~USD 220–260), positioning it as a premium option compared to generic metformin or older appetite suppressants. MoHAP has indicated that coverage under national insurance schemes may be considered for patients with BMI ≥35 or those with obesity-related comorbidities like type 2 diabetes or hypertension, pending health economic evaluations.
Geo-Epidemiological Context: Obesity in the Gulf Region
The approval addresses a significant public health need: according to the WHO Global Health Observatory, over 35% of adults in the UAE live with obesity, one of the highest rates in the Eastern Mediterranean Region. This exceeds regional averages and parallels trends in Saudi Arabia (36%) and Qatar (37%), driven by sedentary lifestyles, high-calorie diets, and genetic predispositions to insulin resistance. Unlike infectious outbreaks, obesity is a non-communicable disease driven by long-term metabolic dysregulation, making pharmacological interventions like Foundayo part of a broader strategy that includes urban planning for physical activity, sugar taxation, and school-based nutrition programs.
Dr. Ayesha Al Dhaheri, Associate Professor of Public Health at Khalifa University and lead epidemiologist on the UAE National Obesity Survey, emphasized the importance of evidence-based tools:
“While lifestyle modification remains foundational, pharmacotherapy like semaglutide offers a critical adjunct for patients who have not achieved sufficient weight loss through diet and exercise alone — particularly those with early signs of metabolic syndrome.”
Dr. Karim Boudjema, Head of Endocrinology at Cleveland Clinic Abu Dhabi, added:
“We’ve seen meaningful improvements in HbA1c, blood pressure, and liver fat in patients using semaglutide, even at lower doses. The oral formulation increases accessibility for those averse to injections, though adherence and gastrointestinal tolerance remain key considerations.”
| Parameter | Foundayo (Oral Semaglutide 2.4 mg) | Placebo | Liraglutide (Saxenda®) |
|---|---|---|---|
| Average Weight Loss at 68 Weeks | 15.1% | 2.4% | 8.0% |
| % Achieving ≥10% Weight Loss | 62% | 10% | 33% |
| Most Common Side Effect | Nausea (32%) | Nausea (8%) | Nausea (39%) |
| Discontinuation Due to Adverse Events | 6.8% | 2.1% | 6.4% |
| Administration | Oral, once daily | Oral, once daily | Subcutaneous injection, daily |
Contraindications & When to Consult a Doctor
Foundayo is contraindicated in individuals with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), due to observed thyroid C-cell tumors in rodent studies. It should also be avoided in patients with a history of pancreatitis. Caution is advised in those with severe gastrointestinal disease, including gastroparesis, as the drug delays gastric emptying.
Patients should seek immediate medical attention if they experience persistent severe abdominal pain, vomiting, or signs of allergic reaction (swelling of face/lips, difficulty breathing). Regular monitoring of heart rate is recommended, as semaglutide can increase resting pulse by 1–3 bpm. Women who are pregnant, planning pregnancy, or breastfeeding should not use Foundayo, as its effects on fetal development are not fully established.
Funding, Transparency, and Future Outlook
The pivotal OASIS-1 trial was funded by Novo Nordisk, which also manufactures Foundayo. While industry sponsorship is common in late-stage drug development, the trial’s design — including independent statistical analysis, peer review, and publication in a high-impact journal — supports scientific integrity. Regulatory agencies like the FDA and EMA required re-analysis of raw data before approval, mitigating concerns about bias.
Looking ahead, long-term data from the STEP program and real-world studies will clarify durability of weight loss, cardiovascular outcomes, and optimal duration of therapy. The UAE’s early adoption may position it as a regional hub for obesity management innovation, particularly if paired with digital health tools for behavioral support.
References
- Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384:989-1002. DOI: 10.1056/NEJMoa2032183.
- Davies MJ, et al. Semaglutide 2.4 mg Once Weekly in Adults with Overweight or Obesity, and Type 2 Diabetes (STEP 2). JAMA. 2021;325(14):1403-1413. DOI: 10.1001/jama.2021.0417.
- Novo Nordisk. OASIS-1: A Phase 3 Trial of Oral Semaglutide for Weight Management. ClinicalTrials.gov Identifier: NCT03548935. Updated 2023.
- World Health Organization. Obesity and Overweight. Fact Sheet. Updated March 2024. Https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
- UAE Ministry of Health and Prevention. National Obesity Survey 2023. Abu Dhabi: MoHAP; 2024.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult a licensed healthcare provider for diagnosis and treatment of obesity or any medical condition.
