UK approves daily GLP-1 pill for diabetes and weight loss amid counterfeit drug warnings

Starting Monday, a new daily tablet for diabetes and weight loss will sit on pharmacy shelves across the UK, marking the arrival of Foundayo—a pill that represents a significant shift in how weight-management drugs reach patients. Made by American pharmaceutical company Eli Lilly, the medication was approved by the UK's Medicines and Healthcare products Regulatory Agency earlier this month, making Britain the first country in Europe to authorize it. The timing matters: just two months ago, the same regulator approved another weight-loss pill, a tablet version of Wegovy, signaling a broader move away from injectable treatments toward oral alternatives.

For many patients, this shift is genuinely welcome. Some people cannot tolerate injections, find them inconvenient, or simply prefer taking a pill. Foundayo addresses that gap. The drug is licensed for people with a body mass index of 30 or above, or those between 27 and 30 with at least one weight-related condition such as high blood pressure or heart disease. It also works to improve blood sugar control in people with poorly managed type 2 diabetes. The pill requires no special timing, no food restrictions, no water—just once daily, whenever suits the patient.

Khalil Asmar, vice-president of cardiometabolic health at Lilly Northern Europe, framed the approval as expanding choice. "There is another oral treatment option for eligible UK patients alongside licensed injectable treatments," he said. Henry Gregg, chief executive of the National Pharmacy Association, echoed that sentiment, calling it "particularly significant for patients who cannot or do not want to take an injectable medicine." For now, Foundayo will be available only through private prescription, though Eli Lilly is already working with the National Institute for Health and Care Excellence to assess whether it should be made available through the NHS. That assessment could reshape access, potentially breaking what Gregg described as the current "postcode lottery" in weight management services, where availability depends heavily on where you live and which GP practice you use.

But beneath the optimism runs a darker current. Pharmacists are sounding alarms about counterfeit GLP-1 drugs flooding the market. The problem has grown visibly: last year, the MHRA seized £250,000 worth of unlicensed weight-loss pens and raw ingredients from a factory in Northampton. Eli Lilly itself is pursuing legal action against multiple suppliers it accuses of operating an illegal underground market for its medications. The shift from injectables to pills has made counterfeiting easier—tablets are simpler to manufacture than complex injectable formulations, requiring less specialized equipment and expertise. A fake pen might be obvious; a fake pill can look identical to the real thing.

The regulatory agency and pharmacy bodies are now urging patients to buy only through licensed, regulated pharmacies. It's a straightforward instruction that masks a real risk: someone desperate to lose weight, unable to afford private prescription prices, or impatient for NHS approval might turn to online sellers or unlicensed suppliers offering cheaper alternatives. Those counterfeit drugs could contain anything—wrong doses, inactive ingredients, harmful substances entirely. Gregg called for a "redoubling of efforts" from government and the NHS to get weight-loss treatments to eligible patients through the health service, framing it not just as a matter of fairness but as a way to protect people from the counterfeit market by making legitimate treatment accessible.

The approval of Foundayo represents genuine progress for patients who need oral options. But it also exposes a tension in modern medicine: as demand for weight-loss drugs has exploded, so has the incentive to fake them. The next chapter will depend on whether the NHS moves quickly to assess and fund the drug, and whether patients trust that regulated pharmacies are worth the wait.