Analysis links orforglipron to up to 13% weight loss in adults 65 and older

A post-hoc subgroup analysis of two Phase 3 trials found that once-daily oral orforglipron, sold under the brand name Foundayo, was associated with weight loss of up to about 13% at 72 weeks in adults aged 65 and older with obesity or overweight, with or without type 2 diabetes. The analysis was published in Obesity Pillars ^[1].

The analysis looked at older participants in ATTAIN-1, which enrolled adults with obesity or overweight but not type 2 diabetes, and ATTAIN-2, which enrolled adults with obesity or overweight who also had type 2 diabetes ^[1]. Across the two trials, 616 randomized participants were 65 or older, and 613 received treatment: orforglipron 5.5 mg (118 people), 9 mg (135), 17.2 mg (146), or placebo (214) ^[1]. Everyone took the drug, or a placebo, along with a healthy diet and physical activity ^[1].

At Week 72, the average change in body weight among older ATTAIN-1 participants was -7.9% (95% confidence interval: -10.0 to -5.9) with 5.5 mg, -11.3% (-13.4 to -9.3) with 9 mg and -13.0% (-15.7 to -10.4) with 17.2 mg, compared with -1.6% (-3.2 to 0.1) with placebo. All three comparisons were statistically significant (p < 0.001) ^[1].

Results in ATTAIN-2 were similar: -7.5% (-9.1 to -5.9) with 5.5 mg, -8.3% (-9.7 to -6.8) with 9 mg and -12.2% (-13.9 to -10.6) with 17.2 mg, compared with -2.3% (-3.1 to -1.4) with placebo, again with p < 0.001 for each dose ^[1]. The published abstract says comparable findings were observed in participants younger than 65 ^[1].

Gastrointestinal side effects were the most common with orforglipron and were generally mild to moderate in severity, according to the analysis, which pooled safety data from both trials. The authors concluded that the safety profile in this older group was generally consistent with other GLP-1 receptor agonists ^[1].

For context, in the full ATTAIN-1 trial, participants taking the highest dose who stayed on treatment lost an average of 27.3 pounds (12.4%), compared with 2.2 pounds (0.9%) with placebo ^[2]. Foundayo was approved by the FDA on April 1, 2026, for adults with obesity, or overweight plus at least one weight-related medical condition, along with a reduced-calorie diet and increased physical activity ^[2]. The label carries a boxed warning for the risk of thyroid C-cell tumors ^[2]. The analysis tested three doses, 5.5 mg, 9 mg and 17.2 mg; the approved label also lists 0.8 mg, 2.5 mg and 14.5 mg tablets ^[1][2].

Why it matters for patients

Older adults with obesity have been studied less than younger adults in trials of incretin-based medicines such as GLP-1 drugs, and this analysis was aimed at part of that gap ^[1]. It reports that weight loss in people 65 and older fell in the same range as in younger participants, and that the side effect pattern looked like the rest of the drug class ^[1].

Two limits are worth knowing. This was a post-hoc subgroup analysis, meaning it was not the pre-specified main analysis of the trials, whose primary endpoint was percent change in body weight from baseline to Week 72 ^[1]. The numbers above are group averages with confidence intervals; the publication's figures also show the share of older and younger participants who reached 5%, 10%, 15% and 20% weight reduction, but those percentages are not in the abstract ^[1].

The analysis covers weight and safety in this age group. Effects on heart attacks, strokes or death among participants 65 and older were not reported ^[1].

What happens next

Both trials have finished and are registered: ATTAIN-1 as NCT05869903 and ATTAIN-2 as NCT05872620 ^[1]. Orforglipron is already FDA-approved and available by prescription, so this analysis does not change who can be prescribed the drug; whether the findings lead to any change in labeling for older adults has not been reported ^[1][2].