Orforglipron (Foundayo)
Orforglipron (Foundayo) is the first FDA-approved non-peptide oral GLP-1 pill, cleared for obesity in April 2026. It cut body weight about 11.2 percent at 72 weeks in the ATTAIN-1 Phase 3 trial, less than the injectables but with once-daily oral convenience and no food or water restrictions.
Orforglipron (Foundayo) scored 5.9 / 10 (👍 Worth trying) on the BioHarmony scale as a Substance → Pharmaceutical / Drug → Other Pharmaceutical.
What It Is
Orforglipron, sold as Foundayo, is the first non-peptide GLP-1 receptor agonist you can swallow as a daily pill, and that one fact is the whole reason it matters. Every other GLP-1 drug that works well, semaglutide and tirzepatide, is a peptide that stomach enzymes would shred, so it has to be injected or, in oral semaglutide's case, wrapped in a fussy absorption trick. Orforglipron is a small molecule. Enzymes leave it alone, it absorbs at roughly 79 percent, and you take it any time of day with or without food.
It earned FDA approval for obesity on April 1, 2026, backed by one of the largest launch packages in the field: seven Phase 3 trials and more than 11,000 people. In its main obesity study it cut body weight about 11.2 percent at 72 weeks, per Wharton 2025. Here's the honest part, and it's why this lands at the low end of worth trying rather than higher. That 11 percent is excellent for a pill, but it trails injectable semaglutide by about 4 points and tirzepatide by about 10. Orforglipron's edge is access and adherence, no needles, no cold chain, no fasting window, not maximum firepower. For the millions who will never inject, that trade is the whole point.
Terminology
A few terms decide how you read this report, because orforglipron's story is really about chemistry and convenience colliding with a class that already has powerful players.
- GLP-1: Glucagon-like peptide-1, a gut hormone that signals fullness and helps control blood sugar. Orforglipron mimics it.
- GLP-1 receptor agonist: A drug that switches on the GLP-1 receptor. Semaglutide and tirzepatide do this as peptides; orforglipron does it as a small molecule.
- Peptide vs small molecule: Peptides are protein-like and get digested, so they need injection. Small molecules survive the gut, so they can be pills.
- Oral bioavailability: The fraction of a swallowed dose that reaches the bloodstream. Orforglipron's roughly 79 percent is extraordinary for this drug class.
- HbA1c: A blood marker of average glucose over about three months, the standard yardstick for diabetes control.
- CVOT: Cardiovascular outcomes trial, a long study that proves whether a drug actually prevents heart attacks and strokes. Orforglipron's is still running.
- Boxed warning: The FDA's most serious label warning. For the GLP-1 class it covers a thyroid tumor signal seen in rodents.
- Titration: Stepping the dose up slowly, here over about four weeks, to limit early nausea.
Dosing & Protocols
Dosing information is summarized from published research and community reports. This is not a prescribing guide. Consult a healthcare provider before starting any protocol.
View 1 route and 3 protocols
Routes & Forms
| Route | Form | Clinical Range | Community Range |
|---|---|---|---|
| Oral tablet | Once-daily small-molecule tablet, taken with or without food at any time of day | 36 mg once daily (label dose), titrated over about 4 weeks | Not applicable; pharmacy-only prescription medicine, no research-chemical supply |
Protocols
Standard label titration Clinical
- Dose
- Start low, step up to 36 mg
- Frequency
- Once daily
- Duration
- Ongoing (chronic therapy)
Stepwise escalation over about 4 weeks to the 36 mg maintenance dose, the schedule used across the Phase 3 program to limit gastrointestinal side effects.
Maintenance after injectable GLP-1 Clinical
- Dose
- 36 mg
- Frequency
- Once daily
- Duration
- Ongoing
In ATTAIN-MAINTAIN, switching to orforglipron after stopping injectable semaglutide or tirzepatide preserved about three quarters of the prior weight loss over 52 weeks.
Lower-dose option Clinical
- Dose
- 6 to 12 mg
- Frequency
- Once daily
- Duration
- Ongoing
Lower approved doses trade some weight loss for better tolerability; weight effect is dose-dependent across the trials.
How this score is calculated →
Upside contribution: 3.41
| Dimension | Weight | Score | Visual | Weighted |
|---|---|---|---|---|
| Efficacy | 25% | 4.8 | 1.200 | |
| Breadth of Benefits | 15% | 4.4 | 0.660 | |
| Evidence Quality | 25% | 4.9 | 1.225 | |
| Speed of Onset | 10% | 4.2 | 0.420 | |
| Durability | 10% | 2.4 | 0.240 | |
| Bioindividuality Upside | 15% | 4.4 | 0.660 | |
| Total | 4.405 |
Upside Rationale
The upside is a rare combination of strong evidence and genuine convenience, held back only by an effect size that loses to the injectables. Orforglipron's biggest assets are a deep, high-quality trial base and an oral route that removes nearly every practical barrier to GLP-1 therapy. Its weaker spots are durability, since weight returns after stopping, and the simple fact that it is less powerful than the best injectables. Speed and bioindividuality both score well because the drug acts within weeks and works across a wide range of people.
Efficacy (4.8/5.0): Efficacy is high because the weight and glucose effects are large and proven in Phase 3, just short of the injectable ceiling. The 36 mg dose cut body weight about 11.2 percent at 72 weeks versus roughly 2 percent on placebo, per Wharton 2025, and lowered HbA1c about 1.48 percent in early diabetes, per Rosenstock 2025. In a direct comparison it beat oral semaglutide on both endpoints, per ACHIEVE-3 (2026). It does not match injectable semaglutide or tirzepatide on raw weight loss, which keeps this just below a perfect score, but for an oral drug the effect size is the best yet seen.
Breadth of Benefits (4.4/5.0): Breadth is wide because orforglipron moves several metabolic systems at once. Beyond weight, the Phase 3 program showed significant improvements in blood pressure, lipids, waist circumference, and the inflammation marker hsCRP, per Horn 2025, plus strong glucose control good enough to beat dulaglutide in Phase 2, per Frias 2023. The boundaries are real: there is no muscle, bone, or cognitive benefit, and rapid loss can cost lean mass. But across the cardiometabolic cluster that drives most chronic disease, the reach is broad and consistent.
Evidence Quality (4.9/5.0): Evidence quality is the standout dimension and the reason confidence is high. Orforglipron arrived with seven Phase 3 trials and more than 11,000 participants, an unusually deep base for a newly approved drug, anchored by 72-week obesity data, per Wharton 2025, and a head-to-head superiority result against oral semaglutide, per ACHIEVE-3 (2026). The trials are large, randomized, placebo and active controlled, and consistent across obesity and diabetes. The single gap holding this back from a perfect mark is the still-running cardiovascular outcomes trial, which means hard heart-disease prevention is not yet proven for this molecule.
Speed of Onset (4.2/5.0): Speed is a genuine strength. Appetite suppression appears within the first weeks as the dose climbs, and meaningful weight loss accumulates steadily over the following months, still building at the 72-week endpoint, per Wharton 2025. Blood sugar improves over the first weeks to a few months. A roughly four-week titration is needed before the full 36 mg dose, so the very fastest effects are tempered by the ramp, but compared with most lifestyle or supplement interventions the response is quick and clearly felt.
Durability (2.4/5.0): Durability is the weakest upside dimension because the benefit depends on staying on the drug. There is no dedicated orforglipron stopping trial yet, but the entire GLP-1 class regains most lost weight within a year of discontinuation, and the appetite signal disappears as the drug clears. The one bright spot is maintenance: switching to orforglipron after injectable GLP-1 therapy preserved about 75 percent of prior loss over 52 weeks, per ATTAIN-MAINTAIN (2026). That makes it a durable maintenance tool while taken, not a one-time reset.
Bioindividuality Upside (4.4/5.0): Response is both strong and fairly predictable across people. In the main trial more than half of those on the full dose lost at least 10 percent of body weight and about 36 percent lost at least 15 percent, per Wharton 2025, a wide responder base with a clear dose-response. Tolerability varies more than efficacy: a minority cannot get past the early nausea. But unlike many interventions that work for only a subset, orforglipron produces meaningful loss in most people who can take it, which lifts this score well above average.
Downside contribution: 2.51 (safety risks weighted extra)
| Dimension | Weight | Score | Visual | Weighted |
|---|---|---|---|---|
| Safety Risk | 30% | 4.0 | 1.200 | |
| Side Effect Profile | 15% | 2.5 | 0.375 | |
| Financial Cost | 5% | 2.0 | 0.100 | |
| Time/Effort Burden | 5% | 1.6 | 0.080 | |
| Opportunity Cost | 5% | 2.0 | 0.100 | |
| Dependency / Withdrawal | 15% | 3.5 | 0.525 | |
| Reversibility | 25% | 1.8 | 0.450 | |
| Total | 2.830 | |||
| Harm subtotal × 1.4 | 3.570 | |||
| Opportunity subtotal × 1.0 | 0.280 | |||
| Combined downside | 3.850 | |||
| Baseline offset (constant) | −1.340 | |||
| Effective downside penalty | 2.510 |
Downside Rationale
The downside is dominated by the class safety signal and by dependence on continued use, not by cost or hassle, which are unusually low for this drug. Orforglipron inherits the GLP-1 class pancreatitis and thyroid warnings, so safety carries real weight even though serious events were rare in trials. The side-effect, cost, and effort burdens are all light for a drug this effective: it is a once-daily pill, priced well below the injectables, with milder gastrointestinal effects than the shots. The heavier marks are the functional need to keep taking it and the weight regain that follows stopping.
Safety Risk (4.0/5.0): Safety risk is moderate and set by the class signal rather than by anything unique to orforglipron. As a GLP-1 drug it carries a boxed warning for thyroid C-cell tumors, seen in rodents and not confirmed in humans, and the class caution for pancreatitis, both potentially serious, which is why this does not score lower. In the trials themselves serious events were rare, there were no liver-injury cases, and ALT actually fell, per Hageen 2026. The FDA still required long-term liver monitoring and 15 years of thyroid follow-up because the non-peptide mechanism is new and its long-term profile is less mapped than the peptides.
Side Effect Profile (2.5/5.0): Side effects are real but milder than the injectables, which is a practical advantage. The common complaints are gastrointestinal, nausea in roughly 13 to 18 percent, plus dyspepsia and constipation, mostly mild to moderate and concentrated during dose escalation, per Hageen 2026. Discontinuation for side effects ran about 4 to 8 percent, comparable to injectable GLP-1 drugs, so the pill format does not fully erase the tolerability problem. Most symptoms ease after the titration period, and the slow ramp exists precisely to soften them.
Financial Cost (2.0/5.0): Cost is low for this drug class, a meaningful part of orforglipron's appeal. Self-pay starts around 149 dollars per month through LillyDirect, with a savings card bringing some insured patients to about 25 dollars and Medicare coverage expanding through 2026. That undercuts the injectable GLP-1 drugs, which often run far higher without coverage. It is still an ongoing monthly expense over years, but among effective obesity medicines it sits at the affordable end.
Time/Effort Burden (1.6/5.0): Effort is the lowest-burden dimension and a core selling point. It is a single tablet once a day, taken at any time with or without food, with no injections, no reconstitution, no cold-chain storage, and none of the strict fasting that oral semaglutide demands. The only real task is the four-week titration. Compared with weekly self-injection and refrigeration, the daily-pill routine is about as light as effective obesity treatment gets.
Opportunity Cost (2.0/5.0): Opportunity cost is low because orforglipron is itself a top-tier option, not a distraction from one. The main consideration is that the injectables deliver more weight loss, so someone prioritizing maximum results might choose tirzepatide or retatrutide instead and accept the needle. For anyone who will not inject, there is no better-evidenced alternative it could be crowding out, and it pairs normally with the diet, training, and sleep work that should run alongside any GLP-1 drug.
Dependency/Withdrawal (3.5/5.0): Dependency is functional rather than addictive. Orforglipron does not create cravings or a withdrawal syndrome, but the appetite control and weight loss depend on continued dosing, so stopping reliably leads to regain as the drug clears. That is the same need-to-continue pattern seen across the GLP-1 class. It is best understood as ongoing management of a chronic condition, which is why this scores in the functional-dependence range rather than low.
Reversibility (1.8/5.0): Reversibility is excellent, one of the drug's quiet strengths. With a half-life of roughly one to three days, orforglipron clears within days of stopping, side effects resolve, and there is no taper or lasting physiological change. The weight regain that follows is a durability issue, the absence of ongoing appetite control, not an irreversible harm. You can start and stop cleanly, which lowers the stakes of trying it.
Verdict
Orforglipron sits at the bottom of the worth-trying tier because it pairs genuinely strong, deep evidence and unmatched oral convenience with an effect size that loses to the injectables. For the indicated population, adults with obesity or weight-related metabolic disease, it is a legitimately good option: an effective, once-daily, needle-free GLP-1 with the largest launch evidence base in the class and a price below the shots. The honest caveats are that it is less powerful than injectable semaglutide or tirzepatide, that a dedicated cardiovascular outcomes trial is still years out, and that weight returns after stopping. Judge it as ongoing therapy, not a quick course.
✅ Best for: Adults with obesity, or overweight plus a metabolic condition, who want effective GLP-1 treatment without injections. People who cannot tolerate the strict fasting of oral semaglutide and want a pill they can take with food. Those who value access, cost, and adherence over squeezing out the last few percent of weight loss. Patients transitioning off an injectable GLP-1 who want an oral maintenance option, supported by the maintenance data in ATTAIN-MAINTAIN (2026). Anyone who will pair the drug with resistance training and adequate protein to protect lean mass.
❌ Avoid if: You have a personal or family history of medullary thyroid cancer or the MEN2 syndrome, an absolute contraindication for the GLP-1 class. You have had pancreatitis. You are pregnant or trying to conceive, since safety is not established. You are chasing maximum weight loss and will accept injections, where tirzepatide and injectable semaglutide do more. You take insulin or a sulfonylurea without medical supervision, given the added risk of low blood sugar shown in the diabetes trials, per Rosenstock 2025.
Use Case Breakdown
The overall BioHarmony score reflects the intervention's primary evidence profile. These subratings are independent assessments per use case.
Body Composition / Fat Loss: 6.5/10
Score: 6.5/10Body composition is orforglipron's strongest use case, with real Phase 3 weight loss as an oral pill. The 36 mg dose cut body weight about 11.2 percent at 72 weeks versus roughly 2 percent on placebo, per Wharton 2025, and in a head-to-head it beat oral semaglutide on weight, per ACHIEVE-3 (2026)00202-3). The honest boundary is that this trails injectable semaglutide by about 4 points and tirzepatide by about 10. Like the rest of the class, most weight returns after stopping, and some of the loss is lean mass, so resistance training and adequate protein matter.
Metabolic Health: 6.0/10
Score: 6.0/10Metabolic health improves broadly, not just on the scale. Across the Phase 3 program orforglipron significantly improved blood pressure, lipids, and waist circumference versus placebo, per Wharton 2025, and it lowered the inflammation marker hsCRP. The 72-week design and the size of the program, more than 11,000 people, make these among the better-evidenced metabolic claims for any oral agent. The cap is that durability depends on continued use, so the metabolic gains, like the weight loss, fade if the drug is stopped.
Blood Sugar / Glycemic Control: 6.0/10
Score: 6.0/10Blood sugar control is well supported even though the diabetes indication is still pending. In early type 2 diabetes the 36 mg dose lowered HbA1c about 1.48 percent versus 0.41 percent on placebo, per Rosenstock 2025, and it beat oral semaglutide on HbA1c in a direct comparison, per ACHIEVE-3 (2026)00202-3). Phase 2 data reached up to a 2.1 percent reduction, per Frias 2023. The effect is glucose-dependent, so the risk of lows on its own is modest, but combining it with insulin or sulfonylureas needs dose care.
Cardiovascular: 5.0/10
Score: 5.0/10Cardiovascular evidence is reassuring but not yet a finished story. In its largest safety study the drug was noninferior to insulin glargine for major cardiovascular events, with a hazard ratio of 0.84, per ATTAIN and ACHIEVE program data (Horn 2025), and it improved blood pressure and lipids across trials. What is missing is a completed dedicated cardiovascular outcomes trial in high-risk patients; ATTAIN-Outcomes is years from reading out. Because this is a novel mechanism, the cardiovascular benefits proven for injectable semaglutide and tirzepatide do not automatically transfer.
| Use Case | Score | Summary |
|---|---|---|
| ○ Liver / Detoxification | 3.5 | Modest, indirect liver benefit through weight loss and falling ALT, but no dedicated fatty-liver program. |
| ○ Healthspan | 3.0 | Plausible healthspan gains via better metabolic markers, but unproven as a direct endpoint for orforglipron. |
| ○ Anti-Inflammatory | 3.0 | hsCRP fell across trials, consistent with weight loss; not an anti-inflammatory drug in its own right. |
Frequently Asked Questions
What is orforglipron, and how is it different from Ozempic or Wegovy?
Orforglipron, sold as Foundayo, is a once-daily GLP-1 pill that lowers appetite and blood sugar by activating the same GLP-1 receptor as Ozempic and Wegovy. The key difference is chemistry: it is a small molecule, not a peptide, so stomach enzymes do not destroy it and it does not need an injection. It reached about 11.2 percent weight loss at 72 weeks, per Wharton 2025.
How much weight can you lose on orforglipron?
In its main Phase 3 obesity trial, the 36 mg dose produced about 11.2 percent weight loss at 72 weeks versus roughly 2 percent on placebo, per Wharton 2025. More than half of people lost at least 10 percent. That is strong for an oral drug, but it trails injectable semaglutide, near 15 percent, and tirzepatide, near 21 percent. Orforglipron's win is convenience and access, not maximum weight loss.
How do you take orforglipron, and do you need to fast?
You take one tablet once daily at any time, with or without food, and step up to the 36 mg dose over about four weeks to ease early nausea. That food freedom is a real advantage over oral semaglutide (Rybelsus), which demands an empty stomach, a 30-minute wait, and no more than a small sip of water. Orforglipron's roughly 79 percent oral absorption removes those rules entirely.
Is orforglipron safe?
Orforglipron's common side effects are gastrointestinal, mostly nausea, dyspepsia, and constipation, generally mild to moderate and worst during dose escalation, per the pooled analysis in Hageen 2026. It carries the GLP-1 class boxed warning for thyroid C-cell tumors and the class pancreatitis caution. Trials showed no liver-injury signal, with ALT actually falling, but the FDA still mandated long-term liver monitoring because the mechanism is new.
Who should not take orforglipron?
Avoid orforglipron if you have a personal or family history of medullary thyroid cancer or the genetic syndrome MEN2, or a history of pancreatitis, and do not use it in pregnancy. People on insulin or sulfonylureas need dose adjustments to avoid low blood sugar, since orforglipron also lowers glucose, per Rosenstock 2025. Delayed stomach emptying can also affect the timing of other oral medicines.
How fast does orforglipron work?
Appetite suppression usually shows up within the first weeks as the dose climbs, while meaningful weight loss builds over months and was still accumulating at the 72-week mark in the main trial, per Wharton 2025. Blood sugar improves over the first weeks to a few months. Plan on a four-week titration before reaching the full 36 mg dose, and judge results over months, not days.
Orforglipron vs oral semaglutide (Rybelsus): which is better?
In a direct head-to-head in type 2 diabetes, orforglipron beat oral semaglutide on both blood sugar and weight, with about a 2.2 percent HbA1c drop versus 1.4 percent, per ACHIEVE-3 (2026). It is also far easier to take, since Rybelsus requires strict fasting and orforglipron does not. For most people choosing an oral GLP-1, orforglipron is the stronger and more convenient option.
Does the weight come back if you stop orforglipron?
Yes. Like the entire GLP-1 class, weight tends to return after stopping, because the appetite signal goes away when the drug clears. There is no dedicated orforglipron stopping trial yet, but the class pattern is regain of most lost weight within a year. On the flip side, orforglipron worked as a maintenance option after injectable GLP-1 use, holding about 75 percent of prior loss over 52 weeks, per ATTAIN-MAINTAIN (2026). Treat it as ongoing therapy, not a course.
How This Score Could Change
BioHarmony scores are living assessments. New research, regulatory changes, or personal context can shift the score up or down. These are the most likely scenarios that would change this intervention's rating.
The most likely score move is upward, and it hinges on the cardiovascular outcomes trial. If ATTAIN-Outcomes shows orforglipron prevents heart attacks and strokes the way injectable semaglutide and tirzepatide do, evidence and breadth both rise and the drug moves toward strong recommend. The fastest path down would be a real-world safety signal that the trials were too short to catch, the reason the FDA mandated long-term liver and thyroid follow-up. Because the evidence base is already deep, routine updates will move this less than they would for an early-stage compound.
| Scenario | Dimension shifts | New Score |
|---|---|---|
| A dedicated cardiovascular outcomes trial proves heart protection | Evidence 4.9 to 5.0, Breadth 4.4 to 4.8 | 6.2 / 10 👍 Worth trying |
| The diabetes indication is approved with strong real-world uptake | Breadth 4.4 to 4.7, Bioindividuality 4.4 to 4.6 | 6.1 / 10 👍 Worth trying |
| A higher-dose or combination version closes the gap to the injectables | Efficacy 4.8 to 5.0, Durability 2.4 to 2.8 | 6.3 / 10 👍 Worth trying |
| Long-term monitoring surfaces a genuine liver or other organ signal | Safety 4.0 to 4.5, Side Effects 2.5 to 3.2 | 5.1 / 10 ⚖️ Neutral |
| Real-world adherence proves far worse than in trials | Bioindividuality 4.4 to 3.8, Durability 2.4 to 2.0 | 5.5 / 10 ⚖️ Neutral |
| A serious post-marketing safety action is taken | Safety 4.0 to 4.8, Evidence 4.9 to 4.5 | 4.7 / 10 ⚠️ Caution |
Key Evidence Sources
- Wharton 2025, N Engl J Med (ATTAIN-1): oral orforglipron 36 mg cut body weight about 11.2 percent at 72 weeks versus about 2 percent on placebo in adults with obesity.. Primary Phase 3 obesity efficacy
- Horn 2025, Lancet (ATTAIN-2): orforglipron 36 mg reduced weight about 9.6 percent versus 2.5 percent on placebo in obesity with type 2 diabetes over 72 weeks, with broad cardiometabolic improvement.. Phase 3 obesity plus diabetes; CV-event safety context
- Rosenstock 2025, N Engl J Med (ACHIEVE-1): orforglipron 36 mg lowered HbA1c about 1.48 percent and weight about 7.6 percent in early type 2 diabetes over 40 weeks.. Phase 3 diabetes efficacy and discontinuation rates
- Wharton 2023, N Engl J Med: Phase 2 obesity trial of orforglipron showed up to about 14.7 percent weight loss at 36 weeks at the highest dose.. Phase 2 obesity dose-finding
- Frias 2023, Lancet: Phase 2 diabetes trial of orforglipron reduced HbA1c up to about 2.1 percent and weight up to about 10.1 kg, beating dulaglutide 1.5 mg.. Phase 2 diabetes dose-finding
- Pratt 2023, Diabetes Obesity & Metabolism: Phase 1b dose-finding established the orforglipron dose range and once-daily pharmacokinetics.. Phase 1b pharmacology
- ACHIEVE-3 2026, Lancet: head-to-head in type 2 diabetes, orforglipron 36 mg beat oral semaglutide 14 mg on HbA1c (about 2.2 versus 1.4 percent) and weight (about 9.2 versus 5.3 percent).. Phase 3 active-comparator superiority vs oral semaglutide
- ATTAIN-MAINTAIN 2026, Nature Medicine: switching to orforglipron after injectable GLP-1 preserved about 74.7 percent of prior weight loss versus 49.2 percent on placebo over 52 weeks.. Phase 3b weight-maintenance evidence
- Sloop 2024, Science Translational Medicine: characterized orforglipron as a non-peptide full GLP-1 receptor agonist with biased signaling that supports once-daily oral dosing.. Mechanism of action
- Hageen 2026, Endocrinology Diabetes & Metabolism: pooled network meta-analysis quantified orforglipron gastrointestinal adverse events and discontinuation rates across trials.. Pooled safety and tolerability
- U.S. FDA: orforglipron (Foundayo, NDA 220934) approved April 1, 2026 for chronic weight management, with a boxed warning for thyroid C-cell tumors.. Regulatory approval and label warning
Holistic Evidence Profile
Evidence on this intervention is summarized across three complementary streams: contemporary clinical research, pre-RCT-era pharmacology and observational use, and the traditional medical systems that documented it first. Convergence across streams signals higher confidence; divergence is surfaced honestly.
Modern Clinical Research
Confidence: High
Citations: Wharton 2025, Rosenstock 2025, ACHIEVE-3 2026
What to Track If You Try This
These are the data points that matter most while running a 30-day Experiment with this intervention.
How to read this section
- Pre
- Test or score before starting the protocol. Anchors a baseline.
- During
- Track while running the protocol so you can see if anything is changing.
- Post
- Re-test after a full cycle to confirm the change held.
- Up
- The marker should rise. For most positive outcomes, that is a good sign.
- Down
- The marker should fall. For most positive outcomes, that is a good sign.
- Stable
- The marker should hold steady. Big swings in either direction are a yellow flag.
- Watch
- Direction depends on dose, timing, and your baseline. Pay close attention to the trend.
- N/A
- No expected direction. The entry is there to anchor a baseline reading.
- Primary
- The Pulse dimension most likely to shift. Track this first.
- Secondary
- Also relevant, but a smaller or less consistent shift. Track if Primary is unclear.
Bloodwork to Order
Open These Markers In Your Dashboard
- HbA1c Pre | Expected Watch During | Expected Down
- Fasting Glucose During | Expected Down
- ALT During | Expected Watch
Pulse Dimensions to Watch
- Body During | Expected Watch | Primary
- Energy During | Expected Watch | Secondary
- Drive During | Expected Watch | Tertiary
Subjective Signals (Daily Voice Card)
- Nausea, fullness, or reflux after dosing Scale 1-5 | During | Expected Watch
- Appetite and portion size at meals Scale 1-5 | During | Expected Down
Red Flags: Stop and Consult
- Severe, persistent abdominal pain, possibly radiating to the back (possible pancreatitis): stop and seek care immediately.
- A lump or swelling in the neck, hoarseness, or trouble swallowing (thyroid warning): stop and consult a clinician.
- Personal or family history of medullary thyroid cancer or MEN2: do not use.
- Repeated vomiting or signs of dehydration during titration: pause and reassess the dose with a clinician.
Other interventions for Body Composition
See all ratings →📊 How BioHarmony scoring works
BioHarmony translates a weighted expected-value calculation into a reader-facing 0–10 score. Tier bands: Skip 0–3.6, Caution 3.7–4.7, Neutral 4.8–5.7, Worth Trying 5.8–6.9, Strong Recommend 7.0–7.9, Top-tier 8.0+.
Harm-type downsides (safety risk, side effects, reversibility, dependency) carry a 1.4× precautionary multiplier. Harm weighs more than benefit. Opportunity-type downsides (financial cost, time/effort, opportunity cost) are subtracted at face value.
Use case subratings are independent assessments of how well the intervention addresses specific health goals. They are not components of the overall score. Each subrating reflects the scorer's judgment based on use-case-specific evidence, safety, and effect sizes.
Every dimension is evaluated on a 1–5 scale, and the baseline (1) is subtracted before weighting. A perfect intervention with zero downsides contributes zero penalty rather than a residual floor, so top-tier scores are actually reachable.
EV = Upside − Downside
EV = 3.405 − 2.510 = 0.895
Formula v0.5 maps EV = 0 to score 5.0. Above neutral, 1 EV point equals 1 score point. Below neutral, 1 EV point equals about 0.71 score points, so EV = −7 reaches 0.0 while EV = +5 reaches 10.0. Both sides use the full 5-point half-scale.
Score = 5 + (0.895 / 5) × 5 = 5.9 / 10
