Prescription weight-loss pills in Spain (2026): which ones have evidence, what they cost and how to get them

In Spain you can currently buy two prescription-only oral weight-loss medicines, Wegovy tablets (oral semaglutide) and orlistat 120 mg (Xenical and its generics), plus one that doesn't need a prescription, orlistat 60 mg (Alli). Mysimba is authorised in Spain but isn't on the market. None of them is funded by the Spanish National Health System, and all of them are meant to be used alongside a reduced-calorie diet and more physical activity.

A search for "weight-loss pills" lumps together three things that have nothing in common: authorised medicines, backed by clinical trials and an official summary of product characteristics; food supplements, which don't have to prove they work before they go on sale; and illegal products, which are sometimes adulterated. This guide sorts out what falls into each group.

Which prescription weight-loss pills are available in Spain?

• Wegovy tablets (oral semaglutide). The European Commission authorised it in July 2026, and CIMA, the AEMPS medicines database, lists four strengths, 1.5, 4, 9 and 25 mg, all marketed in Spain as of 5 November 2026. Its summary of product characteristics indicates it for adults with a BMI of 30 or more, or a BMI of 27 to under 30 with at least one weight-related condition, such as prediabetes or type 2 diabetes, high blood pressure, dyslipidaemia, sleep apnoea or cardiovascular disease.
• Xenical and generic orlistat 120 mg (Cinfa, Sandoz, Stada, Teva, Aurovitas, Normostat). These need a prescription. Together with a moderately reduced-calorie diet, they are indicated for obesity (BMI of 30 or more) or for overweight (BMI of 28 or more) with risk factors. Orlistat works in the gut: it blocks the lipases that digest fat, so some of the fat in your food isn't absorbed.
• Alli and other orlistat 60 mg products. These are sold without a prescription in pharmacies, for overweight adults (BMI of 28 or more) following a mildly reduced-calorie, low-fat diet. The product information limits use to three capsules in 24 hours.
• Mysimba (naltrexone/bupropion). It is authorised for obesity, or for overweight with related conditions, but CIMA lists it as not marketed in Spain, so you won't find it in pharmacies.

None of them replaces those lifestyle habits: that's how their summaries of product characteristics describe them, and that's how they were used in the trials below.

Which ones aren't available in Spain, even though people talk about them?

Foundayo (orforglipron, made by Lilly) is the pill getting the most attention. The US Food and Drug Administration approved it on 1 April 2026, and on 15 October the EMA's medicines committee recommended authorising it in Europe for weight management and type 2 diabetes. But the European Commission hasn't made its decision yet and the drug isn't listed in CIMA, so it is currently neither authorised nor available in Spain. We cover this in detail in what orforglipron is and why it isn't available in Spain.

Oral tirzepatide simply doesn't exist: every Mounjaro product listed in CIMA is an injection. And although Rybelsus is semaglutide in tablet form, in Spain it is authorised only for type 2 diabetes; its summary of product characteristics doesn't cover weight management. If you're interested in it for another reason, see the price of Rybelsus per dose and per month.

How much weight did people lose on each one in trials?

Wegovy tablets. In the OASIS 4 trial (New England Journal of Medicine, 2025), 307 adults with obesity or overweight and without diabetes took either oral semaglutide 25 mg or a placebo. After 64 weeks, body weight had fallen by an average of 13.6% on the drug and 2.2% on placebo. Novo Nordisk quotes a figure of around 17%, but that only counts people who stayed on treatment; the figure in the summary of product characteristics is 13.6%.

Orlistat 120 mg. In the European multicentre trial published in The Lancet in 1998, with 688 patients, the orlistat group lost an average of 10.2% of their body weight in the first year compared with 6.1% on placebo, including a four-week lead-in diet during which both groups were already losing weight. The Xenical summary of product characteristics, drawing on five two-year studies, gives an average difference of 3.2 kg versus placebo after one year.

Orlistat 60 mg. The Alli product information reports two six-month trials: an average weight loss of 4.6% on the drug compared with 2.2% on placebo.

Mysimba. In the 56-week NB-301 trial, average weight loss was 5.4% compared with 1.3% on placebo, according to its summary of product characteristics. And Foundayo, in its 72-week ATTAIN-1 trial at the highest dose, achieved 11.2% compared with 2.1%, although those trial doses aren't the ones the EMA has announced for Europe.

A word of caution when reading these figures: they come from trials with different lengths, populations and methods of analysis, so they can't be ranked against each other. What they do show is the rough scale of each medicine's effect compared with its own placebo.

How much do they cost, and does the National Health System pay for them?

None of the obesity pills is funded. Wegovy tablets have been listed in BIFIMED, the Spanish Ministry of Health's funding database, as "not funded by resolution" since 1 September 2026, and the price isn't regulated: the press has reported €236.20 for a box of 30 tablets of 25 mg, around €236 a month, and no price has been published for the starter packs. Xenical and Alli are listed as "not included" in public funding and don't appear with a price in the Nomenclátor, Spain's official medicines price list, so there is no official price: each pharmacy sets its own.

The only tablet in this family with an official price is Rybelsus, at €123.53 for a box of 30 tablets, and the public health system only funds it, subject to prior authorisation (visado), for type 2 diabetes with a BMI of 30 or more and in combination with other antidiabetic drugs. To work out the full cost, including consultations and follow-up, see how much medical weight-loss treatment costs in Spain.

Why don't fat burners and "GLP-1" supplements work?

Because they aren't medicines, and nobody has had to prove that they work. In Spain, a food supplement can go on sale once its label has simply been notified to the health authority, under Royal Decree 1487/2009, and the same regulation prohibits claiming that it prevents or treats any disease. A product presented as an alternative to obesity treatment is promising something that, by law, it isn't allowed to promise.

"Natural GLP-1" is a marketing hook. The GLP-1 receptor agonists that produce weight loss in trials are prescription medicines, and in September 2025 the AEMPS, Spain's medicines regulator, circulated the European alert about the sharp rise in illegal products sold under that name through fraudulent websites and social media. These may not contain the declared active ingredient and may contain other harmful substances instead.

And some fat burners have a hidden drug inside. On 2 September 2026 the AEMPS ordered the withdrawal of 22 slimming products, including Slim U, P57 Hoodia and Pezo Mega, because they contained sibutramina not declared on the label, an appetite suppressant suspended in the EU because of its serious cardiovascular effects; seven of them also contained phenolphthalein, a laxative.

How do you get a prescription weight-loss pill?

The route is always the same: a doctor assesses whether you meet the indication (your BMI and any related conditions), reviews your medical history and the medicines you already take and, if appropriate, issues a prescription. You then collect the medicine from a pharmacy and, as it isn't funded, you pay the full price. The Wegovy tablets summary of product characteristics also describes a step-by-step start, with each step lasting at least four weeks, until the maintenance dose is reached, so follow-up is part of the treatment.

What doesn't exist is a legal online shortcut. Spanish law prohibits the distance selling of prescription-only medicines, and Royal Decree 870/2013 only allows non-prescription medicines, such as orlistat 60 mg, to be sold online, and only by authorised pharmacies that have notified the authorities. We explain how to recognise legal channels in our guide to buying Ozempic and Mounjaro in Spain legally and safely.

For each oral option there's a more detailed guide: Wegovy tablets: price and prescription and what Ozempic in tablet form is called.

Where should you start if you want to lose weight with medical help?

The key points: there are only a few oral treatments with evidence behind them, all of them go hand in hand with diet and physical activity, and the prescription ones go through a doctor and a pharmacy. Everything else either hasn't proven anything or is outright illegal. If you're looking for a serious route, medical weight-loss treatment is available in Spain, with an assessment beforehand, a prescription from a registered doctor when appropriate, and ongoing follow-up, which is what we do at AiON. You can:

Find out in a few minutes whether the treatment is right for you