Liraglutide for Weight Loss

Are you considering trying Saxenda or Victoza (Liraglutide)? Scroll down to learn more about Liraglutide!

What is Liraglutide?

Liraglutide is a type of GLP-1 agonist medication that is often used to treat Type 2 Diabetes. It is sold under the brand name Victoza and Saxenda at different doses. Saxenda is FDA-approved for the treatment of obesity and is often used to help people lose weight. Victoza also uses Liraglutide as the active ingredient, however it is only FDA approved for the treatment of Type 2 Diabetes, not obesity. It can be used off-label to help people with obesity.

How does Liraglutide Work?

As mentioned before, Liraglutide belongs to a class of medications called GLP-1 receptor agonists, which mimic the action of the naturally occurring hormone GLP-1 (glucagon-like peptide 1) in the body.

GLP-1 is produced by the intestine in response to food intake, and it helps to stimulate the release of insulin from the pancreas in order to lower blood glucose levels. GLP-1 also helps to slow down the rate at which food is digested and absorbed in the intestine, which can help to reduce appetite and promote weight loss. Liraglutide is similar in structure to GLP-1, and it binds to the GLP-1 receptor in the body, which activates a number of different pathways that help to lower blood glucose levels and promote weight loss.

Who Qualifies For Liraglutide?

As mentioned, Victoza is FDA-approved for the treatment of Type 2 Diabetes.You may be eligible for Victoza if you are currently or were recently diagnosed with Type 2 Diabetes. It is not currently used to treat people with Type 1 Diabetes.

Saxenda is FDA-approved for the management of obesity. Victoza can be used off-label to treat obesity as well. If you have a BMI >30 or a BMI > 27 with at least one obesity related condition (diabetes, pre-diabetes, high blood pressure, or high cholesterol) you may be eligible to take these medications

Can Liraglutide Be Used for Weight Loss?

In the SCALE trial published in 2015, researchers looked at how effective Liraglutide was at helping non-diabetic patients struggling with obesity lose weight. Participants were given Liraglutide along with counseling on appropriate lifestyle modifications (diet and exercise) for 56 weeks. At the end of 56 weeks, people taking liraglutide lost an average of 8.4 kg (~18 lbs) which was significantly more than the placebo group who only did lifestyle modifications (1). This showed us that Liraglutide, in combination with diet and exercise, can effectively help people with obesity lose weight.

Liraglutide vs Other GLP-1 Medications

Liraglutide vs Dulaglutide

In an observational study published in 2020, researchers compared dulaglutide (Trulicity) and liraglutide head-to-head on how effective these medications were for type 2 diabetes. They found that both medications effectively helped with weight loss (1.14kg for dulaglutide and 1.64kg for liraglutide), but there was no significant difference between the two medications. Both medications reduced body weight by a similar amount. They also saw that dulaglutide did improve blood pressure better than liraglutide.

Liraglutide vs Semaglutide

Semaglutide is another type of GLP-1 medication that are used to treat type 2 diabetes and obesity. It is sold under the brand names: Wegovy, Ozempic and Rybelsus. Wegovy and Ozempic are both weekly pen injections. Rybelsus is a once daily oral tablet. Rybelsus and Ozempic are both approved to treat type 2 diabetes and are used off-label to treat obesity. Wegovy is FDA-approved in the treatment of obesity.

When comparing semaglutide to liraglutide, semaglutide has been shown to have a more significant weight loss effect. In a study published in 2022 called the STEP-8 clinical trial, researchers compared the weight loss effect of semaglutide vs. liraglutide for non-diabetic patients struggling with obesity (3). Participants were given either semaglutide or liraglutide, were started on a calorie restriction diet and regular exercise, then were followed for a 68-week period. The researchers found that participants taking semaglutide noticed a 15.8% change in body weight, while participants taking liraglutide noticed a change of 6.4%.

Liraglutide Side Effects

The most common side effects of liraglutide include:

• Nausea (40%)
• Diarrhea (20%)
• Constipation (20%)
• Vomiting (16%)
• Abdominal Pain (5%)
• Decreased Appetite (10%)
• Headache (13%)

These side effects are often mild to moderate in severity and disappear over time. If you experience severe side effects while taking Liraglutide, you should notify your provider as soon as possible.

Liraglutide (both Saxenda and VIctoza) should not be used during pregnancy if it is being used solely for weight loss. The weight loss from the medication may not benefit pregnant patients and can also cause harm to the fetus. If you are taking it for Type 2 Diabetes, discuss with your providers to see if the benefits from the medication outweigh the potential risks to the fetus. Always let your provider know if are pregnant or plan on becoming pregnant before starting Liraglutide

Liraglutide Dosage and Administration

Liraglutide is the common active ingredient used by Victoza and Saxenda. Though they use the same active ingredient, they are dosed differently

Saxenda is a once-daily pen injection that is started at a dose of 0.6 mg for one week. After one week, the dose can be increased with each week of treatment to 1.2 mg, 1.8 mg, 2.4 mg, to a max of 3 mg. At 16 weeks of treatment, if you have not seen at least a 4% decrease in body weight, you should stop using Saxenda since it will unlikely lead to meaningful weight loss.

Victoza is also a once-daily pen injection that is started at a dose of 0.6mg for one week. After the first week, it can be increased to 1.2 mg then to a maximum of 1.2 mg. This dosing schedule is used specifically for the treatment of Type 2 Diabetes.

For both medications, the injection can be administered in the abdomen, thigh or upper arm. Make sure to rotate injection sites with each dose. If a dose is missed, DO NOT take an extra dose to make up for the missed dose. Continue with the dosage as scheduled.

Liraglutide Contraindications and Warnings

Pancreatitis

Pancreatitis occurs when the pancreas becomes inflamed. This is an infrequent but potential side effect of Liraglutide. If you have a history of pancreatitis, please let your provider know before starting Liraglutide.

Hypoglycemia (Low Blood Sugar)

Since Liraglutide increases insulin secretion, there is a risk that your blood sugar can be lowered to dangerous levels. This is known as hypoglycemia. If you have a history of hypoglycemia or are currently using insulin, you must inform your provider before starting Liraglutide.

Serious Allergic Reaction

You may experience a severe allergic reaction to Liraglutide when first taking it. Signs of a severe allergic reaction include swelling of your face, lips, tongue, or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, and very rapid heartbeat. Let your provider know immediately if you have experienced this with other GLP-1 medications or are currently experiencing this when taking LIraglutide.

Kidney Disease

Though Liraglutide is safe for people with kidney disease, the stomach problems associated with Liraglutide may lead to fluid loss by vomiting, nausea, or vomiting. If you do have kidney problems, it is essential to stay hydrated while on Liraglutide. If the gastrointestinal side effects of Liraglutide are preventing you from adequately staying hydrated, then let your provider know immediately.

Severe Stomach Problems

The most common side effect of Liraglutide is gastrointestinal upset, which includes stomach ache, nausea, diarrhea, vomiting, and loss of appetite. If these symptoms become so severe that they significantly affect your daily life or ability to eat regularly, then let your provider know.

Changes in Vision

For patients with a history of diabetic retinopathy, there is a chance that your vision can worsen when taking Liraglutide. If you do have a history of diabetic retinopathy, then let your provider know before starting Liraglutide.

Gallbladder Disease

Liraglutide can also cause some gallbladder issues along with other gastrointestinal side effects. Since Liraglutide can decrease the movement of food through the gastrointestinal system, it can also reduce the function of the gallbladder. This can lead to gallstone formation, which can block the release of bile, leading to the inflammation of the gallbladder.

If you have a history of gallstones or cholecystitis (inflammation of the gallbladder), then let your provider know before starting Liraglutide. If you have had your gallbladder removed in the past, then you can still take Liraglutide.

Thyroid Cancer or Family History of MEN-2

Though very rare, there is a risk of the development of a specific type of thyroid cancer when taking Liraglutide, called Medullary Thyroid Cancer. If you have a history of medullary thyroid cancer or a family history of Multiple Endocrine Neoplasia Cancer Syndrome Type 2 (MEN-2), let your provider know before starting Liraglutide. MEN-2 is a genetic cancer syndrome that puts a patient at risk for the development of Medullary Thyroid Cancer, which is why patients with this syndrome should avoid taking Liraglutide.

Pregnancy

As mentioned before, you should avoid using Liraglutide if you are pregnant or plan on becoming pregnant. The weight loss effects may not benefit you during pregnancy and has the potential to harm the fetus.

Liraglutide Coverage and Costs

Liraglutide can be expensive depending on if you have insurance or not. Victoza on average costs around $1000-$1100 for a month’s supply. Saxenda can cost around $1300-$1400 for a month’s supply. Depending on your insurance plan, you may be eligible for the Saxenda Savings Offer were you can pay as little as $25 per 30-day supply. Though there is no savings card for Victoza, you may be eligible for the Patient Assistance Program offered by Novo Nordisk which may allow you to obtain free medication.

Where Can I Get Liraglutide?

If you would like to learn more about GLP-1 medications or want to see if you might be eligible for medication-assisted weight loss, check out Mochi Health, where board-certified obesity medicine physicians can offer expertise in this realm!

Mochi Health is a virtual obesity medicine practice that connects you with medical providers, like licensed physicians and nurse practitioners, to help you optimize your weight loss journey. We provide monthly video chats with actual medical providers to provide guidance about weight management and to get you started on prescription weight loss medications to supplement your weight loss plan.

Frequently Asked Questions

Check out our Mochi Health Blogs to learn about different topics on weight loss medications.

Who should avoid taking Liraglutide?

What is the best diet while taking Liraglutide?

Can Liraglutide lower my blood sugar?

Does Liraglutide cause thyroid cancer?

Can Liraglutide prevent me from having babies?

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References

1. Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DC, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JP; SCALE Obesity and Prediabetes NN8022-1839 Study Group. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015 Jul 2;373(1):11-22. doi: 10.1056/NEJMoa1411892. PMID: 26132939.
2. Chang KC, Shao SC, Kuo S, Yang CY, Chen HY, Chan YY, Ou HT. Comparative effectiveness of dulaglutide versus liraglutide in Asian type 2 diabetes patients: a multi-institutional cohort study and meta-analysis. Cardiovasc Diabetol. 2020 Oct 9;19(1):172. doi: 10.1186/s12933-020-01148-8. PMID: 33036617; PMCID: PMC7547475.
3. Rubino DM, Greenway FL, Khalid U, et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022;327(2):138–150. doi:10.1001/jama.2021.23619