Saxenda for Weight Loss: What Is Saxenda & How It Works | Mochi Health
Do you want to learn more about how Saxenda can help you lose weight? Scroll down and see if Saxenda is right for you!
Saxenda is a type of GLP-1 agonist medication with the active ingredient of Liraglutide. Saxenda is FDA-approved for treating obesity and is often used to help people lose weight. It is a once-daily pen injection similar to Victoza.
As mentioned before, the active ingredient in Saxenda is Liraglutide, which belongs to a class of medications called GLP-1 receptor agonists. These medications mimic the action of the naturally occurring hormone GLP-1 (glucagon-like peptide 1) in the body.
The intestine produces GLP-1 in response to food intake, which helps to stimulate insulin release from the pancreas 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, activating several pathways that help lower blood glucose levels and promotes weight loss.
Saxenda is FDA-approved for the management of obesity. 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 Saxenda. It can also be used for teens ages 12-17 struggling with obesity.
In the SCALE trial published in 2015, researchers looked at how effective Saxenda (Liraglutide) was at helping non-diabetic patients struggling with obesity lose weight. Participants were given Saxenda and counseling on appropriate lifestyle modifications (diet and exercise) for 56 weeks. At the end of 56 weeks, people taking Saxenda lost an average of 8.4 kg (~18 lbs), significantly more than the placebo group, who only did lifestyle modifications (1). This showed us that Saxenda, in combination with diet and exercise, can effectively help people with obesity lose weight.
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 (2). Both medications reduced body weight by a similar amount. They also saw that dulaglutide did improve blood pressure better than liraglutide.
Semaglutide is another type of GLP-1 medication that ae used to treat type 2 diabetes and obesity. It is sold under the brand names: Wegovy, Ozempic and Rybelsus.
When comparing Wegovy to Saxenda, 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 Wegovy vs. Saxenda for non-diabetic patients struggling with obesity (3). Participants were given either Wegovy or Saxenda, were started on a calorie restriction diet and regular exercise, then were followed for a 68-week period. The researchers found that participants taking Wegovy noticed a 15.8% change in body weight, while participants taking Saxenda noticed a change of 6.4%.
The most common side effects of Saxenda include:
These side effects are often mild to moderate in severity and disappear over time. If you experience severe side effects while taking Saxenda, you should notify your provider as soon as possible.
Saxenda is a once-daily pen injection started at 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, and 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 significant weight loss.
Saxenda 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.
Pancreatitis occurs when the pancreas becomes inflamed. This is an infrequent but potential side effect of Saxenda. If you have a history of pancreatitis, please inform your provider before starting Saxenda.
Since Saxenda 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 Saxenda.
You may experience a severe allergic reaction to Saxenda 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 Saxenda.
Though Saxenda is safe for people with kidney disease, the stomach problems associated with Saxenda may lead to fluid loss by vomiting, nausea, or vomiting. If you do have kidney problems, it is essential to stay hydrated while on Saxenda. If the gastrointestinal side effects of Saxenda are preventing you from adequately staying hydrated, then let your provider know immediately.
The most common side effect of Saxenda 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.
For patients with a history of diabetic retinopathy, there is a chance that your vision can worsen when taking Saxenda. If you do have a history of diabetic retinopathy, then let your provider know before starting Saxenda.
Saxenda can also cause some gallbladder issues along with other gastrointestinal side effects. Since Saxenda 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 Saxenda. If you have had your gallbladder removed in the past, then you can still take Saxenda.
Though very rare, there is a risk of the development of a specific type of thyroid cancer when taking Saxenda, 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 Saxenda. 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 Saxenda.
You should avoid using Saxenda if you are pregnant or plan on becoming pregnant. The weight loss effects may not benefit you during pregnancy and have the potential to harm the fetus.
Saxenda can be expensive, depending on whether you have insurance. 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, where you can pay as little as $25 per 30-day supply.
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.
Check out our Mochi Health Blogs to learn about different topics on weight loss medications.
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Dr. Constantine Joseph Pella, MD
Boston University Medical Center