Using Saxenda for weight loss: what to expect, dosage, and side effects

A medication-managed approach to weight loss has become increasingly popular for treating obesity and overweight. Some medications previously marketed for type 2 diabetes have even been approved by the Food and Drug Administration (FDA) for weight loss. Saxenda (liraglutide) is one such medication. 

Originally marketed for type 2 diabetes under the brand name Victoza, Saxenda was FDA-approved for weight loss and weight management in 2014. In this article, we learn more about using Saxenda for weight loss.

What is Saxenda for weight loss?

Saxenda (liraglutide) is an injectable prescription medication approved for weight loss and weight management. It’s made by Novo Nordisk and often prescribed as part of a medically-supervised weight loss plan, alongside a modified diet and increased physical activity. 

Saxenda is a glucagon-like peptide 1 (GLP-1) agonist medication. GLP-1 agonists work in the body by acting like the hormone GLP-1, which stimulates insulin production to lower blood sugar levels after eating. While lower blood sugar levels are helpful for controlling type 2 diabetes, it’s not clear how GLP-1 agonists cause weight loss. What we do know is that GLP-1 medications appear to curb hunger, likely by delaying gastric emptying (the movement of food from the stomach into the small intestine).

Who can take Saxenda for weight loss?

Saxenda is FDA-approved for weight loss and weight management in adults and adolescents along with a reduced calorie diet and exercise who fall under the following classifications:

• Adult with a body mass index (BMI) of 30 or greater (BMI is an indicator of weight status based on a person’s height and weight)
• Adult with a BMI of 27 or greater and one or more weight-related conditions, such as hypertension or type 2 diabetes 
• Adolescents older than 12 with a BMI in the 95th percentile for age and sex

What does Saxenda cost and is it covered by health insurance?

The retail price for a one-month supply of the maintenance dose of Saxenda is $1,430.01 according to drugs.com. 

Your health insurance plan may cover a portion or all of the cost of Saxenda. Although if you don’t meet the approved criteria for Saxenda use, insurance companies aren’t likely to cover it. You can verify your coverage details, including any co-pays or deductibles you’re required to pay, by reaching out to your insurance provider. You can also use the Novo Nordisk website to check coverage.

Health insurance companies may require prior authorization before covering Saxenda. This process involves your provider submitting paperwork to justify the use of Saxenda. The manufacturer provides steps to expedite the process on its website. 

If Saxenda isn’t covered by your insurance plan, talk to your healthcare provider. They may be able to write a letter of appeal to your insurance company on your behalf. You can print a sample letter from the Novo Nordisk website and give it to your healthcare provider to submit.

There are also a few ways to make your Saxenda prescription affordable if insurance doesn’t cover it.  You may be eligible for a savings card from Novo Nordisk. Additionally, websites, like GoodRx and SingleCare Rx, can help you find the best prices at pharmacies near you.

How does Saxenda work for weight loss?

Saxenda is a GLP-1 agonist medication that acts like GLP-1, a hormone that naturally occurs in the body. GLP-1 works for weight loss by signaling satiety, or fullness, to the brain and slowing gut movement after eating. This effectively reduces your appetite, making you feel less hungry. 

Natural GLP-1 hormone only stays in the body for a few minutes. But GLP-1 agonist medications break down more slowly which helps you feel fuller throughout the day, so you’re satisfied eating less.

How long can you take Saxenda?

Saxenda is intended for long-term weight management as part of a medical weight loss program that includes diet and exercise. You should follow up with your healthcare provider 12 weeks after starting the medication to see if Saxenda is working for you, but there’s no set time limit for treatment with Saxenda. The weight loss program you develop with your provider will determine how long you take Saxenda for weight loss. 

One study showed that individuals who lose weight on Saxenda tend to gain it back after stopping treatment. 

It’s important to follow a weight loss program that includes diet and exercise to reduce weight gain after stopping Saxenda. Work with your healthcare provider to better understand how diet and exercise work alongside medication to help you reach your weight loss goals and maintain them. 

How much weight can you lose with Saxenda?

Saxenda begins to work after your first injection, but it might be a few weeks before you start to see results on the scale. This is because a lower dosage of 0.6 milligrams is taken to start and increased weekly until you reach the full maintenance dose of 3 milligrams at 5 weeks.

In clinical trials, patients who didn’t have diabetes and took the maintenance dose of 3 milligrams of Saxenda and were advised to make lifestyle changes lost between 5% and 10% of their initial body weight after 56 weeks.

Keep in mind that metabolism varies between individuals and your weight loss journey may be just as unique as you are. Talk to your healthcare provider if you have any concerns about your progress while taking Saxenda for weight loss.

What to know before you start Saxenda

Before starting treatment with Saxenda for weight loss, there are a few things to keep in mind. 

Saxenda isn’t recommended for everyone

Saxenda isn’t recommended for patients with a personal or family history of medullary thyroid cancer (MCT) or multiple endocrine neoplasia syndrome type 2 (MEN2). Tell your provider if you or a family member have a history of thyroid cancer or other endocrine disorders. 

Additionally, Saxenda isn’t recommended for individuals with certain medical conditions, including gallbladder disease, pancreatitis, and kidney disease. Talk to your provider before taking Saxenda if you have or have had any of the following conditions:

• Thyroid or endocrine tumors
• Gallbladder, kidney, or liver disease
• Pancreatitis
• Stomach or digestive problems
• Allergic reaction to liraglutide
• Suicidal thoughts, ideation, or behaviors
• Pregnant, planning to become pregnant, or breastfeeding
• High cholesterol
• History of alcohol abuse

History of one or more of these conditions doesn’t necessarily exclude you from using Saxenda for weight loss. Your healthcare provider will review your personal and family medical history to determine whether Saxenda is the right weight loss treatment for you.

Saxenda may interfere with other medications

Before starting treatment with Saxenda, be sure to tell your healthcare provider of any other medications you take. There are no known specific drug interactions with Saxenda; however, Saxenda slows gut motility and may interfere with the absorption of oral medications that need to pass through the stomach. Also, combining Saxenda with diabetes medications, such as insulin and sulfonylureas, raises the risk of hypoglycemia (low blood sugar), which can be life-threatening. 

Saxenda is an injectable medication

Saxenda comes in pen-form (like an EpiPen) and is taken by injection under the skin in the stomach area (abdomen), upper leg (thigh), or upper arm. Make sure you’re comfortable giving yourself injections or have a reliable caregiver around to help. You need to take Saxenda every day. 

Your healthcare provider will show you how to perform the injection and answer any questions you may have. If you need a refresher at home, video instructions are available on Novo Nordisk’s Saxenda website. 

What are the side effects of Saxenda?

It’s possible to have side effects when taking Saxenda. Mild to moderate gastrointestinal side effects are most common with Saxenda, especially in the first 4 to 8 weeks. Sometimes they only last a few days. 

If you have more serious side effects on Saxenda immediately contact your healthcare provider or call 911.

Common side effects of Saxenda and what to do

Common side effects of Saxenda include:

• Nausea or vomiting
• Constipation or diarrhea
• Indigestion
• Headache
• Hypoglycemia, especially in individuals with type 2 diabetes
• Fatigue
• Dizziness
• Upper abdominal pain
• Injection site reaction

Most of these side effects are due to changes in food intake and slowed gut movement caused by treatment with Saxenda. These typically last a few days or weeks and resolve as your body adjusts to the medication. Talk to your healthcare provider or pharmacist if these side effects continue, worsen, or interfere with your daily life. They may make suggestions for managing the side effects or even recommend discontinuing Saxenda if the side effects outweigh the benefits.

Some things you can do on your own to reduce nausea and other gastrointestinal side effects include:

• Eat smaller, more frequent meals
• Avoid greasy, spicy, and rich foods
• Avoid lying down or having poor posture after eating
• Avoid clothing that’s tight around your abdomen and waist
• Try peppermint or ginger tea to soothe indigestion
• Drink small sips of water frequently

If you have an injection site reaction, try the following:

• Apply a warm compress for 10 to 20 minutes to soothe irritated muscles.
• Apply an ice pack for 10 to 20 minutes at a time to relieve swelling and reduce itching. 
• Take an over-the-counter (OTC) pain reliever, such as acetaminophen or ibuprofen, to relieve pain and swelling.
• Try an anti-itch medication, such as an over-the-counter antihistamine, like diphenhydramine, to relieve itching at the injection site.

Serious side effects of Saxenda

Serious side effects reported with Saxenda include, but may not be limited to:

• Gallbladder issues and gallstones
  Symptoms can include:
  • Abdominal pain
  • Fever
  • Nausea or vomiting
  • Jaundice
  • Pale-colored bowel movements
    
• Increased heart rate
  Symptoms can include:
  • Heart palpitations
  • Chest pain
    
• Pancreatitis
  Symptoms can include:
  • Sudden upper abdominal pain (may spread to back)
  • Vomiting
  • Persistent severe burning pain in the abdomen
    
• Suicidal thoughts or behavior.
  Symptoms can include:
  • New or worsening depression
  • Changes in mood or behavior
  • Thoughts of self-harm or ending your life
    
• Kidney failure.
  Symptoms can include:
  • Urinated less
  • Confusion 
  • Nausea
  • Swelling in your feet and ankles

Kidney issues on Saxenda are most commonly caused by dehydration due to vomiting or diarrhea. In some cases, kidney failure occurred in patients taking other medications that affect kidney function, such as ibuprofen, alongside Saxenda. If you’re concerned, talk to your healthcare provider about your risk of developing kidney issues while on Saxenda.

• Hypoglycemia
  Symptoms can include:
  • Dizziness and/or confusion
  • Irritability
  • Hunger
  • Tremors and/or sweating
    
• Severe allergic reaction
  Symptoms can include:
  • Swelling under the skin 
  • Swelling in the airways
  • Skin rash
  • Itching and/or flushing
    
• Risk of thyroid cancer
  Saxenda has an FDA black box warning for the risk of medullary thyroid cancer. In animal studies, liraglutide was reported to cause medullary thyroid cancer (MTC). It’s not yet clear if there’s a risk to humans. 

Talk to your healthcare provider about your risk for thyroid cancer. They may choose not to prescribe Saxenda if you have a personal or family history of certain thyroid cancers. 

Contact your healthcare provider immediately if you develop these or other serious side effects while taking Saxenda. If you can’t reach your provider or feel that the situation is a medical emergency, call 911.

Are there alternatives to Saxenda?

Saxenda doesn’t work for everyone and isn’t recommended for certain medical conditions. Additionally, your BMI may not meet the criteria for Saxenda use. If it’s not a good match for you, your healthcare provider may suggest an alternative GLP-1 agonist medication, such as Wegovy or Zepbound. 

There are currently many types of GLP-1 drugs on the market. They’re mainly FDA-approved to treat type 2 diabetes; however, three GLP-1 agonists have been approved as weight loss injections: Saxenda, Wegovy, and Zepbound. 

Wegovy as an alternative to Saxenda

Wegovy (semaglutide) is another GLP-1 agonist medication. Just like Saxenda, it mimics GLP-1 in the body to cause slowed gut movement and a sustained feeling of satiety. It’s manufactured by the same company and is also an injectable medication. Reported side effects are similar to Saxenda.

The main difference between Wegovy and Saxenda is that Wegovy is taken less often. While Saxenda is injected daily, Wegovy lasts longer in the body and is only injected once a week. Also, the injection pens work a little differently. The Wegovy pen is prefilled with a single dosage, while the Saxenda pen contains 5 different dose options.

You may also lose more weight with Wegovy. In clinical trials comparing Wegovy and Saxenda, patients who took Wegovy lost roughly 16% of their initial body weight on average. Patients who took Saxenda lost an average of 6% of their initial body weight.

Some studies suggest that some people tolerate Wegovy better. The clinical trial mentioned above also compared the side effects of Wegovy and Saxenda. While the 2 medications have overlapping side effects, a larger percentage of patients discontinued Saxenda, half of which reported that they discontinued due to side effects.

Zepbound as an alternative to Saxenda

Zepbound (tirzepatide) is a dual-agonist medication, meaning it works on 2 hormone pathways; in this case, GLP-1 and gastric inhibitory polypeptide (GIP). Zepbound simulates both of these hormones; it acts like GLP-1 by delaying gastric emptying and causing feelings of fullness while the GIP pathway stimulates insulin release to stabilize blood sugar after eating. Like Saxenda, Zepbound comes in an injection pen and the most common side effects are gastrointestinal.

With Zepbound, weight loss appears to be dose-dependent. So depending on your dosage, you may lose more weight with Zepbound. In clinical trials, patients taking the lowest dose of Zepbound lost an average of 15% of their initial body weight, while patients taking the highest dose lost roughly 21% of their initial body weight on average.

Other alternatives to Saxenda

Other type 2 diabetes medications, such as Ozempic, Rybelsus, and Mounjaro, can also be used off-label for weight loss at your healthcare provider’s discretion. 

Xenical, a lipase-inhibiting medication that reduces the amount of fat absorbed by the body, is a pill and can also be prescribed as an alternative to Saxenda. Other non-injection prescription weight-loss options include Qsymia (phentermine-topiramate), Contrave (bupropion-naltrexone), Adipex-P (phentermine), and Plenity. There’s also Alli, which is a lower-dose, over-the-counter version of orlistat (Xenical). 

If you’re interested in weight loss medication, talk to your healthcare provider about the best prescription weight loss pill options available to you. They can help you create a plan to reach your weight loss goals that may or may not include medication.

What to ask your healthcare provider

If you’re considering Saxenda as part of your weight loss program, here are some questions to ask your healthcare provider.

What should I expect when starting treatment with Saxenda?

Before you start treatment with Saxenda, your healthcare provider will help you come up with a long-term weight management plan. This typically includes changes to diet and an exercise routine, in addition to weight loss medication. Your provider may even recommend that you work with a dietician or nutritionist when developing your weight management plan to get the best results. 

When should we follow up?

Most people follow up with their provider at 12 weeks to review their progress and renew their prescription. Your provider may ask to follow up sooner depending on your health history.

What should I expect after stopping treatment with Saxenda?

After you stop treatment with Saxenda, you may experience increased appetite because Saxenda works by limiting how hungry you feel. As your body adjusts, you may experience weight gain and indigestion. Be sure to consult your provider before you stop taking Saxenda. They can help you understand what to expect and how to manage any side effects. They may also want to wean you off gradually to help minimize the effects.

How do I take Saxenda?

Saxenda is administered by self-injection once daily. Your healthcare provider or pharmacist can show you how to give yourself the injection. It’s injected under the skin in the abdomen, thigh, or upper arm. Saxenda should never be injected into a muscle or vein.

Saxenda can be taken at any time of day, independent of meals. It’s recommended that you take it at the same time every day to get the best results. Try to choose a time that is convenient for you and easy to remember. Consider setting a reminder on your phone so you don’t miss a dose.

How do I handle and dispose of the needles?

After the injection, carefully remove the needle from the pen and place it in a sharps container, not the household trash or recycling. Your healthcare provider or pharmacist can provide a medically-issued sharps container or you can order one online. 

When your container is full, check with your local trash removal service, pharmacy, or health department to see what disposal methods are available in your area. 

It’s important to note that the Saxenda injection pen should only be used with the needle provided by the manufacturer. Talk to your healthcare provider about how to obtain the needles, which are sold separately and may require a prescription.

How do I store Saxenda?

Each Saxenda injection pen lasts 6 days. Store new, unused pens in the refrigerator at between 36°F and 46°F. After the first use, Saxenda can be stored either in the refrigerator or at room temperature (59°F to 86°F). 

Saxenda pens that have been started should be thrown away after 30 days, regardless of whether there’s medication left in them. Saxenda should never be frozen. Don’t use a Saxenda pen that’s been frozen.

Will Saxenda interfere with the medications I’m already taking?

Saxenda may interfere with certain oral medications. Because Saxenda slows gastric emptying, it can affect the absorption of medications that need to pass through the stomach quickly. Tell your healthcare provider or pharmacist about any oral medications you’re currently taking, including vitamins, OTC drugs, supplements, and herbal remedies. They can tell you if Saxenda may interfere with what you’re taking and recommend a solution.

Can I drink alcohol with Saxenda?

There are no known interactions between alcohol and Saxenda. However, alcohol can cause some of the same side effects as Saxenda, such as nausea and headache. Alcohol can even worsen side effects you may already be experiencing, such as dehydration or hypoglycemia. If you drink alcohol, talk to your provider about how much is safe to consume while on Saxenda.

Find out more about Saxenda when you find a weight loss provider on Klarity

If you’re struggling to lose weight, consult with a healthcare professional to develop a weight loss plan and decide if a medically-supervised weight loss plan, such as treatment with Saxenda, is right for you.

On Klarity, you can find a licensed weight loss specialist to help you manage losing weight and with medications. Find a provider on Klarity and start your weight loss journey today! 

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.