Saxenda vs Wegovy, which is better for weight loss?

In clinical trials and real life, a medication-managed approach to weight loss has been shown to work. Two popular options are Saxenda and Wegovy. These weight loss injections are made by the same manufacturer and work similarly in the body. But how do they compare? In this article, we dig into Saxenda vs Wegovy for weight loss.

What is Saxenda and who can it be prescribed for?

Saxenda is a brand name of medication with the active ingredient liraglutide. It’s approved for weight loss and weight management alongside a low-calorie diet and increased physical activity. Saxenda can be prescribed for adults and adolescents who meet certain criteria related to body mass index (BMI), an indicator of weight status based on a person’s height and weight. These criteria include:

• Adult with BMI of 30 or greater
• Adult with BMI of 27 or greater and at least one weight-related health condition, such as hypertension or type 2 diabetes
• Adolescent 12 years or older with BMI in the 95 percentile for age and sex

Originally marketed to treat type 2 diabetes under the brand name Victoza, Saxenda is a higher dose of liraglutide approved for weight loss in 2014. It’s a glucagon-like peptide 1 (GLP-1) agonist medication that works in the body to increase satiety. GLP-1 medications work for weight loss by making you feel more full and are less hungry.

Manufactured by Novo Nordisk, Saxenda is a once-daily injectable medication that comes in pen-form (similar to an EpiPen). It’s prescribed as part of a medically-supervised weight loss plan that includes a modified diet and increased physical activity.

What is Wegovy?

Wegovy is another type of GLP-1 agonist medication approved for weight loss and management. Its active ingredient, semaglutide, differs from Saxenda’s active ingredient, liraglutide. Wegovy is also made by Novo Nordisk. It comes in an injection pen. It lasts longer in the body than Saxenda and is taken weekly instead of daily. Wegovy’s BMI criteria for use are the same as Saxenda. Like Saxenda, taking Wegovy should be combined with a reduced-calorie diet and increased activity.

While Wegovy was approved for weight loss in 2021, other brand-name products containing semaglutide, such as injectable Ozempic and the oral tablet Rybelsus, are approved to treat type 2 diabetes. It’s important to note that these medications are dosed differently and not interchangeable with Wegovy. 

Saxenda vs Wegovy: at-a-glance

*Average weight loss obtained from a study comparing Saxenda vs Wegovy

Wegovy vs Saxenda for weight loss: how do they work?

Wegovy and Saxenda are both GLP-1 agonist medications that work for weight loss by promoting a feeling of fullness after eating. GLP-1 is a hormone naturally released by the body when you eat and that stimulates insulin secretion and delays gastric emptying. This lowers blood sugar levels and curbs appetite, so you may eat less and potentially lose weight.

GLP-1 agonist medications work in the body by mimicking GLP-1. While natural GLP-1 leaves the body rather quickly, GLP-1 agonists produce a more sustained effect. The resulting decrease in appetite means you can eat less without feeling deprived and the lower calorie intake results in weight loss. 

Studies on the effects of semaglutide on appetite found that many patients feel full faster, in addition to being less hungry overall.

Although Wegovy and Saxenda work similarly in the body, their results differ. Studies show that Wegovy is more effective for weight loss than Saxenda.

A study comparing the 2 weight loss drugs showed that patients taking Wegovy lost significantly more weight over 68 weeks than those taking Saxenda. Both groups were advised to diet and exercise while on their assigned medication. While the Saxenda group lost an average of 6.4% of their initial body weight, Wegovy users lost roughly 15.8% on average. That’s 9.4% more for Wegovy users.

Similar findings were reported in clinical trials held before the 68-week comparison study. A Wegovy trial of nearly 1,961 participants found an average weight loss of roughly 14.9% for participants taking 2.4 milligrams of Wegovy along with diet and exercise. A study on Saxenda reported an average weight loss of 5% to 10.6% among 3,731 participants taking a 3 milligrams daily dose along with diet and exercise over 56 weeks.

Wegovy vs Saxenda: the differences 

There are some differences between Wegovy and Saxenda, primarily the active ingredient. Semaglutide (the active ingredient in Wegovy) lasts longer in the body than liraglutide (the active ingredient in Saxenda). Because of that Wegovy is injected less often than Saxenda. Wegovy is taken weekly, while Saxenda is taken daily.

The Saxenda and Wegovy pens also differ. Saxenda comes in a prefilled 3 milliliter (mL) pen that can be adjusted to deliver doses of 6 milligrams, 1.2 milligrams, 1.8 milligrams, 2.4 milligrams, or 3 milligrams. This means that the same pen is used multiple days in a row. On the other hand, the Wegovy pen is prefilled with a single dose of 0.25 milligrams, 0.5 milligrams, 1 milligrams, 1.7 milligrams, or 2.4 milligrams. A new pen is used for each injection, and you need a new pen each week. 

The initial doses of Wegovy and Saxenda also vary from the maintenance doses and you increase to a different maintenance dose over a number of weeks for each. 

With Saxenda, you start with a 6 milligram dose and increase weekly until you reach the 3 milligram maintenance dose at week 5. 

Reaching the maintenance dose of Wegovy takes longer. You start with a 0.25 milligram dose in weeks 1 to 4, then increase the dosage every 4 weeks until reaching the 1.7 milligram maintenance dose at week 13. Your provider may increase your maintenance dose to 2.4 milligrams at 17 weeks depending on how your body responds to treatment with Wegovy.

Wegovy vs Saxenda: side effects

Both Wegovy and Saxenda can cause side effects. Because they’re similar weight loss medications, many of their side effects overlap. The most common side effects are gastrointestinal (GI) in nature and tend to diminish over time. More serious side effects have been reported with both Wegovy and Saxenda use, which we cover later in this section.

Common side effects of Saxenda and Wegovy

The table below compares the most common side effects of Wegovy and Saxenda taken from the medication guide for each. Note that some of these side effects while not common and marked with a “no” below may occur, but simply aren’t among the most common experienced. For full details see the Wegovy medication guide and the Saxenda medication guide.

These side effects are typically mild to moderate and are usually more pronounced when starting the medication and when increasing the dose. For many people, side effects tend to resolve over a few days or weeks.

Research suggests that Wegovy may be better tolerated than Saxenda. The aforementioned study comparing Wegovy and Saxenda reported that GI side effects were more common with Wegovy; however, a larger percentage of patients stopped taking Saxenda during the study due to side effects with half of them stopping because of side effects.

If you’re considering using Wegovy or Saxenda, your healthcare provider or pharmacist can explain your risk of experiencing side effects as well as provide suggestions for dealing with them.

Wegovy vs Saxenda: serious side effects 

Both Wegovy and Saxenda have an FDA box warning (the FDA’s highest safety warning of potential risks from taking a medication) for thyroid cancer. This is because GLP-1 agonists are known to cause medullary thyroid cancer (MCT) in mice. 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 a GLP-1 agonist for you if you have a personal or family history of certain thyroid cancers. 

Other serious side effects have been reported with both Saxenda and Wegovy use. Serious side effects common to GLP-1 agonist medications include, but may not be limited to:

• Pancreatitis (inflammation of the pancreas)
• Gallbladder disease
• Acute kidney injury
• Increased heart rate or heart palpitations
• Behaviors and/or thoughts relating to suicide or self-harm

These and any other serious side effects should be reported to your healthcare provider immediately. If the situation seems life-threatening, call 911.

Wegovy vs Saxenda: who should avoid them?

GLP-1 agonist medications, such as Saxenda and Wegovy, aren’t recommended for everyone. Avoid these drugs if you:

• Have a personal or family history of thyroid cancer
• Have pancreatitis, kidney, liver, or gallbladder disease
• Have had a previous allergic reaction to Wegovy, Saxenda, or any of their inactive ingredients 
• Have a history of suicidal thoughts and/or behaviors
• Are pregnant, planning to become pregnant, or breastfeeding

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

Wegovy vs Saxenda: price difference

The average retail price of a one-month supply of Saxenda is $1,430.01, according to drugs.com. A one-month supply of Wegovy is the same price — $1,430.01. 

Does insurance cover Wegovy or Saxenda?

If you’re prescribed Wegovy or Saxenda, your health insurance plan may cover some or all of the cost. Although they aren’t likely to cover either medication if you don’t meet the approved criteria for use. Reach out to your insurance provider to verify your coverage, including any co-pays or deductibles you’re required to pay. You can also use the Novo Nordisk website to check insurance coverage for Saxenda and Wegovy. 

Your health insurance company may require prior authorization (PA) before it covers Wegovy or Saxenda for you. This process involves your healthcare provider submitting paperwork to justify your use of the medication. Novo Nordisk has partnered with CoverMyMeds to help you navigate the PA process for Saxenda. Visit the Novomedlink website for more information. To start the PA process for Wegovy, the manufacturer provides a sample coverage request letter you can give to your healthcare provider.

If Saxenda or Wegovy aren’t covered by health insurance, there are other ways to save on your prescription. You may be eligible for savings cards from the manufacturer for both Wegovy and Saxenda. And websites like GoodRx and SingleCareRx provide coupons and pricing comparisons to let you find the best prescription price possible — with or without insurance.

Alternatives to Saxenda and Wegovy 

A healthy diet and exercise routine is an important part of any weight loss plan whether it’s a medically supervised weight loss or not. Eating a low-calorie diet and increasing your physical activity can help you lose weight with or without weight loss drugs.

If you and your healthcare provider decide that Saxenda or Wegovy aren’t right for you, your provider can help you find the best prescription weight loss pills and/or plan for you. Some medication alternatives to Saxenda and Wegovy are listed here.

• Zepbound (tirzepatide) is a weekly injectable medication approved for weight management. It works by mimicking two hormones that control appetite, GLP-1 and gastric inhibitory polypeptide (GIP), to cause feelings of fullness. 
• Qsymia (phentermine-topiramate) is a weight loss pill taken by mouth that works in the brain to suppress appetite. (Note: Qsymia is a controlled substance and carries a risk of dependency.)
• Contrave (bupropion-naltrexone) is thought to work on the brain to regulate appetite and control food cravings. It’s taken by mouth.
• Adipex-P (phentermine) is an oral stimulant medication that raises the levels of dopamine and norepinephrine in the brain. These chemicals play a role in the brain’s reward system, which is involved in regulating appetite. (Note: Phentermine is a controlled substance and carries a risk of dependency.)
• Plenity is a medical device that’s swallowed as a pill. It contains cellulose and citric acid and works directly in the digestive tract by absorbing water and mixing with food. This causes the device to expand in the stomach and small intestine, taking up space and making you feel full.
• Xenical (orlistat) is an oral medication used to promote and maintain weight loss by decreasing the amount of fat your body absorbs from food. A lower-strength version of Xenical, called Alli, is available over the counter.

The active ingredients in Saxenda and Wegovy are also marketed for type 2 diabetes under the brand names Victoza (liraglutide) and Ozempic and Rybelsus (semaglutide). It’s important to note that the dosing is different when marketed for weight loss versus type 2 diabetes and medications for type 2 diabetes are not approved for weight loss. 

A note about off-label use of GLP-1 agonists

A medication is considered off-label when it’s prescribed for a use other than what the FDA approved it for. Medications containing liraglutide or semaglutide shouldn’t be used off-label, nor should your provider prescribe them for off-label use. Medications approved for type 2 diabetes should not be used for weight loss, and vice versa. 

With increased popularity in prescription medications for weight loss, off-label use of GLP-1 agonist medications has led to supply shortages. Not only were Saxenda and Wegovy affected, but other medications containing semaglutide and/or liraglutide have also had supply shortages. This includes type 2 diabetes drugs Ozempic, Rybelsus, and Victoza. Because these medications need to be taken regularly, both diabetics and those pursuing weight loss are at risk of not having medication when they need it. 

Talk to your healthcare provider or pharmacist to learn more about supply shortages and how to maintain your medication schedule.

Saxenda vs Wegovy, which is right for you?

Studies have shown that people can lose more weight with Wegovy and it may be tolerated better than Saxenda. If you aren’t keen on giving yourself injections, Wegovy may be preferable since it’s only taken weekly. The retail prices are similar, so cost isn’t a factor when deciding whether Saxenda or Wegovy are right for you.

A conversation with your healthcare provider is the best way to decide which weight loss plan and medication, if any, is best for you. For the best results, it’s important to work with them to develop a medical weight loss program that includes diet and exercise and medication if needed.

Find a healthcare provider for weight loss

If you’re interested in learning more about Saxenda or Wegovy for weight loss, consult with a healthcare provider to develop a medically supervised weight loss program and determine whether weight loss medication is right for you. 

With Klarity, you can find a licensed weight loss specialist to help you develop a tailored weight loss plan to meet your goals. Find a provider on Klarity 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.