What is Saxenda (liraglutide)?

What is Saxenda (liraglutide)?

Liraglutide is one of several types of GLP-1 agonists, commonly referred to as weight-loss injections—and the original. “It was one of the first to hit the market for the treatment of diabetes, in 2010, and the first to also be approved for the treatment of obesity, in 2014,” says Dr. Robert Kushner, M.D., professor of medicine in endocrinology and medical education at Northwestern University Feinberg School of Medicine in Chicago. As such, it helped pave the way for a new direction in treating both diabetes and obesity, he says, by harnessing the power of gut hormones. At the time, this was a novel way to support weight loss.

How does Saxenda (liraglutide) work?

To understand how liraglutide works, you need to first understand GLP-1. A gut hormone that’s released by cells in your gastrointestinal system after you eat, GLP-1’s job is to increase the amount of insulin the body makes in order to balance your blood sugar. It also inhibits glucagon, a hormone that regulates your blood sugar levels. As a result, GLP-1 can prevent blood sugar from spiking after a meal and even lower blood sugar.

GLP-1 agonists, liraglutide included, can amplify and extend the timeline of this effect, ultimately helping to control blood sugar for longer periods of time. On top of this, “liraglutide has actions in the brain to control appetite and slow stomach emptying, making it easier for people with obesity to follow a reduced-calorie diet and lose weight,” says Kushner. “As some of my patients say, the drug ‘quiets the mind’ and makes it easier to eat healthier.” Over time with continued use, liraglutide helps lower the weight at which the body naturally wants to settle.

How to use Saxenda effectively

Saxenda is taken with a once-daily injection that you give yourself. It sounds intimidating, but the packaging is designed to make it as easy as possible. Here’s a quick run-through of how it goes:

1. Check that the pen label reads “Saxenda (liraglutide),” pull off the cap, and do a quick visual check of the liquid. It should be clear, colorless, and free of particles.
2. Attach the needle. (Needles are sold separately—which may require a prescription in some states.)
3. Dial your dose (each pen contains 18mg of medication and the dose can be adjusted from the lowest dose .6mg to the highest 3mg).
4. Press the pen into your abdomen, thigh, or upper arm. Rotating injection sites helps avoid soreness.
5. Press down on the dose button and count to six slowly.
6. Withdraw the pen and dispose of the needle properly.

“The medication is slowly escalated every week over the first month of treatment,” says Dr. Holly Lofton, M.D., professor of medicine and surgery at NYU Grossman School of Medicine and the director of the Medical Weight Management Program at NYU Langone Health in New York City. While dosing schedules depend upon the individual and their healthcare provider’s guidance, the starting dose for Saxenda is generally .6mg, while the maximum is typically 3.0mg, per the manufacturer.

If you miss a dose, take it as soon as you can unless it’s nearly time for the next dose. In that case, take only that dose. If you forget to take the medication for three or more days, call your provider as you may need to restart the medicine at a lower dose. Never take extra doses. If you do take too much

How long does it take to lose weight on Saxenda (liraglutide)?

As with any weight-loss method, it can take some time to see significant results—especially since liraglutide has to be scaled up over several weeks. “Individuals usually feel some appetite reduction after initiating the medication, although the dose is very low at first,” says Kushner, who notes that clinical trials have shown weight loss can begin as soon as the first week of treatment.

Early studies published in the Journal of the American Medical Association and New England Journal of Medicine found that the average amount of weight loss was between 5% and 10% of one’s body weight after 36 months. However, a more recent study published in Obesity Facts found that liraglutide can help people lose nearly 10% of their body weight within four months. To lose the most weight and improve health, experts recommend that patients pair liraglutide—like any other weight-loss medication—with a healthy lifestyle.

A diet that prioritizes protein will help ensure you get the nutrition you need despite eating fewer calories. Moving your body, reducing stress, and getting high-quality sleep can help further minimize cravings—all habits that a behavior-change program like WeightWatchers® can help you build, in tandem with medication.

Other health benefits of liraglutide

Liraglutide’s ability to control blood sugar also gives it built-in heart-health benefits. The LEADER clinical trial, which ran from 2010 to 2012, assessed the cardiovascular benefits, glycemic control, safety, and cardiovascular risk factors—weight loss included—of liraglutide. “The LEADER trial determined liraglutide to have a benefit in reduction of cardiac risk in patients with diabetes,” says Lofton. A later analysis of that trial, published in Circulation, found that liraglutide also improved the outcomes of people with type 2 diabetes who had a history of heart attack and stroke, as well as those with heart disease.

Liraglutide versus other GLP-1 agonists

After liraglutide, other weight-loss drugs followed. The other medications in the overarching class of GLP-1 agonists like Zepbound work the same way, but they can vary in their results, dosage, and even frequency. Take semaglutide, which is better known by its brand names Wegovy and Ozempic. It is injected weekly instead of daily like liraglutide and studies have shown it can result in greater weight loss. But providers sometimes prefer to prescribe liraglutide over Wegovy because it has a lower risk of side effects.

How long do you need to take Saxenda?

Since obesity is a chronic condition, the medications to treat it, such as Saxenda, aren’t designed to be a one-and-done treatment. Rather, they’re meant to be used long-term for as long as someone wants to maintain the weight loss. “It is not a short-term use medication for temporary weight loss,” Lofton says. “It is intended to treat obesity, and does so by changing the physiology of one’s body while they are taking the medication.”

If someone stops taking it, they’ll likely regain the weight they lost. After all, if they’ve lost weight on liraglutide as a direct result of reduced appetite—fewer cravings, an increase in satiety, and a reduction in hunger—then “all of these benefits will disappear once the medication is stopped, making it harder for the patient to maintain the weight loss,” says Kushner. While studies haven’t tested liraglutide specifically, clinical trials of other GLP-1 agonists concluded that when people stop taking the medication, they regain weight.

Understanding the safety and side effects of Saxenda

Like other GLP-1 agonists, potential liraglutide side effects are mostly gastrointestinal in nature, and may include:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Heartburn