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Saxenda Review: Effectiveness, Safety, Cost

By Anastasia Climan, RDN, CD-N

Medically Reviewed by Yasmine S. Ali, MD, MSCI, FACC, FACP

Last Updated on November 29, 2022

Dietitian Rating:

4.2

About This Rating
The average rating of this product is calculated based on the evaluation of the following factors:
  • Support for Claims:4.5
  • Ingredient Safety:4.0
  • Customer Service:4.8
  • Value for the Price:3.3

Saxenda® (liraglutide) is an FDA-approved weight loss medication that you inject. Unlike other weight loss products (like stimulants or bariatric surgery), Saxenda works with your body’s hormones to promote a healthier weight.

Written by
Anastasia Climan, RDN, CD-N
Registered Dietitian Nutritionist
Anastasia Climan is a registered dietitian whose career progressed into public health, corporate wellness, and private practice roles. She earned a Bachelor of Science from the University of Connecticut's Coordinated Undergraduate Dietetics Program in 2011. She's led wellness initiatives on HIV/AIDS, children's health, and diabetes.
Medically Reviewed by
Yasmine S. Ali, MD, MSCI, FACC, FACP
Board-certified Cardiologist, Medical Board Member
Yasmine S. Ali, MD, MSCI, is a board-certified cardiologist, clinical lipidologist, and internist with nearly 30 years of experience in direct patient care and 25 years of experience in medical writing, editing, and reviewing.

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Saxenda Review: Effectiveness, Safety, Cost
Photo Credit: iStock.com/FreshSplash

Pros

  • FDA-approved for weight loss
  • May help prevent diabetes
  • May help prevent heart disease
  • Not a stimulant
  • Comes with additional support and resources

Cons

  • Must be injected daily
  • Side effects and risks for certain populations
  • Expensive and not likely covered by insurance

Many people struggle to maintain a healthy weight through diet and exercise alone. And surgical interventions — like bariatric surgery — may seem too extreme.

Fortunately, Saxenda is a non-stimulant prescription medication for weight loss that is approved by the FDA.

It’s designed to help adults and adolescents who are overweight or obese and haven’t had much luck with other weight loss attempts.

Here’s what you should know before deciding if Saxenda fits into your goals of a healthier future.

What Is Saxenda?

Product by the pharmaceutical company Novo Nordisk, Saxenda is an FDA-approved injectable prescription for obesity treatment. (1)

Saxenda is the brand name for 3 milligrams of liraglutide. Liraglutide was initially used to make a medication called Victoza to control blood sugar in people with diabetes.

Victoza is a lower dose of liraglutide than Saxenda — between 0.5 to 2 mg.

The higher dose of liraglutide was later developed for weight loss and trade-named Saxenda. (2)

How Saxenda Works

Saxenda supports weight loss in a few different ways.

First, it alters the body’s insulin and glucagon levels — two hormones that regulate blood sugar. Saxenda stimulates insulin and blocks glucagon. Both of these actions drive blood sugar down to reduce hunger and food cravings. (2)

In addition to lowering blood sugar, Saxenda slows gastric emptying. That means it keeps food in your stomach longer, so you feel full for longer after eating. (2)

By promoting satiety, Saxenda reduces the urge to snack between meals or eat too often.

The manufacturers of Saxenda say you should notice at least a 4% reduction in your body weight within four months of starting the injections.

Summary

Saxenda is a higher dose of the diabetes medicine Victoza. It works with your appetite hormones to control hunger and increase weight loss.

How Effective Is Saxenda? A Look at the Studies

According to Novo Nordisk, Saxenda helps you feel less hungry — while taking it — so that you can lose weight and experience related health benefits.

Here are some of the studies that have examined Saxenda’s impact on body weight.

Researchers did a 56-week double-blind trial on 3731 adults.

Participants either had a body mass index (BMI) over 30 — or a BMI over 27 plus high blood pressure or high cholesterol. People with diabetes at the time of recruitment were not included in the trial. (3)

During treatment, subjects given Saxenda reduced their BMIs and showed additional health improvements compared to the placebo group. (3)

People on Saxenda were also less likely to develop prediabetes and diabetes during the trial duration. (3)

In another randomized controlled trial of 201 adolescents with obesity (ages 12 to 18), Saxenda injections significantly lowered BMI scores compared to placebo. (4)

Initial studies following adults on Saxenda found that weight loss and associated health benefits were maintained during two years of treatment. (1)

Further research evaluated Saxenda’s effects after three years.

A study on over 2200 adults found that 26% of people on Saxenda maintained at least 5% body weight loss at the three-year mark — compared to just 10% of people in the placebo group. (5)

However, in the adolescent trial, subjects were followed for another 26 weeks after the treatment period ended. Those in the Saxenda group regained weight faster than those on placebo. (4)

Summary

Saxenda promotes weight loss and other health benefits while people are taking it, but these results may fade if you come off the medication or don’t adhere to a healthy lifestyle.

Saxenda Safety

Some participants in Saxenda trials have had adverse side effects, but they’re usually described as minimal and temporary.

Adults on Saxenda have reported vomiting and other digestive issues — typically within the first four to eight weeks of starting treatment. (3)

Gallbladder problems — including gallstones — are also more common on Saxenda. However, this may be the result of rapid weight loss. (3)

In the adolescent trial, nausea, vomiting, and diarrhea were reported. (4)

The 13 participants in the trial who dropped out early were all from the Saxenda group.

Also, three participants attempted suicide, but they were from both groups, so it’s not clear if Saxenda was a contributing factor. (4)

The safety information sheet on Saxenda notes a potentially higher risk of thyroid tumors with treatment. However, this effect was observed in rodent — not human — studies.

Nonetheless, people with a family history of certain types of thyroid cancer shouldn’t take Saxenda.

People with pancreatic, kidney, or liver problems may not be able to take Saxenda. Your physician or healthcare professional can help assess your individual risk.

Saxenda can be dangerous for people who are pregnant or planning to get pregnant because it may harm the fetus.

In addition, there’s not enough research to say whether Saxenda is safe to use while nursing, so you should discuss this with your clinician.

It’s important to let your doctor know if you take any medications or supplements before starting Saxenda. Saxenda can affect how your body absorbs medication — especially with diabetes.

For example, people on insulin or sulfonylureas for diabetes may need to reduce their dosage by 50% or more. (2)

Your clinician can monitor you and help ensure your safety.

Summary

Several groups must use caution with Saxenda or avoid taking it. But for most people, the main side effects are temporary digestive issues.

Dosage and How to Take

Saxenda’s active ingredient is 3 milligrams of liraglutide. It comes in a Saxenda pen that allows you to inject the medication at home.

You’ll gradually work up to the 3-milligram dose over five weeks. This progression gives your body time to adjust. Most people starting Saxenda follow this schedule:

  • Week 1: 6 mg
  • Week 2: 2 mg
  • Week 3: 8 mg
  • Week 4: 4 mg
  • Week 5: 3 mg

The injectable pen has a window with metered doses so that you can adjust the amount. You can inject Saxenda on your abdomen, thigh, or upper arm.

It’s important to watch out for veins or muscles when injecting Saxenda since it’s meant to go just beneath the skin’s surface. It’s a good idea to vary the location of your injections.

Many people are nervous about injecting themselves with medication, but your clinician should demonstrate and let you practice using the pen until you feel comfortable doing it yourself.

There’s also an instructional video on the website, and directions come with the medication.

Contact your primary care doctor with questions or call a SaxendaCare Coach during business hours at 1-844-363-4448.

Saxenda injections are meant to be taken every day. If you accidentally miss a dose, just continue with your usual dosage the next day — don’t double up.

However, if it’s been more than three days since your last injection, you should ask your doctor for advice on restarting the medication.

Summary

Saxenda comes in a self-injectable pen meant to be used daily. It usually takes five weeks to build up to the recommended dose.

Getting Started with Saxenda and Its Cost

A prescription is required for Saxenda, so you’ll need to meet with your physician first. If you’re a good candidate, you can pick up the medication at the pharmacy once your prescription is ready.

Your physician may also provide a free sample of Saxenda — but that only lasts for 17 days. To stay on schedule, it’s important to plan on getting your next dose from the pharmacy in time for day 18.

The cost of Saxenda varies based on your health insurance plan. Without any assistance, the price may be over $1000 per month. (6)

There’s no time limit for taking Saxenda. If it works for you, you may need to remain on it to continue losing weight or avoid weight regain.

Saxenda’s website lists several savings plans to help pay for treatment. Call your insurance carrier to discuss your plans and find out what to expect for out-of-pocket costs.

Summary

Saxenda can be purchased with a prescription from your doctor, but the cost may be extremely high — unless your insurance covers it.

How Saxenda Compares to Alternatives

Saxenda is a pricey prescription weight loss medication that requires a daily injection. You can also find options that you take as a daily pill or a weekly shot.

In addition, many current weight loss prescriptions aren’t covered by insurance and don’t have generic alternatives available — making them too expensive for most people to use for an extended time.

Saxenda is more expensive than other options on the market — with a similar lack of long-term safety and efficacy data.

Quick Comparison Table

Saxenda Ozempic Contrave
Average Retail Price $1,615.84/month $1,029.22/month

$99 or less for first month with CurAccess, $708 per month for mail orders afterward

Discounted or Subscription Price

Varies based on insurance coverage, Discount from GoodRx is $1,332.59

Varies based on insurance coverage, Discount from GoodRx is $884.04/month

Varies based on insurance coverage, Store coupons may reduce full price to about $522/month

Key Ingredients Liraglutide (3 mg) Semaglutide (available in 0.5 mg, 1 mg, and 2 mg dosages)

Naltrexone HCL (8 mg)

 

Buproprion HCL (90 mg)

Main Benefits

Reduce hunger, Lose weight, Blood sugar control/diabetes prevention

Manage diabetes, Prevent heart disease, Possible weight loss

Reduce hunger, Control cravings, Lose weight

FDA-Approved
Clinical Studies
Form Daily self-injection Weekly self-injection 4 pills a day

Frequently Asked Questions

Who can use Saxenda?

Saxenda is for approved adults with a BMI of 30 more — or a BMI over 27 with additional health problems.

It’s also approved for adolescents between 12–17 years old with a body weight above 60 kg (132lbs) and a BMI of 30 or more.

You need a prescription to get Saxenda, so you must consult with your doctor about whether it’s a good fit for you.

Where can I buy Saxenda?

You can buy Saxenda from the pharmacy once you receive a prescription. You can also order it through a mail-in prescription service.

How do I know if Saxenda is working?

You should see at least a 4% weight loss after using Saxenda for four months. If you have less weight loss by this time, it may not be effective for you — or you may need more time to see its full effect.

Be sure to discuss your individual case and concerns with your doctor.

What are side effects of Saxenda?

Common side effects from Saxenda include:

  • Abdominal pain
  • Constipation
  • Diarrhea
  • Dizziness
  • Fatigue
  • Headaches
  • Hypoglycemia (low blood sugar)
  • Injection site reactions
  • Nausea
  • Vomiting

More severe side effects may include increased risk for thyroid C-cell tumors, acute pancreatitis, acute gallbladder disease, increased heart rate, kidney problems, allergic reactions, and suicidal behavior and ideation.

The Bottom Line

Saxenda is an effective option to support weight loss and has the potential to lower the risk of diabetes and other health problems.

However, it’s not a guarantee that the benefits will continue once you come off the medication — so you may need to stay on Saxenda long-term or have another plan in place to maintain your results.

As with many prescriptions, the cost of Saxenda can be extremely high without help from your insurance company or another savings program. There aren’t any generic alternatives available, and finding an insurance plan that will cover it can be difficult.

Additionally, although most of the side effects seem manageable, there isn’t any safety information about what happens if you take Saxenda for many years.

Between the lack of long-term safety data and the high cost of treatment, you may want to also explore other options before choosing Saxenda for your weight loss journey.

Not everyone is a good candidate for Saxenda, so you’ll need to consider and discuss with your physician the potential risks and benefits to see if it’s right for you.

Expert Tips

In studies on Saxenda, participants were placed on lifestyle programs for diet and exercise while taking the medication. (3)

Although they still lost more weight than those not taking Saxenda, the placebo groups also experienced some weight loss — possibly because of the extra support during the study.

If you’re struggling to maintain a healthy weight on your own, it’s a good idea to look for outside help.

Meeting with a personal trainer, speaking with a health coach, or working with a registered dietitian nutritionist can provide guidance and accountability.

For people with diabetes, a group education class can help you meet people working on similar goals. Your doctor should be able to give you a referral to an in-person program or an online community.

If you take Saxenda, you should take advantage of their coaching program, where you can sign up for phone calls and other resources to improve your chances of success.

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  1. Liraglutide and obesity: a review of the data so far | DDDT:
    https://www.dovepress.com/liraglutide-and-obesity-a-review-of-the-data-so-far-peer-reviewed-fulltext-article-DDDT
  2. Liraglutide (Saxenda) for Weight Loss | AAFP:
    https://www.aafp.org/pubs/afp/issues/2016/0715/p161.html
  3. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management | NEJM:
    https://www.nejm.org/doi/full/10.1056/nejmoa1411892
  4. A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity – The New England Journal of Medicine:
    https://www.nejm.org/doi/10.1056/NEJMoa1916038?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
  5. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial - PubMed:
    https://pubmed.ncbi.nlm.nih.gov/28237263/
  6. Liraglutide: A New Option for the Treatment of Obesity - PubMed:
    https://pubmed.ncbi.nlm.nih.gov/26497479/