Wegovy vs Saxenda for Weight Loss

Saxenda (liraglutide)

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Saxenda is an FDA-approved medication used for weight management in adults with obesity or overweight. It is a GLP-1 receptor agonist that works by increasing the secretion of insulin and suppressing the secretion of glucagon, which delays gastric emptying. This helps in reducing appetite, altering your cravings, and promoting weight loss. A trial published in 2015 showed that a daily injection of 3.0mg of Saxenda (liraglutide) along with diet and exercise resulted in a mean loss of about 8.4 kg (~18 lbs) after 52 weeks when compared to the placebo group (1).

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Saxenda is injected once a day, and the dosage is gradually increased over several weeks. The maximum dose is 3 mg per day, and the treatment duration depends on the individual's weight loss goals.

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The most common side effects of Saxenda include nausea, vomiting, diarrhea, constipation, headache, dizziness, and abdominal pain. However, these side effects usually subside after a few weeks of treatment. Saxenda is also associated with rare but serious side effects such as pancreatitis, thyroid tumors, and gallbladder disease.

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Wegovy (semaglutide)

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Wegovy is an FDA-approved medication used for weight management in adults with obesity or overweight. It is also a GLP-1 receptor agonist that works by increasing the secretion of insulin and suppressing the secretion of glucagon, similar to Saxenda. When Wegovy (Semaglutide) was given as a once-weekly pen injection over a period of 68 weeks, researchers found that participants were able to lose a significant amount of weight when compared to the placebo (2). The researchers saw that participants on Wegovy were able to see a 15% reduction in body weight compared to their baseline weight. 

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Wegovy is injected once a week, and the dosage is gradually increased over several weeks. The maximum dose is 2.4 mg per week, and the treatment duration depends on the individual's weight loss goals.

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The most common side effects of Wegovy include gastrointestinal symptoms such as nausea, vomiting, and diarrhea. However, these side effects usually subside after a few weeks of treatment. Wegovy is also associated with rare but serious side effects such as pancreatitis, thyroid tumors, and gallbladder disease.

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Comparing Saxenda and Wegovy

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Both Saxenda and Wegovy are GLP-1 receptor agonists that work by suppressing appetite and promoting weight loss. However, there are some differences between the two medications.

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Administration

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Saxenda is injected once a day, whereas Wegovy is injected once a week. This may make Wegovy a more convenient option for those who don't want to take daily injections.

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Dosage

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The maximum dose of Saxenda is 3 mg per day, whereas the maximum dose of Wegovy is 2.4 mg per week. 

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Effectiveness

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Though both medications have shown a significant effect on weight management, a randomized control trial published in 2022 (STEP-8 trial) showed that once-weekly Wegovy (semaglutide) showed greater weight loss after 68 weeks than once-daily Saxenda (liraglutide) injections (3). The mean change in weight from baseline was 15% for participants taking Wegovy and 6.4% for Saxenda. 

Side effects

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Both medications can cause gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Saxenda also can cause headaches, dizziness, and tiredness. In the STEP 8 trial, it was reported that the side effects were more common for participants taking Wegovy compared to those taking Saxenda (84.1% of the participants on Wegovy vs. 82.7% of participants on Saxenda). 

Both of these medications should be avoided in patients with prior history of medullary thyroid cancer, diabetic retinopathy, pancreatitis, gallstones, or prior episodes of hypoglycemia. These medications should also be avoided for patients currently taking insulin as it could lead to hypoglycemia. 

Cost and Coverage

Both of these medications can be very expensive. Luckily, both have been approved by the FDA for weight loss, which can make it more likely for an insurance plan to cover it. Insurance companies may cover these medications if you have a BMI over 27 along with certain obesity-related comorbidities like high blood pressure and high cholesterol. This should overall reduce the costs. On average, both medications cost around the same amount at $1400 per month.

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Conclusion

The decision to start either Wegovy or Saxenda for weight loss is a discussion that should be had with you and your provider. Though they work via similar pathways, there are some key differences between the medications. Saxenda is a once-daily injection, while Wegovy is once-weekly, which may be more convenient for some people. A recent clinical trial showed that Wegovy was more effective at lowering body weight; however, side effects were more common than Saxenda. The average costs are the same, and both can be covered by some insurance plans. 

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How to Get These Medications

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It is always important to remember that along with these medications, you must include healthy lifestyle modifications such as diet and exercise in order to achieve the maximum benefits that are seen with these medications. 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!

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References

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1. Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DC, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JP; SCALE Obesity and Prediabetes NN8022-1839 Study Group. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015 Jul 2;373(1):11-22. doi: 10.1056/NEJMoa1411892. PMID: 26132939.
2. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989-1002. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10. PMID: 33567185.
3. Rubino DM, Greenway FL, Khalid U, O'Neil PM, Rosenstock J, Sørrig R, Wadden TA, Wizert A, Garvey WT; STEP 8 Investigators. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022 Jan 11;327(2):138-150. doi: 10.1001/jama.2021.23619. PMID: 35015037; PMCID: PMC8753508.

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