Comparing Saxenda® vs. Wegovy®: which GLP-1 drug is right for you?

Saxenda® and Wegovy® are some of the first injectable medications that can help you lose at least 8% or more of your body .^1,2 Saxenda® is a daily injection and Wegovy® is a weekly injection. Wegovy® is also the first weight loss medication approved to help reduce risk of cardiovascular disease in adults with known cardiovascular disease and obesity when used in combination with a comprehensive diet and exercise program.³  

Everyone’s body is different, and you need a weight loss program that will work for you. Our experienced, online primary care doctors online can help you discuss the pros and cons of different medications and help you build a healthy long-term diet, exercise, sleep, and stress routines to help keep you reach your health goals. 

Saxenda® and Wegovy® are injectable drugs that can help you lose weight when combined with reduced calorie diets and physical activity. Both drugs are manufactured by the pharmaceutical company Novo Nordisk. 

The active ingredients in both Wegovy® and Saxenda® injections mimic a natural hormone in your body called GLP-1 that controls  gastric emptying, hunger, and blood sugar regulation.⁴ This hormone helps you feel full sooner and stay satisfied longer when eating, which helps you reduce  your portion sizes GLP-1 medications work in your brain to reduce food cravings,  By mimicking the GLP-1 hormones that your body naturally makes, GLP-1 agonists work by triggering insulin release in response to eating, increasing insulin sensitivity, and lowering blood sugar.  These medications help reduce hunger, but they do not effectively cause weight loss without being combined with a healthy, reduced calorie meal plan. 

Any weight loss will cause both loss of fat and muscle. It is important that weight loss programs always include an individualized exercise routine to build strength and endurance throughout the weight loss journey. This helps achieve better quality of life and reduces weight related medical conditions such as heart disease, insulin resistance, diabetes, and joint pain. 

The main difference is found in their active ingredients.  

Liraglutide is the active ingredient in Victoza® and Saxenda®. Liraglutide is a daily injection. Victoza® for the management of diabetes was FDA approved in 2010. This medication not only helped patients manage diabetes; it also helped patients lose significant weight. In 2014 the FDA approved liraglutide for weight loss and it was named Saxenda. Saxenda, also a daily injection, was one of the first FDA approved weight loss medications that could help people lose 5 - 10% of their body weight when it was combined with healthy, low calorie meal plan and exercise routines. This is important because weight loss of 5-10% of body weight leads to significant long term health improvements.  

Victoza® and Saxenda® have been around for the longest and doctors have the most experience with these medications. Because these medications are given every day, the dose can be easily adjusted or stopped to reduce side effects.  

Semaglutide is the active ingredient in Ozempic and Wegovy. Semaglutide is a weekly injection. The FDA approved Ozempic for treatment of diabetes in 2017. Wegovy® was FDA-approved for the treatment of weight loss in 2021. When combined with healthy, low-calorie meal plans and exercise routines this can lead to 15-20% weight loss. This amount of weight-loss can show significant improvement in diabetes and prediabetes. In patients with prior heart attacks and strokes who are overweight or obese, Wegovy® reduces the risk of future cardiovascular events. For patients who have more medical conditions related to their weight, Wegovy® in combination with low calorie, healthy diets and exercise routines now offers an option to help lose weight and improve the underlying health conditions. 

These are safe and effective medications when used correctly that can help people lose significant weight to improve their long-term health. While clinical trials suggest that Wegovy® may lead to more weight loss than Saxenda®, it's important to remember that individual results can vary.⁵ Weight loss can also vary based on underlying an individuals medical conditions, genetic factors, life stressors, sleep schedules, dietary habits, and exercise routines. For many patients, a weight loss of 5-10% that is achieved on Saxenda® will have significant health improvements without needing to take a stronger medication. Also, side effects vary between people are an important factor to consider as everyone’s body responds differently to different medications.  

The best option for you will come down to your specific situation and needs. These medications should not be taken without a medical evaluation and treatment plan. Your doctor can consider your medical history, weight loss goals, and overall health to recommend the best option for you as an individual. Our online primary care doctors are highly experienced in helping patients lose weight, manage other underlying health conditions, and improve their long-term health.  

The weight loss goals for these medications are based on your underlying health. BMI is not a good measure of how healthy you are. The goal is to lose enough weight to improve your health and risk of diabetes, heart attacks, strokes, joint pain, and improve your quality of life. For some patients, losing 5-10 pounds is enough to have significant improvement. Other patients will need to lose more weight. You can have a healthy weight and BMI but lose so much muscle that your health is not improved. It is important to have a doctor guide your weight loss so that your health is improving.   

Both Wegovy® and Saxenda® can cause similar side effects, most commonly gastrointestinal symptoms.  

Common side effects include:  

• Runny nose 

• Nausea/vomiting 

• Diarrhea or constipation 

• Low blood sugar 

• Gallstones 

• Skin rash or itching 

Drinking water, eating smaller meals, and avoiding high-fat or high-sugar foods help reduce discomfort.  

Severe side effects include:  

• Persistent pain originating in the upper left or middle stomach area, potentially extending to the back, with or without nausea and vomiting 

• Swelling around the eyes, face, mouth, tongue, throat, legs, ankles, or feet 

• Trouble breathing or swallowing 

• Reduced frequency of urination 

• Changes in vision 

• Experiencing fainting spells or bouts of dizziness 

• Severe upper stomach pain 

• Yellowing of the skin or eyes 

• The onset of fever 

• Stools that are pale or clay-colored 

• An unusually rapid heartbeat 

• Onset or worsening of depression, including thoughts of self-harm. 

Seek medical attention and talk to your doctor right away if you experience any of these severe symptoms. 

Both Wegovy® and Saxenda® interact with other hormones, so tell your doctor about any other medications you're taking before starting either drug. Be especially cautious if you're on: 

• Insulin or other diabetes medicines 

• Thyroid hormone replacements 

• Oral contraceptives 

• Digoxin (for heart failure) 

In rare cases, both Wegovy® and Saxenda® can cause serotonin syndrome when combined with antidepressants, migraine drugs, or St. John's wort.11 Watch for symptoms such as confusion, hallucinations, rapid heartbeat, and loss of coordination. Seek medical help right away if any of these symptoms occur. 

You have other options beyond Saxenda® and Wegovy® for weight management. If you prefer a non-injectable medication, Contrave (phentermine/topiramate) may be a good option. Other medications such as Zepbound is a new GLP-1/GIP injection.  Ozempic® and Mounjaro® are diabetes medications that are used off label for weight loss. Insurance companies do not cover the cost of these medications when they are used off label, so this is a cash payment option only. 

Be sure to talk to your doctor before taking any new medication and remember that regardless of the medication and dose chosen, the most effective path to lasting weight loss involves combining it with healthy lifestyle changes. 

We can help you get your prescriptions regardless of your insurance situation. Schedule an online consultation with one of our board-certified doctors, who will ask you a few questions in order to assess your needs and prescribe the proper medication.