Saxenda (liraglutide) in the treatment of obesity

More information about liraglutide in Saxenda

Liraglutide is a GLP-1 receptor agonist, a synthetic analogue of the endogenous hormone glucagon-like peptide-1 (GLP-1). The hormone is released postprandially from the intestine and acts centrally by modulating appetite-regulating signals in the hypothalamus, leading to increased satiety and reduced hunger.

Treatment with Saxenda usually reduces energy intake by enhancing satiety and decreasing hunger. As a result, people treated with Saxenda tend to eat less, which over time can contribute to clinically relevant weight loss. It is important to emphasise, however, that Saxenda is not a quick or stand-alone solution for overweight or obesity. The medicine should be viewed as part of a comprehensive treatment plan in which dietary changes, regular physical activity and support for lifestyle modification are central components for long-term success and weight stability (2–4).

Who can be treated with Saxenda?

Saxenda is indicated for individuals with obesity (BMI ≥ 30 kg/m²) and for those with overweight (BMI ≥ 27 kg/m²) combined with at least one weight-related comorbidity, such as dysglycaemia (prediabetes or type 2 diabetes), hypertension, dyslipidaemia or obstructive sleep apnoea (1).

Before treatment is initiated, a physician must perform an individual medical assessment to determine whether the medicine is appropriate and to provide the patient with relevant information about the treatment plan and follow-up. Because treatment response varies between individuals, some patients may require closer clinical monitoring to optimise effectiveness and safety. The patient should also inform their doctor about any other medical conditions or medicines they are taking.

How Saxenda is used

Saxenda is administered as a subcutaneous injection once daily. The treatment begins with a low starting dose that can be gradually increased depending on the patient’s tolerance and clinical response. Stepwise dose escalation allows the body to adjust to the treatment and reduces the risk of side effects. The patient should always follow the doctor’s instructions.

The injection can be given at any time of day, with or without food, but administering it at the same time each day is recommended to ensure a consistent therapeutic effect. Saxenda is injected subcutaneously into the abdomen, thigh or upper arm, and the injection site should be changed daily to avoid local irritation (1).

Common side effects and risks

During the first weeks of treatment, patients may experience side effects such as nausea, diarrhoea, constipation or headache. These usually lessen over time as the body adapts to the medicine.

There is also a risk of more serious side effects, such as inflammation of the pancreas (pancreatitis) or gallstones. A doctor should be contacted if the patient develops severe abdominal pain or any other unusual symptoms (1).

Lifestyle changes with Saxenda

For Saxenda to provide the best possible results in terms of weight loss, a comprehensive strategy is required. This means the medicine should be combined with healthy lifestyle changes such as improved eating habits, regular physical activity, stress management and good sleep, ideally with support from healthcare professionals (5).

Diet for a healthy weight

To achieve weight loss, a calorie deficit is required — meaning energy intake must be lower than energy expenditure. Medication can facilitate this by increasing satiety and reducing hunger, which often arises during calorie restriction.

With reduced energy intake, it is particularly important that the diet remains nutrient-dense to meet the body’s needs for vitamins, minerals and protein. Adequate protein supports improved satiety, preservation of muscle mass during weight loss and better body composition — especially when combined with strength training (5).

Treatment should always be individualised. Adjustments should be based on the patient’s current eating habits, preferences and circumstances.

The importance of physical activity and training

Physical activity is a key component of comprehensive weight-loss treatment. It can enhance the effect of medication, improve overall wellbeing, and help prevent or reduce side effects. It supports the preservation of muscle mass, improves metabolic health and boosts mental wellbeing. Regular movement can also reduce stress, improve sleep and lower the risk of related conditions (5).

Recommended types of activity include:

• Everyday movement: taking the stairs, walking, cycling or standing more often
• Cardiovascular activity: such as brisk walking, swimming or cycling
• Strength training: 2–3 times per week, particularly important for preserving muscle mass and promoting healthy body composition (6)

Recommendations should always be tailored to the individual’s abilities, limitations, health status and goals.

The importance of sleep

Adequate sleep is essential for healthy weight regulation. Poor sleep affects several hormonal systems that control appetite, satiety and energy balance. When sleep quality is low, this can lead to increased hunger and cravings for energy-dense foods, making it more difficult to maintain a healthy weight (7).

Stress management

Chronic stress can lead to elevated cortisol levels, which influence appetite regulation and metabolism (8). What is perceived as stressful is highly individual and shaped by personality, life circumstances and past experiences. Support and treatment must therefore be tailored to each person’s needs.

For some, this may involve reducing external stressors; for others, strengthening recovery and developing strategies for coping with strain is more relevant. Regular physical activity, adequate sleep and stress-reducing techniques can all be valuable tools (8).

Summary – Saxenda

Saxenda (liraglutide) is a treatment option for overweight and obesity that works by modulating appetite and satiety via GLP-1 receptors. The treatment can lead to clinically relevant weight reduction when combined with dietary changes, physical activity and long-term support for lifestyle modification.

For best results, the treatment should be individualised based on the patient’s circumstances, preferences and medical history. Regular follow-up is recommended to ensure effectiveness, adherence and tolerance.

Long-term weight management requires a comprehensive approach in which medication provides support rather than an isolated solution. Combined with sustainable habits, Saxenda can contribute to improved metabolic health, reduced risk of associated diseases and enhanced quality of life.

References

1. European Medicines Agency (EMA). Saxenda – EPAR – summary for the public. Published 2015, last updated 2023.
   https://www.ema.europa.eu/en/medicines/human/EPAR/saxenda
2. Mehta, A., Marso, S.P. & Neeland, I.J. (2017). Liraglutide for weight management: a critical review of the evidence. Obesity Science & Practice.
   https://onlinelibrary.wiley.com/doi/pdf/10.1002/osp4.84
3. Al-Khalifah, R.A., Al-Mutairi, M., Al-Saif, M. et al. (2024). Efficacy of liraglutide for weight loss in overweight and obese non-diabetic adults: a systematic review and meta-analysis of randomized controlled trials. Cureus.
   https://www.cureus.com/articles/350251-efficacy-of-liraglutide-for-weight-loss-in-overweight-and-obese-non-diabetic-adults-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
4. Wong, H.J., Sim, B., Teo, Y.H., Teo, Y.N., Chan, M.Y., Yeo, L.L.L., Eng, P.C., Tan, B.Y.Q., Sattar, N., Dalakoti, M. & Sia, C.H. (2025). Efficacy of GLP-1 receptor agonists on weight loss, BMI, and waist circumference for patients with obesity or overweight: a systematic review, meta-analysis, and meta-regression of 47 randomized controlled trials. Diabetes Care, 48 (2), 292–300.
   https://doi.org/10.2337/dc24-1678
5. Koskinas, K.C., Van Craenenbroeck, E.M., Antoniades, C., Blüher, M., Gorter, T.M., Hanssen, H., Marx, N., McDonagh, T.A., Mingrone, G., Rosengren, A., Prescott, E.B., & the ESC Scientific Document Group. (2024). Obesity and cardiovascular disease: an ESC clinical consensus statement. European Heart Journal, 45 (38), 4063–4098.
   https://doi.org/10.1093/eurheartj/ehae508
6. World Health Organization (WHO). (2020). WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization.
   https://www.who.int/publications/i/item/9789240015128
7. Chaput JP, McHill AW, Cox RC, Broussard JL, Dutil C, da Costa BGG, Sampasa-Kanyinga H, Wright KP Jr. The role of insufficient sleep and circadian misalignment in obesity. Nat Rev Endocrinol. 2023 Feb;19(2):82-97. doi: 10.1038/s41574-022-00747-7. Epub 2022 Oct 24. PMID: 36280789; PMCID: PMC9590398.
8. Lengton, R., Schoenmakers, M., Penninx, B.W.J.H., Boon, M.R. & van Rossum, E.F.C. (2024). Glucocorticoids and HPA axis regulation in the stress-obesity connection: a comprehensive overview of biological, physiological and behavioural dimensions. Frontiers in Endocrinology.
   https://pubmed.ncbi.nlm.nih.gov/39623561/

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