Wegovy vs Saxenda: Which is Better for Weight Loss?

Wegovy and Saxenda are two medications in the class of drugs called glucagon-like peptide-1s receptor agonists (GLP-1s). 

Also known as incretin mimetics, GLP-1s are medications that have been proven effective in the treatment of type 2 diabetes and weight loss. Examples of other GLP-1 medications include dulaglutide (Trulicity) and semaglutide (Ozempic).

Both Wegovy and Saxenda have been shown to be effective in support of weight loss when combined with behavioral modifications including diet and exercise. 

In this article, I’ll go over what Wegovy and Saxenda are, why they’re effective, and their dosages. I’ll also cover potential side effects and cost. 

What Is Wegovy?

Wegovy is a GLP-1 medication that delivers an active compound called semaglutide. Semaglutide was originally approved as a diabetes medication in 2017, sold under the brand name Ozempic. 

Though both Wegovy and Ozempic contain the same active compound, Wegovy contains a much higher dose of semaglutide. It received FDA approval as a weight loss medication in 2021, the first new weight loss medication to gain approval in several years.

What is Saxenda?

Saxenda is a GLP-1 medication that delivers an active compound called liraglutide.

Liraglutide was originally approved by the FDA as an adjunct therapy to diet and exercise for management of type 2 diabetes in 2010, sold under the brand name Victoza. 

But following clinical trial results, liraglutide sold under the name Saxenda gained approval in 2017 as a weight loss medication for people with a BMI of 30 or higher or people with a BMI of 27 and higher who also have a metabolic health condition. 

Importantly, Saxenda is not used to treat type 2 diabetes.

Wegovy vs. Saxenda

Wegovy and Saxenda are both FDA approved GLP-1 medications that have been shown to be effective at supporting weight loss in certain individuals when combined with other lifestyle modifications, chiefly diet and exercise. 

Though they’re both GLP-1s, they contain different active compounds: Wegovy delivers the active compound while Saxenda contains the active compound liraglutide. 

Both medications are also manufactured by the same Danish pharmaceutical company, Novo Nordisk.

Though the medications contain different active compounds, they work similarly to promote metabolic health and support weight loss. 

The majority of research investigating how GLP-1s work to support weight loss focus on liraglutide. 

Research suggests that these GLP-1 medications help to improve insulin production in the pancreas, slow down the rate of stomach emptying, and stabilize glucose and insulin levels after eating. 

These results suggest that GLP-1s ultimately help to lower insulin levels, reduce appetite, and decrease muscle insulin sensitivity—all of which helps to support weight loss.

Effectiveness

Both medications have been shown to be safe and effective treatments in support of weight loss. 

In fact, the class of GLP-1 medications has been researched for over 16 years and has repeatedly shown promising results in the reduction of body weight in obese patients with and without diabetes.

Wegovy

Results of a double-blind trial of almost 2,000 adults with a BMI of 30 or higher found that 50% of participants were able to lose at least 15% of their initial body weight when taking semaglutide alongside behavioral modifications.

Additional research suggests that Wegovy not only showed effectiveness in improving in diabetes and body weight but may also help to lower the rate of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke in patients with type 2 diabetes at high risk of cardiovascular disease. 

Some research, including the results of SUSTAIN (semaglutide unabated sustainability in treatment of type 2 diabetes) and STEP (semaglutide treatment effect in people with obesity) suggest that semaglutide (the active compound in Wegovy) may be more effective in support of weight loss than liraglutide (the active compound in Saxenda). 

But, as with any research, it’s important to remember that what works best for you may not be the same medication that works best for the majority of people under similar circumstances.

Saxenda

Results of five randomized, placebo-controlled trials found that, in addition to recommended diet and physical activity, Saxenda consistently resulted in helping patients to lose at least 5-10% of their body weight when compared with placebo. 

Research also suggests that Saxenda may offer long-term cardiovascular benefits, too, including improved glycemic control.

It’s important to keep in mind that neither of these medications offer a “quick-fix” for weight loss. 

To effectively and safely reap the benefits of either medication, you should work closely with your medical provider to ensure that you’re consistently incorporating lifestyle modifications while on one of these medications. 

Following your provider’s diet and exercise recommendations is key to ensuring long-term and sustainable weight loss success with these medications.

Dosage

Importantly, both Wegovy and Saxenda are generally delivered via injection. However, Wegovy is administered once weekly while Saxenda is administered once daily.

Wegovy

If you’re prescribed Wegovy, your provider will start you on a low dose and gradually increase the dose over 16-20 weeks until you reach a dosage of 2.4 mg delivered once weekly. 

Gradually increasing the dose of the medication may help to reduce the risk of gastrointestinal side effects. 

Saxenda

Similarly to Wegovy, if you’re prescribed Saxenda, your provider will start you on a low dose of 0.6 mg per day and gradually increase the dose weekly by 0.6mg for four weeks until you reach a dosage of 3.0 mg. 

Side Effects

Both Wegovy and Saxenda can cause side effects. The most common side effects are gastrointestinal. 

Wegovy

74% of those on Wegovy (semaglutide) reported at least one gastrointestinal side effect. The most common side effects of Wegovy include:

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Constipation
• Heartburn
• Burping

Serious side effects are less common, but possible. If you experience any of the following, seek emergency treatment:

• Ongoing pain that begins in the upper left or middle of the stomach but may spread to the back, with or without vomiting
• Rash; itching
• Swelling of the eyes, face, mouth, tongue, or throat
• Difficulty breathing or swallowing
• Decreased urination
• Swelling of legs, ankles, or feet
• Vision changes
• Fainting or dizziness
• Pain in upper stomach
• Yellowing of skin or eyes
• Fever
• Clay-colored stools 
• Rapid heartbeat

Saxenda

The most common side effects of Saxenda include:

• Headache
• Constipation
• Heartburn
• Runny nose, sneezing, cough
• Fatigue
• Difficulty urinating or pain while urinating
• Injection side rash or redness

Unfortunately, serious side effects are also possible with Saxenda. If you experience any of the following, seek emergency treatment:

• Ongoing pain that begins in the upper left or middle of the stomach but can spread to the back
• New or worsening depression
• Suicidal ideation (thinking about harming or killing yourself)
• Unusual changes in mood or behavior
• Vomiting
• Nausea
• Diarrhea
• Clay-colored stools
• Yellow eyes or skin
• Heart pounding
• Fainting or feeling dizzy
• Swelling of the eyes, face, mouth, tongue, or throat
• Rash
• Itching
• Difficulty breathing or swallowing

Cost

Wegovy

The cost of Wegovy can vary depending on several factors, including your insurance coverage and the rates at your local pharmacy.

Without insurance, Wegovy can cost over $1,500 per month. With coverage, you may pay as little as $25 per month. 

Saxenda

The cost of Saxenda is similar to the cost of Wegovy.

Without insurance, monthly rates can be $1,300 or more. But with insurance, the monthly cost of Saxenda can be as little as $25 per month. 

Which is Better?

Results of the Step 8 Randomized Clinical Trial found that semaglutide resulted in significantly greater weight loss at 68 weeks in obese and overweight adults with or without diabetes (importantly, the two medications were not compared in phase III trials). 

However, what works best for you will depend on several factors, including your medical history and current health.

If you’re interested in weight loss medication as an adjunct therapy for behavioral modifications, reach out to your medical provider to discuss which options may be best for you.

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