Wegovy vs. Saxenda: Comparing Two Weight-Loss Injections

The challenge of weight management has risen to the forefront of global concern. Amidst various strategies and solutions available, pharmaceutical aids play a pivotal role in helping individuals achieve their weight loss goals.

Two prominent drugs in this arena are Wegovy (semaglutide) and Saxenda (liraglutide), both injectable prescription medicines supporting chronic weight management in adults.

In this article, we dive into an in-depth comparison of Wegovy and Saxenda, exploring their similarities and differences across different dimensions: administration, efficacy, mechanisms of action, side effects, convenience, and cost.

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What is Wegovy?

The U.S. Food and Drug Administration granted approval to Wegovy (semaglutide) in 2021.

This injectable prescription medication is specifically designed for long-term weight management in adults who are either obese or overweight and have at least one weight-related health concern, such as hypertension, type 2 diabetes, or elevated cholesterol levels.

The active drug in Wegovy is semaglutide, a GLP-1 agonist. It operates by mimicking GLP-1, a natural hormone in the body that controls hunger and appetite while reducing blood sugar levels.

By lessening the sensation of hunger, enhancing the feeling of fullness (satiety), and slowing gastric emptying, Wegovy injections help decrease caloric intake and thus aid in weight loss. To achieve optimal weight management, semaglutide should be used with a low-calorie diet and increased physical activity.

Wegovy is self-administered once a week by subcutaneous injection (just below the skin surface) at home.

This medication comes in user-friendly, prefilled, single-dose injector pens that deliver different dosages of semaglutide: 0.25 mg (in the green pen), 0.5 mg (red pen), 1 mg (brown pen), 1.7 mg (blue pen), and 2.4 mg (black pen).

The dosage regimen typically starts with 0.25 mg once per week, with a gradual increase over a span of 16 to 20 weeks until the dose reaches 2.4 mg. However, the dosage might be tailored based on individual needs. As always, adhere to the prescribed dosage given by your healthcare provider.

Related article: Wegovy Vs. Ozempic: Comparing Two Semaglutide Injections.

What is Saxenda?

Saxenda is another FDA-approved prescription medication for weight loss. It has been on the market for longer than Wegovy. It is indicated for adults with obesity, defined as a Body Mass Index (BMI) of 30 or more, or in overweight adults (BMI of 27 or more) with at least one weight-related medical condition such as hypertension, type 2 diabetes, or high cholesterol.

The active ingredient in Saxenda is liraglutide, another peptide-1 (GLP-1) receptor agonist. Like semaglutide used in Wegovy, it mimics the action of GLP-1, a hormone that plays multiple roles in glucose metabolism and appetite regulation.

Saxenda is administered via subcutaneous injection once daily. It is recommended to be used with a reduced-calorie diet and increased physical activity for comprehensive weight management.

Saxenda is supplied in convenient and easy-to-use prefilled injection pens. Each pen contains 3mL of liraglutide. They’re available in packs of 1, 3, or 5. A Saxenda pen contains various doses of medicine to be selected with a precise built-in dosage knob. The patient adjusts the quantity of medicine for each injection according to their doctor’s prescription.

The exact dosage should be determined and supervised by a healthcare professional.

Related article: Mounjaro vs. Ozempic, Comparisons in Diabetes and Weight-Loss Therapies.

Other GLP-1 drugs

Glucagon-like peptide-1 (GLP-1) receptor agonist drugs like Wegovy and Saxenda are quite efficient at promoting weight loss and/or treating type 2 diabetes. Different ones have been formulated and are now available to patients, including:

Trulicity (dulaglutide): Dulaglutide is a once-weekly subcutaneous injection primarily used for managing blood sugar levels in adults with type 2 diabetes. However, it can also contribute to weight loss as a beneficial side effect.

Victoza (liraglutide): Approved for type 2 diabetes, Victoza, like Saxenda, is a daily subcutaneous injection of liraglutide. But while Victoza and Saxenda both contain liraglutide, they are approved for different uses and are not interchangeable.

Bydureon and Byetta (exenatide): These two exenatide drugs are used to improve blood sugar control in adults with type 2 diabetes. Bydureon is a once-weekly injection, while Byetta is taken twice daily. Both can lead to weight loss as a side effect.

Ozempic (semaglutide): Like Wegovy, Ozempic contains semaglutide as the active ingredient. It is a once-weekly subcutaneous injection used to manage type 2 diabetes and can also contribute to weight loss.

Adlyxin (lixisenatide): A once-daily injection, Adlyxin improves blood sugar control in type 2 diabetes. It can also contribute to weight loss.

Rybelsus (oral semaglutide): Rybelsus is the first oral GLP-1 receptor agonist approved for managing type 2 diabetes. It is taken once daily and can also lead to weight loss.

Mounjaro (tirzepatide): Mounjaro is the newest anti-diabetic injectable drug approved for type 2 diabetes. Considering its powerful weight-loss properties, it is currently under trial and soon-to-be approved for weight loss.

All these medications work by mimicking the effects of the natural hormone GLP-1, which is involved in appetite regulation and insulin secretion. As such, they can help reduce calorie intake, contribute to weight loss, and control blood sugar levels.

Some are FDA-approved for weight loss, while others are for diabetes. They work with different dosages and should only be used with a medical prescription and supervision.

Not everyone responds the same to medication. While one GLP-1 drug can work well for some patients, it may not work for you. Choosing one or the other depends on various factors and must be discussed with your healthcare provider.

Wegovy Vs. Saxenda: Similarities and Differences

Wegovy (semaglutide) and Saxenda (liraglutide) are two GLP-1 injectable drugs FDA-approved for long-term weight loss management. So, how do they differ? Is there one better than the other?

Semaglutide vs. Liraglutide

Semaglutide (Wegovy) and liraglutide (Saxenda), both glucagon-like peptide-1 (GLP-1) receptor agonist drugs, share a similar mechanism of action. However, slight differences in their molecular structure affect their mechanisms of action and potency.

All GLP-1 drugs, like semaglutide and liraglutide, work by mimicking the effects of the body's natural GLP-1 hormone. GLP-1 is an incretin hormone that stimulates insulin secretion from the pancreas, decreases glucagon production (a hormone that increases blood sugar), slows gastric emptying, and reduces food intake by increasing satiety (the feeling of fullness).

The molecular structure of semaglutide (Wegovy) enhances its half-life and allows it to be administered once weekly (instead of once daily, like liraglutide). Additionally, its fatty acid chain is also thought to increase its penetration through the blood-brain barrier, potentially enhancing its effect on appetite regulation in the brain.

So, while Wegovy and Saxenda work similarly, these slightly different structural modifications lead to differences in their dosing frequency and effects on appetite regulation.

Weekly injections vs. Daily injections

The frequency of administration makes a big difference between Wegovy and Saxenda. As mentioned above, while Wegovy is injected weekly, Saxenda is injected daily, which can have a significant impact on one’s quality of life.

Both are administered via subcutaneous injections (just under the skin surface) thanks to user-friendly injector pens.

Wegovy pens are single doses, meaning you're using a new one every week, and it contains your exact dose as prescribed by your doctor. There's no risk of confusion.

On the other hand, Saxenda pens are multi-dose. They usually contain a few weeks’ worth of medicine, but that depends on your prescribed dosage. Every day before the injection, you must select your dose with a built-in dosage knob. The pens are reusable until empty or expired. Only the needle is changed.

Both drugs must be kept refrigerated. Wegovy pens can stay 28 days out of the fridge (at room temperature) compared to 30 days for Saxenda.

Related article: Does Insulin Need to be Refrigerated?

Efficacy in weight loss

Generally, Wegovy shows greater results than Saxenda in reducing body weight.

First, here are the results of their respective clinical trial:

Saxenda: In the SCALE Obesity and Prediabetes trial, participants taking Saxenda lost an average of 4.5% of their body weight compared to placebo participants. The majority of those who took Saxenda, along with lifestyle modifications, lost at least 5% of their body weight.

Wegovy: In the STEP 1 clinical trial program, the average weight loss with Wegovy was approximately 9% of the participants' initial body weight, compared to 2.4% for the placebo.

These trials suggest that both medications are effective for weight loss, with Wegovy showing a higher average percentage of weight loss in its trials.

Besides, a new study recently published in 2022[1] directly compares weekly semaglutide injections (Wegovy) with daily liraglutide injections (Saxenda). According to this study, among 338 participants, “(...) body weight change from baseline to 68 weeks was – 15.8% with semaglutide vs. – 6.4% with liraglutide, a statistically significant difference.”

There’s clear evidence that Wegovy is more efficient than Saxenda for weight loss.However, it does not necessarily mean that you should choose Wegovy over Saxenda. Again, choosing between these two weight-loss medications isn’t only about statistics. Your health situation, goals, and other individual factors must be closely discussed with your healthcare provider to determine whether Wegovy, Saxenda, Mounjaro, or other weight-loss drugs are best for you.

Side effects

Wegovy and Saxenda can lead to similar side effects commonly associated with the GLP-1 class of drugs. These include feelings of nausea, indigestion, vomiting, diarrhea, and constipation. Both medications work by decelerating the digestive process, making gastrointestinal disturbances somewhat expected.

For individuals with type 2 diabetes, the risk of hypoglycemia, or low blood sugar, may increase. Rare but serious side effects have also been linked to both drugs, including a slightly elevated risk of pancreatitis (pancreas inflammation), thyroid tumors or cancer, and gallbladder disease, although these risks remain relatively small.

Nonetheless, some research implies that Wegovy may be associated with a lower incidence of side effects, particularly nausea, compared to Saxenda.

Price

According to Novo Nordisk, the manufacturer of both Saxenda and Wegovy, the two weight-loss injections have the same list price: $1,349. However, insurance coverage must be considered too, and different rates may be applied to these two drugs.

Switching from Saxenda to Wegovy

Considering the higher efficiency of Wegovy, as well as its more convenient weekly injection and its fewer side effects, many patients switch from Saxenda to Wegovy.

While the change is generally well tolerated, switching between GLP-1 weight management medications like Saxenda (liraglutide) and Wegovy (semaglutide) should always be done under the supervision of a healthcare provider.

Several factors need to be considered, including your current health status, how well you are tolerating the current medication, the effectiveness of the current medication, potential side effects, and your personal preferences. The healthcare provider may also consider whether a gradual tapering off of Saxenda before starting Wegovy is appropriate or whether it's safe to switch directly from one to the other.

Also, remember that while both medications can help with weight loss, they can only be effective when used with lifestyle changes like diet and physical activity.

Can you take Wegovy and Saxenda together?

Taking Wegovy (semaglutide) and Saxenda (liraglutide) together is not recommended unless specifically prescribed by your doctor. Both drugs work in very similar ways to help manage weight.

Taking two drugs from the same class could potentially increase the risk of side effects.

Always ask for your doctor’s advice. The goal of this article and its subsequent discussion is not to provide medical advice but to foster informed conversation about these important weight-loss medications.

Related article: Insulin Injection Sites, Where to Inject Insulin?

References:
[1] 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.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753508/