Obesity is a complex, chronic disease that affects more than 2 in 5 adults in the United States. Reaching a healthier weight can reduce the long-term risk of obesity-related complications including type 2 diabetes, high blood pressure, and cardiovascular disease. FDA-approved medications Ozempic® or Saxenda® may be prescribed to help a person achieve a healthier weight in conjunction with lifestyle changes. In this article, we will discuss the similarities and differences between Saxenda vs. Ozempic, why one may be chosen over another, and how much weight loss is typical in patients who take these medications.
Ozempic is a once-weekly injectable medication that is FDA-approved for the treatment of type 2 diabetes. Ozempic is also commonly used off-label for the treatment of obesity (note: off-label prescribing is legal and common. In fact, 1 in 5 prescriptions written in the U.S. are off-label). Ozempic is a type of medication called a GLP-1 agonist. It has the same active ingredient, semaglutide, as Wegovy(R), which has been FDA-approved for treating obesity.
GLP-1 agonist medications mimic gut hormones that our body naturally produces after meals. These hormones help with weight regulation by decreasing appetite and cravings in the brain and slowing stomach emptying to produce earlier and longer-lasting feelings of fullness. GLP-1 agonist medications also enhance appropriate insulin release and sensitivity. This results in improved blood sugar regulation which is important for long-term metabolic health.
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Saxenda, like Ozempic, is also a GLP-1 agonist medication. Saxenda, however, is injected daily rather than weekly, and is FDA-approved for the treatment of obesity. It also has a medication counterpart under a different name with the same active ingredient that is FDA-approved for treating type 2 diabetes.
As with Ozempic, Saxenda also mimics the naturally-produced GLP-1 gut hormones to decrease appetite and cravings, increase feelings of fullness and enhance insulin release and sensitivity in the body for improved metabolic health.
What are Ozempic and Saxenda Prescribed for?
Ozempic and Saxenda can both be prescribed for weight loss for people living with obesity, even though Ozempic is primarily prescribed for treatment of type 2 diabetes. You can learn more about choosing between different medication options here. There are notable scenarios in which a provider may choose to prescribe one of these medications over the other. Some example scenarios include:
- A patient with type 2 diabetes and high cardiovascular risk may be a better candidate for Ozempic, as Ozempic has been FDA-approved to reduce the risk of major adverse cardiovascular events (including heart attack, stroke and death) in people with type 2 diabetes and cardiovascular disease.
- A patient who prefers less frequent injections may choose Ozempic (or Wegovy®) over Saxenda due to the more convenient weekly, instead of daily, dosing schedule.
- While both Ozempic and Saxenda are generally well-tolerated, a patient who is concerned about potential for side effects and therefore prefers a shorter-acting medication may prefer to start with daily Saxenda rather than weekly Ozempic or Wegovy.
- A patient who has insurance coverage for either Ozempic or Saxenda but not the other may choose the insurance-covered option.
Ozempic vs Saxenda Dosing
Exact dosing for each individual patient will depend on how the medication is prescribed by a medical provider, side effects experienced, weight loss achieved, and blood glucose response to the medication. Below, we have listed common dosing schedules for these medications as a reference.
Common dosing schedule for Ozempic:
- Weeks 1-4: 0.25 mg weekly
- Weeks 5-10: 0.5 mg weekly
- Weeks 11-14: 1 mg weekly*
- Weeks 15 and on: 2 mg weekly
*Note: many patients choose to stay at 1 mg dose long-term rather than increasing to 2 mg weekly, depending on side effects and response.
Common dosing schedule for Saxenda:
- Week 1: 0.6 mg daily
- Week 2: 1.2 mg daily
- Week 3: 1.8 mg daily
- Week 4: 2.4 mg daily
- Week 5 and on: 3 mg daily
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What’s Better for Weight Loss: Ozempic or Saxenda?
In clinical trials, semaglutide (the active ingredient in both Ozempic and Wegovy) results in more weight loss, on average, than liraglutide (the active ingredient in Saxenda), when combined with healthy dietary and lifestyle changes. GLP-1 agonist medications have improved in efficacy over time as new versions of these medications have been developed. Liraglutide was first FDA-approved for the treatment of type 2 diabetes in 2010, under the brand name of Victoza. It was later FDA-approved for the treatment of obesity in 2014 under the name Saxenda.
By contrast, semaglutide was not FDA-approved for treating type 2 diabetes, under the brand name Ozempic, until 2017. Additionally, semaglutide was not FDA-approved for the treatment of obesity, under the name Wegovy, until 2021. The reason for the increased efficacy of semaglutide over liraglutide is not fully understood. It is likely related to improved GLP-1 receptor binding and longer duration of action of the medication.
How Much Weight Can You Lose with Saxenda vs. Ozempic?
- While there are no head-to-head trials comparing Ozempic to Saxenda directly, one trial that compared Wegovy (semaglutide) 2.4mg weekly to Saxenda (liraglutide) 3mg daily in people with overweight or obesity without diabetes showed a 15.8% average weight loss in the Wegovy (semaglutide) group and a 6.4% average weight loss in the Saxenda (liraglutide) group over 68 weeks when combined with healthy dietary and lifestyle changes.
- It is important to note that the dose of semaglutide used in this trial was 2.4 mg, while Ozempic only goes up to 2 mg weekly dose. It should also be noted that other studies have shown a higher average weight loss with Saxenda, around 9.2% over 56 weeks for patients with overweight or obesity without diabetes.
- For all GLP-1 agonist medications, data suggests that people with type 2 diabetes tend to lose less weight, on average, than people without type 2 diabetes. In one study of people with overweight or obesity and type 2 diabetes, Saxenda 3 mg daily produced a 6% average weight loss over 56 weeks. In another study of people with overweight or obesity and type 2 diabetes, Ozempic 2 mg weekly produced an average of 14.1 pound weight loss over 40 weeks (important note: this was a shorter study and percent weight loss was not reported, only pounds lost, as weight loss was not the focus of this study).
- While these results are important to consider when choosing a treatment plan, weight loss results for all medications vary widely between individuals and can be affected by many factors, including other medical diagnoses, other medications, genetics, environment, and lifestyle changes. It is important to work with a program that takes all of these factors into account when choosing a medication as part of a comprehensive weight loss plan.
Get Started with Saxenda or Ozempic
For patients struggling with their weight despite dietary and lifestyle changes, medications like Ozempic or Saxenda may be prescribed. These medications can help achieve a healthy body weight and reduce risk of other chronic weight-related health conditions. At FORM, all patients undergo a comprehensive medical evaluation, including laboratory studies, and participate in frequent visits with a medical provider and Registered Dietitian who provide personalized lifestyle counseling, accountability, and support for long-term behavior change. If you are interested in starting a medical weight loss program, schedule a call or send a message to FORM today for more information. You can also take our quiz to see if you are eligible to join FORM.
Wegovy®, Saxenda® and Ozempic® are registered trademarks of Novo Nordisk A/S.
About the Author:
Claire Pauley, PA-C is passionate about providing individualized, evidence-based care to patients struggling with their weight. Claire earned her Master of Medical Science degree from Midwestern University in 2017 and is a nationally board certified Physician Assistant. She holds a Certificate of Advanced Education in Obesity Medicine from the Obesity Medicine Association. Claire developed a specific interest in treating the root-cause of diseases early in her career and has specialized in chronic disease and weight management since 2018.