Obesity is a growing problem in the UK. A quarter of UK
adults are obese, and this proportion could rise further with our increasingly
sedentary lifestyles and readily available cheap, unhealthy food. With many of
us moving less due to sitting at desks at work, getting around by car and
spending more time on the sofa instead of up and about, we burn fewer calories.
Combined with a higher calorific intake thanks to the generally lower cost and greater
accessibility of unbalanced ready meals and fast food compared with fresh
produce, this equates to weight gain. (1)
Most of us know that on a basic level, the key to losing
weight is simply eating less and moving more, so that on a daily basis,
calories taken in amount to less than calories burnt. But in reality, many
factors can stand in the way of this change in lifestyle, including time constraints
and lack of motivation. In addition, several medical conditions such as type II
diabetes mellitus, pre-diabetes, polycystic ovarian syndrome (PCOS) and
hypothyroidism, as well as certain medications, can make weight loss harder to
achieve. That’s why medical intervention may sometimes be needed. (1)
Until recently, there was only one medication – orlistat – licensed to treat obesity in
this country. Orlistat stops around a third of the fat in your diet being
absorbed, helping to prevent weight gain. However, unpleasant side effects
directly related to this mode of action include oily, loose stools, flatulence,
urgency to pass stools more frequently than is normal for you, and an oily
rectal discharge. (1)
What is Saxenda and
how does it work?
The newest addition to the obesity treatment market is Saxenda,
a brand of the medication liraglutide.
Liraglutide was originally developed as an anti-diabetic drug and is licensed
for this purpose under the name Victoza, at a different strength to Saxenda.
Saxenda is available as a pre-filled pen for subcutaneous (under the skin)
injection containing 18mg of liraglutide in 3ml of solution. (2)
Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor
agonist, meaning it acts at the receptor for GLP-1, an appetite-regulating substance
naturally produced in the body. The way in which liraglutide interacts with the
receptor is currently unclear. (2)
Saxenda is different from weight management
products that you may have taken in the past. Saxenda makes you feel full
and less hungry, which can help you eat less and reduce your body weight.
It can help you to not only lose weight, but keep it off as well.
Use the Saxenda pen at home or on the go
You can inject your dose in your stomach area (abdomen), upper leg
(thigh), or upper arm.
Who can use Saxenda?
Saxenda is licensed to treat obesity in people with a body
mass index (BMI) of 30kg/m2 or higher, or those with a BMI of 27kg/m2
to 30kg/m2 who have one or more of a number of weight-linked health
conditions including type II diabetes mellitus, hyperlipidaemia (raised fat or
cholesterol levels in the blood), high blood pressure and obstructive sleep
apnoea. It should be used in combination with a reduced-calorie diet and
regular exercise. (2)
Children and young people under the age of 18 should not use
Saxenda, as it is not yet known how the drug affects this age group.
Furthermore, Saxenda should not be used by pregnant or breastfeeding women due
to unknown effects on the foetus or baby. (3)
What is the dose for
When starting Saxenda, the initial dose is 0.6mg daily,
injected into the abdomen, front of the thigh or upper arm, but not into a vein or muscle. The dose is
increased at least on a weekly basis by a further 0.6mg until the daily dose is
3mg, the maximum recommended daily dose. The reason for this gradual increase
in dose is that gastrointestinal side effects, such as nausea, vomiting,
diarrhoea and constipation are very common, especially at the beginning of
treatment, so lower doses to start improve tolerability and make it more likely
that the patient will continue treatment. If Saxenda is still intolerable two
weeks after stepping up to the next dose, treatment should be stopped. (2)
How long before
Saxenda starts to work?
Patients using Saxenda can expect to have lost at least 5%
of their starting weight once they have been on 3mg daily for twelve weeks,
given they have also been consuming fewer calories and increasing exercise. If
this hasn’t been achieved, treatment with Saxenda should no longer be
What results have been
seen with Saxenda?
Medical studies with more than 3,000 people taking
Saxenda were conducted to understand the benefits and risks of Saxenda. The
results from the study showed significant weight loss.
Along with a low-calorie meal plan and increased
physical activity, some people lost nearly 2.5 times more weight with
Saxenda versus placebo (17.3 lb vs 7 lb). Study participants had an
average starting weight of 234 lb and an average BMI of 38. (3)
In a different 1-year study, most people who stayed on
Saxenda kept the weight off. (3)
Can I use Saxenda
alongside other medication?
If you take a type of medication for diabetes known as a
sulfonylurea (such as gliclazide or glimepiride), the dose may need to be
adjusted while you use Saxenda to reduce the risk of hypoglycaemia (low blood
If you use Victoza for diabetes you should not use Saxenda
at the same time. This is because they both contain liraglutide, so using them
together will lead to overdose.
Patients taking warfarin or other anticoagulants may need to
have more frequent tests to monitor how long it takes their blood to clot. (4)
Where can I find
Saxenda is usually only prescribed privately as the
manufacturer does not intend for it to be promoted within the NHS. It will be
available to purchase from Webmed Pharmacy in the near future, so watch this
- NHS. Obesity – Overview [cited 24 March 2019].
Available at: https://www.nhs.uk/conditions/obesity/
- NICE. Obese, overweight with risk factors: liraglutide (Saxenda) – Product overview [cited 24 March 2019].
Available at: https://www.nice.org.uk/advice/es14/chapter/Product-overview
- Novo Nordisk. Saxenda [cited March 2019] https://www.saxenda.com/learn-about-saxenda/what-results-have-been-seen-with-saxenda.html
- emc. Saxenda 6 mg/mL solution for injection in
pre-filled pen [cited 24 March 2019]. Available at: https://www.medicines.org.uk/emc/product/2313/pil
- NICE. Obese, overweight with risk factors: liraglutide (Saxenda) – Estimated impact for the NHS [cited 24 March
2019]. Available at: https://www.nice.org.uk/advice/es14/chapter/Estimated-impact-for-the-NHS
Gabby Gallaher MPharm
Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
4 April 2019