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Saxenda: still the newest recruit in the battle against obesity

Posted 1 March 2021 in Weight Loss

Feet on weighing scales. Source: medicalimages.com

Obesity is a growing problem in the UK. A quarter of UK adults are obese, and this proportion is rising further due to lockdown. Before the current pandemic, our increasingly sedentary lifestyles and readily available cheap, unhealthy food were resulting in us, as a nation, gaining weight. (1)

Now, due to us being in lockdown, we are working from home. This leaves us with ready access to the biscuit jar, unhealthy snacks, and limited opportunities for outdoor physical activity which has resulted in an exacerbated obesity problem.

It has been reported that there is an increased risk in persons with obesity developing the Covid-19 disease. The obese tend to require hospitalisation and are more likely to be admitted to the Intensive Care Unit (ICU), to have invasive mechanical ventilation, suffering an increase in mortality. (6)

You can read our previous blog for more information about how Covid-19 affects those with obesity.

Buy Saxenda from Webmed from only £75 FInd out more

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, 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 is why medical intervention may sometimes be needed. (1)

Until relatively 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 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 best tool to be used in the battle against obesity 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. However, we would recommend the stomach area as you're less likely to feel it and you have a bigger area to vary where you inject.

Saxenda - self-injectable pen can be used in the upper arm, abdomen or thigh

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 Saxenda?

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 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 minimised. These side-effects are very common, especially at the beginning of treatment, so lower doses at the start of treatment 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 continued. (2)

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 sugar). (4)

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?

Saxenda is not usually prescribed by your GP and is only offered on the NHS through specialist multidisciplinary weight management (tier 3) services. Access to these services in variable throughout the UK and most people have to resort to buying it privately. (5)

It is available to purchase from Webmed Pharmacy following a simple online assessment by our Doctors - click here to see your options to buy Saxenda and find out if it is suitable for you.

What is Ozempic?

There have been recent posts in the media about some people who have lost a lot of weight using an unlicenced product for weight loss called Ozempic. (7)

The most important difference between Ozempic and Saxenda, is that Saxenda is licenced for use as a weight loss medication in the UK and Ozempic is not. Also, there is very little data available for the use of Ozempic in weight management.

Furthermore, it's unethical to routinely offer Ozempic in a weight management service but some websites and clinics will supply it routinely as they are only interested in making money and not concerned about your safety. You can read more about it here.


References

1.       NHS. Obesity – Overview [cited 1st March 2021]. Available at: https://www.nhs.uk/conditions/obesity/

2.       NICE. Obese, overweight with risk factors: liraglutide (Saxenda) – Product overview [cited 1st March 2021]. Available at: https://www.nice.org.uk/guidance/ta664

3.   Novo Nordisk. Saxenda [cited March 2021] https://www.saxenda.com/learn-about-saxenda/what-results-have-been-seen-with-saxenda.html

4.   emc. Saxenda 6 mg/mL solution for injection in pre-filled pen [cited 1st March 2021]. Available at: https://www.medicines.org.uk/emc/product/2313/pil

5.       NICE. Obese, overweight with risk factors: liraglutide (Saxenda) – Estimated impact for the NHS [cited 1st March 2021]

Available at: https://www.nice.org.uk/guidance/ta664

6.   World Obesity Organisation. [cited March 2021] https://www.worldobesity.org/resources/policy-dossiers/obesity-covid-19

7.    BBC NEWS. [cited March 2021]   Obesity: Appetite drug could mark 'new era' in tackling condition. Available at   https://www.bbc.co.uk/news/health-56011979

Author
Margaret Hudson
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
Originally posted 27th December 2019, Saxenda: the newest recruit into the battle against obesity.

Updated: 1st March 2021

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