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
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.
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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
Saxenda is different
from weight management products that you may have taken in the past.
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
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.
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 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
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 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.
NHS. Obesity – Overview
[cited 1st March 2021]. Available at: https://www.nhs.uk/conditions/obesity/
NICE. Obese, overweight
with risk factors: liraglutide (Saxenda) – Product overview [cited 1st March 2021].
Available at: https://www.nice.org.uk/guidance/ta664
Novo Nordisk. Saxenda
[cited March 2021] 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 1st March 2021]. 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 1st
Available at: https://www.nice.org.uk/guidance/ta664
Organisation. [cited March 2021] https://www.worldobesity.org/resources/policy-dossiers/obesity-covid-19
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
pharmacist Margaret Hudson BSc(Hons) MRPharmS
Originally posted 27th December 2019, Saxenda: the newest recruit into the battle against obesity.
Updated: 1st March 2021