Saxenda vs. Ozempic for weight loss— what’s the difference?

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, both in the GLP-1 receptor agonist class of medications, why one may be chosen over another, and how much weight loss is typical in patients who take these medications.

Ozempic explained

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®, which is an FDA-approved weight loss medication.

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 levels, which is important for long-term metabolic health.

Saxenda explained

Like Ozempic, Saxenda is also a GLP-1 receptor agonist medication. Some differences between Saxenda vs Ozempic is that Saxenda 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 patients with 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.

Saxenda vs Ozempic: What are they 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. When choosing between different medication options, there are notable scenarios in which a healthcare provider may choose to prescribe Ozempic vs Saxenda or vice versa.

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. Both Saxenda and Ozempic share similar common side effects such as nausea, diarrhea, constipation, and stomach pain.
• A patient who has insurance coverage for Saxenda or Ozempic 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, the 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: In terms of how long to use Ozempic, many patients choose to stay at 1 mg dose long-term rather than increasing to 2 mg weekly, depending on their 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

What’s better for weight loss: Saxenda vs Ozempic

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 a healthy diet 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 hat 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 Ozempic vs Saxenda or any other 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 diseases. At Form Health, all patients undergo a comprehensive medical history 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, take our quiz to see if you are eligible to join Form Health.

Wegovy®, Saxenda® and Ozempic® are registered trademarks of Novo Nordisk A/S.