Saxenda vs Ozempic: how to choose the medicine that suits you

Comparison table: Saxenda vs Ozempic

The main differences are set out side by side below:

*From the head-to-head comparison study STEP 8; the semaglutide dose studied (2.4 mg) is the dose of Wegovy, the weight loss version of semaglutide. A one-off supervision fee of €400 applies to both programmes.

How GLP-1 medicines work

Liraglutide and semaglutide both mimic the body's own hormone GLP-1. That hormone is released when you eat and signals to your brain that you are full. The medication strengthens that signal: you are less hungry, feel full sooner and therefore automatically eat less. More about how fast Ozempic works.

That is exactly why these medicines are such a good fit for people whose attempts to lose weight keep failing because of hunger and cravings. The programme mainly takes away the feeling of hunger, so you can keep up what did not work before. In our clients, we usually see the first effect after about 4 weeks.

It is important to be clear: GLP-1 medication is not a miracle cure. It works as support alongside a healthy diet and exercise, not instead of them. Without changing your lifestyle, the weight often comes back after stopping.

What is each medicine approved for?

Saxenda has been registered in the EU since 2015 for weight management in adults with obesity, according to the Geneesmiddeleninformatiebank of the CBG (the medicines database of the Dutch Medicines Evaluation Board). This makes it formally a weight loss medicine, intended as an addition to diet and exercise.

Ozempic is a different story. According to the Diabetes Fonds (the Dutch Diabetes Research Foundation), Ozempic is only registered for the treatment of type 2 diabetes. The fact that a doctor may still prescribe it for overweight is called off-label use: prescribing outside the official registration. This is only allowed under medical supervision, precisely because the doctor then has to weigh up particularly carefully whether the medicine suits you.

Good to know: there is also a version of semaglutide that is registered for weight loss, namely Wegovy. The active substance is the same as in Ozempic; the registered use and the dose differ.

Side effects: which medicine causes more complaints?

Saxenda and Ozempic largely cause the same side effects, mainly stomach and bowel complaints such as nausea, diarrhoea, constipation and abdominal pain. In the head-to-head comparison study STEP 8, 82.7% of liraglutide users and 84.1% of semaglutide users reported such complaints. So Saxenda is not clearly "worse" or "milder" than Ozempic.

Most complaints occur in the first weeks and when the dose is increased, and ease off afterwards. Serious side effects, such as gallstones or an inflamed pancreas, are rare but exist with both medicines. You can read a full overview in our article on GLP-1 side effects.

This is exactly why supervision is not a luxury. At Qlinic, you have your own BIG-registered doctor (the BIG register is the Dutch register of healthcare professionals) who personally reviews your progress with you every 4 weeks, including if something is bothering you. A complaint can often be resolved with an adjusted build-up schedule.

How much weight do you lose with them?

In studies, the average user loses more weight with semaglutide than with liraglutide. In the STEP 8 trial, published in the journal JAMA, participants on weekly semaglutide 2.4 mg lost an average of 15.8% of their body weight after 68 weeks, compared with 6.4% on daily liraglutide 3.0 mg. Both groups also received support with diet and exercise.

These percentages are averages, not guarantees. How much you lose depends on your starting situation, your lifestyle and how your body responds to the medicine. The figures do show why many doctors are more likely to think of semaglutide or newer medicines for a new start, and mainly use Saxenda when there is a medical reason for it.

Do you find that losing weight never quite works, whatever you try? Our doctor personally assesses whether medical weight loss suits your situation. Take the eligibility check →

Switching from Saxenda to Ozempic?

Switching from Saxenda to Ozempic (or the other way round) is possible, but only through a doctor. Because they are different active substances, you stop one medicine and build up the other gradually again from the starting dose. This keeps the chance of side effects as small as possible.

Reasons to switch include disappointing results, persistent side effects, availability of the medication or growing tired of injecting every day. Never adjust your medication yourself: the doctor decides the timing and the schedule. At Qlinic, you simply discuss such a switch in your four-weekly follow-up.

Costs and insurance cover in 2026

Saxenda is considerably more expensive per month than Ozempic, mainly because you inject liraglutide every day and therefore use many more pens. At Qlinic, the programme with liraglutide (Saxenda) costs €850 per month and the programme with semaglutide (Ozempic) €250 per month, or €699 per 3 months. A one-off supervision fee of €400 applies to every programme. You can read a detailed breakdown of the Saxenda cost in our separate article, and all programme prices are listed under the cost of medical weight loss.

Reimbursement is limited. Saxenda is only covered by basic health insurance (basisverzekering) for a small group of people with severe overweight, under strict conditions. Ozempic is only covered for type 2 diabetes, not if you use it to lose weight. So most people pay for medical weight loss themselves.

Which choice suits you?

You do not make the choice between Saxenda and Ozempic alone, but together with a doctor. As a rule of thumb: in studies, semaglutide gives more weight loss on average, requires only one injection per week and is cheaper per month. Saxenda may be the right choice if semaglutide is not medically suitable for you, or if your body responds better to liraglutide.

At Qlinic we support adults, including many women going through menopause, who have already tried everything. You get your own BIG-registered doctor who knows your situation, follow-up every 4 weeks and home delivery. We look at which programme suits each person: medical weight loss with injections, medical weight loss with injections or another GLP-1 programme.

Whichever medicine it turns out to be: it starts with the question of whether medical weight loss is right for you. That is assessed by our doctor, not by a form or a salesperson.

Would you like to know whether Saxenda, Ozempic or another programme suits you? After the eligibility check you know where you stand, and our doctor personally advises you. Take the eligibility check →

Frequently asked questions about Saxenda vs Ozempic

Does Saxenda have worse side effects than Ozempic?

No, the side effects of Saxenda and Ozempic are comparable. Both mainly cause stomach and bowel complaints such as nausea and diarrhoea; in the STEP 8 trial, 82.7% of liraglutide users and 84.1% of semaglutide users reported such complaints, usually mild and temporary. How you personally respond differs per medicine and per body.

How much weight can you lose in 3 months on Saxenda?

With a good response to Saxenda, about 5% weight loss in the first 3 months is achievable. The official patient information leaflet also uses that as a benchmark: if you lose less than 5% after 12 weeks on the full dose, the advice is to discuss with the doctor whether continuing makes sense. Over a whole year, users in studies lost an average of around 6 to 8% of their body weight.

Can I switch from Saxenda to Ozempic?

Yes, switching from Saxenda to Ozempic is possible, but only under the supervision of a doctor. You stop liraglutide and build up semaglutide gradually from the starting dose. The doctor determines the schedule and keeps an eye on how you respond to the new medicine.

What are the downsides of Saxenda?

The main downsides of Saxenda are injecting every day, the higher monthly costs and the smaller average weight loss compared with newer medicines such as semaglutide. Many users also get stomach and bowel complaints at the start. For some people, Saxenda is medically the best choice after all; that is for the doctor to assess.

Can you buy Saxenda or Ozempic without a prescription?

No, Saxenda and Ozempic are prescription medicines: a doctor must first assess whether the medicine is safe and suitable for you. Never buy these medicines from web shops or social media without a prescription. You then have no guarantee whatsoever about what you are actually getting, and you miss out on the medical supervision that belongs with this medication. The safe route is always through a doctor and a registered pharmacy.