How fast does Saxenda work and how much weight will you lose?

When do you notice the first effect of Saxenda?

The first effect of Saxenda is less hunger and feeling full sooner, and most users notice this within 1 to 2 weeks. Saxenda contains liraglutide, a GLP-1 agonist that activates the satiety centre in the brain and slows gastric emptying. As a result, you eat smaller portions without it feeling like a struggle.

On the scales you often see little in those first weeks. That is because the starting doses are low and intended to let your body get used to the medicine. If you use your weight in weeks 1 and 2 as the yardstick, you will be disappointed for no reason. How others experience those first weeks is covered in our article on Saxenda reviews.

The dosing schedule: why the first weeks go more slowly

You start with 0.6 mg per day and increase by 0.6 mg each week up to 3.0 mg. That schedule exists because liraglutide can cause nausea, vomiting, diarrhoea and constipation at the start. By building up slowly, your digestive system gets used to it and the side effects usually stay mild.

The lower doses curb the appetite less strongly than the maintenance dose. That is why weight loss is slower during the build-up phase than afterwards. If you do not tolerate a step well, the doctor can keep you on the same dose for an extra week. How to set the pen and the schedule in practice are in our article on Saxenda dosage; an overview of the symptoms is in our article on Saxenda side effects.

How much weight do you lose with Saxenda? What research shows

How much weight you lose with Saxenda varies from person to person. The research gives a range, not a promise. According to the summary of the European Medicines Agency (EMA), adults in five studies with over 5,800 participants lost an average of 7.5 percent of their body weight on the highest dose, compared with 2.3 percent on placebo.

The largest of those studies is the SCALE study (NEJM, 2015): 3,731 adults with overweight or obesity, without diabetes, received 3.0 mg of liraglutide or placebo for 56 weeks, alongside diet and exercise advice. The liraglutide group lost an average of 8.0 percent, the placebo group 2.6 percent.

For someone weighing 100 kilos, 8 percent means about 8 kilos in just over a year. That is an average: some participants lost clearly more, some less. Your starting weight, your diet, your exercise, your sleep and your medication determine where you end up in that range.

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How much can you lose in 3 months and when is the review point?

After 12 weeks on the maintenance dose of 3.0 mg, the doctor assesses whether Saxenda is working well enough. According to the liraglutide monograph in the Farmacotherapeutisch Kompas (the Dutch national medicines reference), treatment is stopped if, after 12 weeks on 3.0 mg, your weight is not at least 5 percent lower than at the start. For someone weighing 100 kilos, that is 5 kilos.

That rule is not a punishment but a medical benchmark: people who lose less than 5 percent after 3 months on the full dose usually get little benefit from the medicine in the longer term too. It is then better to look at a different approach together with the doctor than to continue with daily injections. How to stop responsibly is covered in our article on stopping Saxenda.

The same benchmark applies to reimbursement. In 2022, Zorginstituut Nederland (the Dutch National Health Care Institute) included Saxenda in the basic package (basispakket) for a small group, on condition that treatment stops if the weight loss after 3 months stays below 5 percent. The conditions per health insurer, CZ and others, are in our article on whether Saxenda is covered by insurance.

Why am I not losing weight on Saxenda?

If you are not losing weight on Saxenda, there are usually four explanations: you are still in the build-up phase, you still eat too much despite less hunger, your body has reached a plateau, or the medicine does not work well enough for you.

• Build-up phase: in the first 4 weeks the dose is low and the effect limited. Only judge the result after weeks on 3.0 mg.
• Eating out of habit: Saxenda reduces hunger, but not eating out of habit, boredom or emotion. Liquid calories, alcohol and snacks still "count".
• Plateau: after months of weight loss, your body adapts and the decline levels off. That is a known pattern and not a sign that the medicine has worn off.
• Insufficient effect: some users respond little to liraglutide. The doctor assesses this after 12 weeks on the full dose.

What you can do in each of these situations is covered in our article on Saxenda not working. Always discuss a lack of results with your doctor; never increase the dose yourself.

What determines your result: diet, exercise and support

Saxenda only works well in combination with fewer calories and more exercise. The medicine makes that change achievable by taking away the hunger; you still have to make the change yourself.

• Diet: choose protein-rich meals, vegetables and fibre, and limit fatty and sugary food, also because that reduces nausea. A practical example is in our article on the Saxenda diet.
• Exercise: strength training and daily activity help you maintain muscle mass while you lose weight. This keeps your metabolism up. Start gently, certainly during the build-up phase, and build up to at least two strength training sessions a week plus daily walking or cycling.
• Sleep and stress: too little sleep and long-term stress increase appetite and slow weight loss, even with medication. Regular bedtimes and moments of rest are therefore part of the plan.
• Support: a doctor who adjusts your dose, deals with side effects and keeps an eye on the review point prevents you from stopping too early or continuing too long without results. How that works with us is on the page about medical weight loss with injections.

At Qlinic, a programme with liraglutide (Saxenda) costs €850 per month, plus a one-off €400 support fee, including the prescription, home delivery through a registered Dutch pharmacy and a follow-up with your own doctor every 4 weeks. Read more about how to buy Saxenda.

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Frequently asked questions about how Saxenda works

How quickly do you notice anything from Saxenda?

Most users notice less hunger and feel full sooner within 1 to 2 weeks. Clear weight loss usually follows from week 5, once the maintenance dose of 3.0 mg has been reached.

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

That varies from person to person. The medical benchmark is at least 5 percent of your starting weight after 12 weeks on 3.0 mg; if that has not been achieved, treatment stops according to the guideline. In studies, participants lost an average of 7.5 to 8 percent after just over a year.

What is the dosing schedule for Saxenda?

Week 1: 0.6 mg per day; week 2: 1.2 mg; week 3: 1.8 mg; week 4: 2.4 mg; from week 5: 3.0 mg. If you do not tolerate a step, the doctor can keep you on the same dose for an extra week.

Why am I not losing weight on Saxenda?

Usually because you are still in the build-up phase, still eat too much out of habit, have reached a plateau or respond little to the medicine. Discuss it with your doctor and never increase the dose yourself.

What should you eat when using Saxenda?

Protein-rich meals, plenty of vegetables and fibre, small portions and little fat and sugar. That supports weight loss and reduces nausea. Drink enough water.

How long does it take to lose 10 kilos with Saxenda?

That cannot be predicted: in studies, participants lost an average of 8 percent in 56 weeks, but the spread is large. What is realistic for a goal of 10 kilos is covered in our article on how to lose 10 kg.

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