Saxenda not working (anymore): what now?

Is it not working, or has it stopped working?

"Saxenda is not working" and "Saxenda has stopped working" are two different situations with different causes. If you have had hardly any reduction in hunger from the start and have not lost weight, you may not respond to liraglutide. If you did lose weight at first and your weight has now stalled, you are probably on a plateau.

The first situation does occur. In the EMA assessment of Saxenda, participants on the maximum dose lost an average of 7.5 percent of their weight compared with 2.3 percent on placebo, but some participants barely responded. That is why the product information contains a fixed rule: if you have lost less than 5 percent after 12 weeks on 3.0 mg, you stop. Results vary from person to person.

A plateau is something else: your body adapts to the lower weight, your metabolism drops with it and the feeling of fullness is less strong than at the start. That is a normal part of every programme and usually not a sign that the medicine has worn off.

How long does it take for Saxenda to work?

You usually notice less hunger in the first week; weight loss follows in the weeks after that, while the dose builds up. Building up to 3.0 mg takes at least 4 weeks, and only after that does the period begin in which the product information of the European Medicines Agency (EMA) has the effect assessed: 12 weeks on the full dose.

So do not judge too early. If you "notice nothing" after 6 weeks, you have often only been on the full dose for one or two weeks. What you can realistically expect in that period is covered in the article on how fast Saxenda works, and what the medicine does is on the overview page about Saxenda.

Five reasons why you are not losing weight on Saxenda

The five most common causes are: a dose that is too low or irregular, an eating pattern that has not been adjusted, adaptation and a plateau, medication that causes weight gain, and an underlying medical cause.

The last two always call for a doctor. An underactive thyroid, PCOS, sleep apnoea or chronic stress with high cortisol can slow weight loss, however well the medicine works. Which conditions stand in the way of weight loss is covered in the article on medical conditions that prevent weight loss.

What do you do if your weight stays stuck?

When your weight stalls, start by measuring instead of guessing: keep a food diary for two weeks, weigh yourself at fixed times and note your doses. You will often see for yourself where the problem lies: a regular snack, liquid calories, bigger portions at the weekend.

Then change one thing at a time. Put protein and vegetables at the centre of every meal, cut the calories you drink and add strength training twice a week. Muscle mass keeps your metabolism up, which helps break a plateau. Concrete meal examples are in the article on the Saxenda diet.

If nothing has changed after 4 to 6 weeks, it is time for the doctor. With a medical weight loss programme with injections, the doctor then looks at your dose, medication list and blood values, and discusses whether another medicine would suit you better.

Stopped losing weight and want a doctor to help find the cause? The doctor assesses whether medical weight loss is right for you and which approach fits best. Read more about medical weight loss with injections →

When do you discuss switching to another medicine with your doctor?

You discuss switching to another medicine if you have lost less than 5 percent after 12 weeks on 3.0 mg, if you cannot tolerate the full dose, or if your weight has stalled for months after a good start despite adjustments. According to apotheek.nl, the patient information website of the Dutch pharmacists' organisation KNMP, there is no point in continuing if you have not lost 5 percent within 3 months.

The alternatives are other GLP-1 medicines: semaglutide (Ozempic, Wegovy) as a weekly injection, or tirzepatide (Mounjaro), which acts on two hormone receptors and gave more weight loss on average in studies. Which medicine suits you depends on your health, your response to liraglutide and the side effects you had. The comparisons are in the articles on Saxenda vs Ozempic and Mounjaro vs Saxenda.

Switching is not a failure. People respond differently to the different medicines, and the doctor chooses the medicine that suits your body.

Stopping Saxenda: when is that the better choice?

Stopping is the better choice if the medicine demonstrably does nothing after 12 weeks on the full dose, if the side effects do not outweigh the effect, or if you have reached your goal and your weight is stable. In the first two cases you discuss an alternative straight away; in the last case you taper off with a plan.

Do not stop out of frustration during a plateau. That is exactly when the medicine helps you hold on to the weight you have reached while you adjust your eating pattern. How to stop responsibly and what then happens to your weight is covered in the article on stopping Saxenda.

Tried everything and wondering whether a medical programme is right for you? A few questions show you where you stand, and the doctor then assesses your situation. Take the eligibility check →

Frequently asked questions about Saxenda not working

Why am I not losing weight on Saxenda?

Usually because of a dose that is too low or irregular, an eating pattern that has not been adjusted, a plateau, medication that causes weight gain or an underlying cause such as an underactive thyroid. First check your dose, daily routine and eating pattern, and discuss the rest with your doctor.

What does Saxenda do in the long term?

As long as you use it, liraglutide keeps your appetite lower and helps you maintain your weight; in studies the medicine has been followed for up to three years. If you stop, your appetite returns. The long-term effect therefore depends mainly on the habits you build while using it.

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

That varies from person to person. The product information uses 5 percent of your starting weight after 12 weeks on 3.0 mg as the minimum for continuing; in studies, about two thirds of participants achieved that. It is no more than a minimum: some people lose more, others less.

What if you stop losing weight on Saxenda after a good start?

Then you are probably on a plateau. Keep a food diary for two weeks, put protein and vegetables at the centre, add strength training and give it 4 to 6 weeks. If nothing changes, discuss with your doctor whether your dose, your medication or another medicine needs attention.

Does the same apply if Ozempic is not working?

Largely, yes: the same causes and the same checklist, with the difference that Ozempic is injected weekly and the dosing schedule takes longer. The step-by-step plan for that is in the article on Ozempic not working.

Why can't I lose weight without medication either?

For many people, losing weight is difficult because of a combination of biology, habits and circumstances, not a lack of willpower. The eight most common causes are in the article on why you can't lose weight.

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