5 Ways Saxenda Helps with Weight Loss & How to use it Safely

Saxenda might be one of the best weight loss medications that exist on the market right now. 

But just because it might work doesn't mean it's necessarily right for your body.

Saxenda works because it alters many hormone systems in your body that tend to interfere with your appetite, metabolism and even other hormones

In this post, I will walk you through how Saxenda helps with weight loss and who should consider using this new medication.

Let's jump in: ​

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What is Saxenda & Does it Work?

First, let's start off by establishing that Saxenda does indeed work for weight loss.

The studies are clear on this matter (1):

Many studies have shown that patients using Saxenda lose significant amounts of weight over several weeks (usually around 10% body fat). ​

Saxenda weight loss vs placebo

That means that using this medication might help you lose up to 20 pounds if you weighed 200 pounds. 

At first, that doesn't sound very good, but it's actually quite impressive if you consider that this weight loss is achieved generally without any other therapies added.

And that's where things get interesting.

If you have an understanding of weight loss and how hormones influence your weight, you can benefit even more from using this medication.

Why?

Because it can safely be combined with other therapies that ALSO increase your weight loss efforts and together this can result in dramatic weight loss. ​

We will talk about those therapies in just a minute but for now, let's discuss why Saxenda actually works... 

5 Ways Saxenda Helps Boost Weight Loss

​Saxenda is a medication that falls into the GLP-1 agonist class of drugs. 

GLP-1 stands for Glucagon-like peptide 1 and that's where Saxenda has its primary action.

Saxenda (or Liraglutide which is another name for this medication) sits on this receptor and causes changes to very important hormones involved in regulating body weight: insulin, leptin, and glucagon.

Liraglutide was originally developed to treat type II diabetes because it can help reduce insulin resistance but was soon found to have a dramatic effect on weight. 

Because of this, the makers of Liraglutide (or Victoza as it is called if used to treat type II diabetes) came out with a new name (saxenda) which is now FDA approved for weight loss.

If you've been following my blog you know that I am a big fan of GLP-1 agonists and that I use them effectively for weight loss (to help patients lose 50+ pounds).

You can read about the case studies here and here - which include before and after pictures.

So, naturally, I am a big fan of the GLP-1 agonists, but in order to get the kind of results you see in those case studies, it has to be used CORRECTLY and combined with other therapies. 

Simply taking Saxenda will help you lose some weight by itself, but it won't get you back to your ideal or normal weight by itself (you will have to add other therapies to get there). 

I will talk about the downside of using Saxenda below, but for now, let's talk about HOW it works. 

#1. Reduces Leptin Resistance

First, and probably most important, is that GLP-1 agonists help lower leptin resistance

You may not even realize it, but when it comes to weight loss leptin is probably the single most important hormone for determining if you will lose weight and how much weight you will lose. 

Leptin is also responsible (at least in part) for the weight gain after rapid weight loss. 

What happens is something like this:

Leptin response to dieting

You go on a calorie restricted diet which helps you lose 20 pounds or so within a matter of 30-60 days.

Your body senses this rapid weight loss and makes changes to your hormones to INCREASE your appetite and LOWER your metabolism to compensate.

The hormone responsible for this is Leptin.

Leptin levels then spike which causes your body to regain that weight that you previously lost (2), but in the process, you have damaged your metabolism slightly (not good).

Repeating this process over and over causes worsening leptin resistance and make it so that you are unable to lose weight even if you try excessive dieting or calorie restriction. 

how leptin resistance develops

Leptin is probably one of the more important hormones involved in weight management and it's also probably the most neglected. 

Until recently we didn't really have a way to treat leptin resistance even though most Doctors recognized that it was involved in many cases of obesity in the US.

So where does Saxenda fit in?

Studies have shown that Liraglutide (Saxenda or Victoza) does two important things related to Leptin and leptin resistance (3):

  • Reduces existing leptin resistance - meaning it helps to change the biochemistry of the body to ALLOW for weight loss to occur
  • Attenuates (or reduces) the rise in leptin resistance once you start losing weight - meaning it helps you keep off the weight that you are losing
how GLP 1 agonists reduce leptin levels

These effects seem to be mediated through receptor changes by the GLP-1 agonist and on the leptin receptor. 

Either way, the result is the same:

This medication helps reduce leptin resistance and can help lower leptin levels.

This changes the biochemistry in your body and helps to naturally reduce your appetite, increase your metabolism and increase fat burning capacity.

This change alone is probably why GLP-1 agonists are so effective for weight loss, but they have more benefits beyond their effects on leptin. ​

You can find more information in my hormone and weight loss guide to find exactly how I use GLP-1 agonists, how to manage your diet to control leptin levels and much more here:

  • Bottom line: Saxenda helps reduce leptin levels and helps treat leptin resistance. Leptin is responsible for weight loss resistance. 

#2. Improves Insulin Sensitivity

Saxenda also helps reduce insulin resistance.

Insulin resistance is the root cause of type II diabetes mellitus and insulin is responsible for the majority of the negative consequences associated with that disease.

What you may not realize is that insulin resistance is incredibly common in the US.

It's estimated that up to 50% of the population has some degree of insulin resistance and, by lab testing, show signs of diabetes or pre-diabetes.

Insulin is also a very important hormone involved in the weight loss equation.

When insulin levels are high it's almost impossible for your body to burn fat (4).

Why?

Because insulin blocks the action of an enzyme called hormone-sensitive lipase.

This hormone is responsible for turning on "fat burning mode" and in the presence of high insulin, this enzyme is always on the "off" setting.

This is obviously a big problem if you are trying to lose weight.

In addition to preventing your body from burning fat as an energy source insulin also has the added problem of promoting fat storage. 

This means that if you consume calories (from any source) these calories will be stored as fat in the presence of high levels of circulating insulin.

This is true even if you are consuming a low-calorie diet.

Insulin doesn't care how many calories you are consuming, it cares about storing whatever you eat as fat. ​

​So how does Saxenda work?

Saxenda helps sensitize the body to insulin levels and helps to lower blood glucose levels in the process.

Using Victoza (especially when combined with the right diet, exercise, and supplements) can dramatically reduce fasting insulin levels and also fasting blood glucose levels.

​The positive effects of reducing insulin also significantly help to improve other hormones in the body. 

For instance:

Insulin resistance can cause low testosterone (in men) and high testosterone (in women).

When you treat insulin levels these hormone imbalances tend to improve which will naturally result in weight loss and a reduction in symptoms associated with THOSE imbalances.

  • Bottom line: GLP-1 agonists help reduce insulin resistance and lower blood sugar. This activates hormone-sensitive lipase and results in more fat burning over time. 

#3. Acts as a Glucagon Suppressant

Glucagon is another hormone which is important for weight loss, but one that is less understood than insulin or leptin. 

Over the next 5-10 years we will see a lot more research done on this hormone and how it relates to weight loss, but for now, we can talk about what we already know.

Glucagon is basically the exact opposite of insulin - in terms of how it alters blood glucose levels.

Insulin lowers blood sugar levels while glucagon helps increase blood sugar levels.

How does this relate to weight loss?

It turns out that in order to help burn fat in the body, your body must naturally deplete liver glycogen stores and have low enough insulin levels to promote hormone-sensitive lipase to activate.

In states that cause insulin resistance, there is also some degree of hyperglucagonemia - and this states promotes consistently high levels of glucose.

High glucagon also seems to interfere with normal glucose control which alters how your body burns energy. ​

Saxenda on glucagon control

Saxenda and other GLP-1 agonists help reduce glucagon levels (5) while simultaneously reducing insulin resistance. 

Both of these changes promote more normal blood glucose levels and help promote proper liver metabolism of glucose and help adipose tissue burn fat. ​

​This is also why GLP-1 agonists are so helpful for patients with type II diabetes. 

Glucagon is just as important (if not more important) in the regulation of glucose levels in the body.

Our current focus is on insulin and how it manages glucose levels and we generally completely ignore glucagon and its effects.

But if you treat both insulin AND glucagon levels, you can get a much more normal glucose level and finally promote weight loss and fat burn. ​

  • Bottom line: Saxenda helps reduce hyperglucagonemia (lower glucagon levels) which promotes normal glucose metabolism in the body and in the liver. 

#4. Reduces Appetite

​Another benefit of using Saxenda is how it alters your appetite. 

You've been conditioned to believe that your weight is the product of how many calories you burn minus the number of calories you consume.

Conventional wisdom would have you believe that reducing your total calories will always result in weight loss, provided you burn more calories than you consume.

Weight loss, in general, happens to be much more complex than this seriously oversimplified and inaccurate equation, but, nonetheless, here we are. 

So here's the deal with appetite and Saxenda...

One of the side effects of Saxenda is slight nausea, and this is felt to occur due to how GLP-1 agonists alter gastric motility (6).

These medications slow down the gastrointestinal motility which means that your gastric contents empty more slowly.

This can result in symptoms such as reflux, and distention of the stomach which manifests as nausea.

Pretty much anything that tells your body that your stomach is full will also promote a reduction in appetite - this is natural and normal. 

But, how does appetite impact weight loss?

thyroid metabolism reset poster for side bar

Well, you do need SOME degree of calorie restriction to result in weight loss (but this should NOT be constant calorie restriction) and this calorie restriction from the loss in appetite is actually welcomed in this case.

The reason this appetite suppression is GOOD, is because it's also accompanied by the attenuation of leptin levels.

What this means is that you can lose the weight by reducing your appetite, and instead of your body responding with increased leptin levels, the saxenda actually blocks that rise.

So you get the benefit of both worlds:

Appetite suppression that does NOT result in your weight being regained AND suppression of leptin levels at the same time.

THIS is why appetite suppression is good in this case. ​

  • Bottom line: Saxenda helps reduce appetite by slowing down gastric motility. This reduction in calories is also coupled with a reduction in leptin levels which results in weight loss over time. 

#5. Increases Metabolism

Saxenda also seems to have an effect on increasing your basal metabolic rate. 

Your metabolism is probably one of the most important aspects involved in weight loss.

Why?

Because your basal metabolic rate, or resting energy expenditure, is responsible for the MAJORITY of calories that you burn.

This metric is also responsible for how likely you are for keeping off any weight that you lose.

If you do any sort of diet that results in metabolic damaged (defined as reducing your metabolic rate) then your chances of regaining that weight back are VERY high.

This is famously illustrated in the biggest loser study (7) which showed that contestants of this program suffered severe basal metabolic rate damage. 

These contestants were burning on average 600-700 calories LESS per day than a normal person, which means that almost all of them gained the weight back that they lost.  ​

calorie restriction leads to a damaged metabolism study

This is why most calorie restricted diets fail and why we, as a nation, have such a difficult time with weight loss.

​We put all of our focus on calories instead of on hormones and basal metabolic rate. 

So how does Saxenda work?

Saxenda helps naturally improve your metabolism, probably through its effects on leptin levels.

Leptin feeds back to your hypothalamus and helps set your body set point - the number of calories your body burns which in terms alters your appetite.

Your body is constantly trying to match the number of calories you burn to the number of calories that you consume. 

  • Bottom line: Saxenda helps improve your metabolism over time, probably through its effects on leptin levels. 

Saxenda vs Victoza

You might be confused about these two medications, so let explain the difference. 

Let me be clear:

Saxenda and Victoza are the exact same medication.

Both medications use the same active ingredient which is Liraglutide.

Liraglutide is the reason that these medications both work.

Where they differ is in dosing and how they are FDA approved, but please note this doesn't mean that you can't use Victoza for weight loss. 

Victoza is FDA approved for type II diabetes in the following dosages:

  • 0.6mg per day
  • 1.2mg per day
  • 1.8mg per day

Saxenda is FDA ​approved for weight loss at the following dosages: 

  • 3.0mg per day

You can see the main difference between the two is really just the dose and what they are approved to treat. 

Why have two medications to begin with? Doesn't it just cause confusion?

Well... you aren't wrong.

The main reason for having two medications has to do with money.

The makers of Victoza wanted to make more money presumably by increasing their patent on Liraglutide and charging more money for the change in the dose.

This means that it will be very difficult to get either of these medications for probably at least 10+ years. ​

But do they both work the same?

Absolutely, so don't let that confuse you.

Studies have been done using both medications and they do indeed show similar results. ​

Liraglutide weight loss graph

What's important here is HOW you dose the medication, how often you increase the dose and when to increase your dose

The benefits listed above are only achieved at a certain minimum dose and this dose is different for each person. 

In my weight loss guide, I talk about how to appropriately use GLP-1 agonists including Victoza and Saxenda. 

I also talk about when you should increase your dose and how to titrate your existing medication to help with your weight loss. 

The worst thing you can do is take the maximum dose and lose 20 pounds quickly, but then stay at a weight loss plateau when you have 30+ more pounds to lose.

How much does Saxenda Cost? ​

One of the biggest drawbacks of using this medication is the cost.

​Saxenda (without a coupon or discount card) costs upwards of about $1,500 per month. 

Even using websites such as goodrx.com which has coupon codes for medications the price only lowers to around $1,100 to $1,200 per month. ​

Saxenda cost

This is obviously an issue because even though Saxenda works this makes the medication unavailable to most people who could actually benefit from it. 

What's worse is that insurance does not cover the medication generally.

Even though there would be a huge benefit to reducing your weight by 50 pounds versus the risk of maintaining 50 pounds of weight gain over 2-3 decades.

Despite this issue, there are some other options... 

Saxenda coupon & Savings card

Like many other medications, Saxenda does have a coupon code or savings card that may work for some people. 

The only problem is that it doesn't work for everyone. 

You can find more information on how to get the savings card for saxenda here. ​

How do you use the coupon?

You must first get a prescription from your Doctor for Saxenda, then you have to apply for the savings card and then have your pharmacy apply the discount to the medication.

The process isn't difficult but it doesn't always work.

This leaves a fair amount of patients without the medication or having to pay the high price.

Luckily there are some ways that you can get Victoza covered by insurance if you know a few tricks.

Saxenda Side Effects​

Even though Saxenda works doesn't mean it comes without any side effects.

While this medication does have many side effects, most of them can be avoided if you use the proper titration schedule.

In addition, the goal of using Saxenda in the way that I recommend results in only using the medication during weight loss phases.

This means that the use of Saxenda is only temporary and doesn't have to be continued once you lose all of your weight.

Even when used appropriately sometimes patients do experience some side effects, the most common being:

  • Nausea
  • Headache
  • Vomiting
  • Muscle cramps
  • Dizziness

​These side effects tend to go away over time, but saxenda can also cause more serious side effects as well: 

  • Inflammation of the pancreas
  • Gallbladder problems
  • Low blood sugar
  • Increased heart rate
  • Kidney problems
  • Depression
  • Chronic pain
Saxenda side effects

In my personal experience of using Saxenda and Victoza, I have never had a patient endorse any of the more serious side effects listed above, but they have been documented in some patients. 

As always make sure to address any issues with your medication with your Doctor.

And just remember that most of the symptoms associated with Saxenda can be mitigated if you use it correctly.

In addition, any risk of serious side effects can generally be mitigated further by the fact that if you use Saxenda correctly you will NOT be on it long term. ​

​How to use Saxenda Effectively with other Therapies and to Boost Weight Loss Results

​After reading this post it may be tempting to think that Saxenda is the answer to your weight loss problems. 

While it is helpful I don't want to leave you with the wrong impression.

Saxenda really shouldn't be used as monotherapy for weight loss.

Meaning that it shouldn't be used without making other changes to your diet, lifestyle, exercise routine, supplements, and hormones.

To get the kind of lasting weight loss that you are looking for it will require a more comprehensive approach that includes ALL of those things.

Saxenda, or Victoza, can be combined with other therapies that multiply the effects of the medication. 

This results in more weight loss that is sustained. ​

You can find more information about therapies that compliment Saxenda or Victoza here

Back to you

​Saxenda is a powerful medication that can seriously help treat weight loss in most patients. 

It does this through its effects on various hormones in the body including leptin, insulin, and glucagon.

These powerful hormones are responsible for your metabolism, how much energy you burn at rest and how your body stores and burns fat.

Using Saxenda can help bring these hormones back into normal balance and help you lose weight in the process.

In order to get the best possible results (with weight loss), Saxenda should be used as part of a more comprehensive treatment plan instead of being used alone. 

Now it's your turn:

Have you used Saxenda?

Did it work for you? Why or why not?

Leave your comments below!​

References (Click to Expand)

Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders.He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances.You can read more about his own personal journey here.

111 thoughts on “5 Ways Saxenda Helps with Weight Loss & How to use it Safely”

      • Hi There,

        I’ve been on Saxenda for almost a month. I’ve seen some enormous changes with my body, which included a 20 lbs weight loss. As you mentioned in the article, I have been combining the drug with daily excercise which includes cardio 3-4 times a week, and 5 days of resistance training. I’ve also been eating very clean (low fat and lots of veggies & fruits, and lean proteins). I’m almost done this program, but I’m very concerned about what happens after saxenda. Will the appetite return? Will I gain the weight back? Hope you can help answer these questions

    • Great article. I am curious to know if there is any benefit to taking smaller doses if a smaller dose adequately suppresses appetite.

      • Hi Angela,

        That’s kind of a loaded question but yes, you do want to use the smallest dose possible but the dose-dependent symptom you are looking for is not necessarily appetite suppression.

  1. Very interesting! But my big question is, can you use it when you have Hashimotos? Or does it react with other Ned’s? Currently on Synthroid, T3, Crestor and zetia. What I wouldn’t give for the 60lbs hashimotos brought on to be gone off my 5’0 frame! Lol

  2. Would Saxenda still work if I don’t have leptin resistance? In October 2016, my fasting leptin levels were 7.6. I am hypothyroid and can’t lose 5-8 lbs that I need to. My endocrinologist suggested Saxenda, but I wanted to do some research first.

  3. I’ve just had my Integrative Hormone nurse call in Belviq XR. Do you think I would benefit more from the Saxenda?
    My Leptin level was a 26.1 but I read that was actually high?
    I definitely think I’m suffering from hormone imbalance as well as thyroid resistance with my elevated reverse T3 (31.5)

    Thank you for your advice and help!

    • Hi Sarah,

      I generally don’t recommend belviq because it just doesn’t target the right pathways for optimal weight loss. Your leptin level is high, but I can’t say for sure if you would do better on a GLP-1 agonist or not based on this information.

  4. I’m confused. I thought you were recommending Saxenda in one of your blogs if we had high leptin levels and have been unsuccessful with weight loss.

  5. I have been taking saxenda for 3 days and have no appetite at all, which is good. Though I am very nauseous and all my muscles hurt really bad.. any idea how long this will go on for? Will my body get used to it? I am tempted to stop bc I have felt so terrible..

    • Hi Beth,

      Symptoms such as those should be directed with the physician who prescribed the medication. At the very least your dose should be reduced.

  6. Started Saxenda 2 weeks ago and the results are already amazing, even though I’m not even up to full dosage yet! My appetite was out of control before but now I can actually resist food and make healthy choices. My energy level is up too. I’ve lost over 7 lbs in 2 weeks. So excited!! Thanks for this post explaining how it works!

    • Hi Ellen,

      No problem and I’m glad it’s working for you. Thanks for sharing your story and keep us updated.

  7. Hi, I have been reading a lot of your posts and different articles about thyroid
    and weight loss . I have hashimoto and would like to lose 35lbs. I just wondered…
    do you not prescribe medications with any of your programs? If not how is a person to get the meds he or she needs to heal and lose weight and just feel overall like a human again? I love the info on your website.
    Thank you for that

    • Hi Cathi,

      The best way to get the medications is to have an open minded provider (PCP usually) who is willing to work with you.

  8. I’ve been taking Saxenda for 5 months. At first, my appetite was reduced and I was losing weight (about 15 pounds total). About month #3, it reversed…my appetite picked up with sugar cravings and I started gaining back weight. Any suggestions? Stop for a while and re-start? Switch to something else? Doctor has recommended Qsymia as a possibility.

  9. I started Saxenda in February 2017 and through diet and walking 3 days a week I am down 49 pounds. I feel wonderful! This article was very helpful explaining all the reasons this drug is working for me. I have stayed at 2.0mg for my daily dosing. Anything higher than that, I developed symptoms of nausea, etc. My question is that when I overindulge, or eat foods higher in fat content, I tend to have symptoms that mimic dumping syndrome with terrible diarrhea and lots of increased motility of the bowel. Anyone else having side effects like this? Or is there a reason for it? Marcy

  10. Dear Dr. Childs, My doctor, who is also a functional medical doctor, is prescribing Saxenda and LDN for me. He’s ordered all the blood work that you recommended (all the various hormone levels, nutrients, etc.) on one of your other pages about Victoza and LDN, should have the results tomorrow. I know in the past, my leptin levels were pretty high (28 and then 15) and Hb1AC was 5.5, with 6 being the highest. Let’s see what tomorrow’s results show. He said other patients of his had success losing with Saxenda. I am hoping I will be successful, too. I have Hashimoto’s, am menopausal, have had leaky gut and adrenal fatigue (now recovered) and am about 50 pounds overweight. I lost about 45 pounds in 2015 with four rounds of HCG injections, but gained everything back last year! I have recently started bioidentical hormone therapy, gone back to the gym (focusing mostly on weight training) and trying to heat more healthfully, though not starving myself, but in two months, I’ve only lost five pounds 🙁 My doctor said I should stop all supplements while taking the Saxenda and LDN. I am wondering, though, if I should really give up the collagen, fish oil, probiotics, B complex, magnesium, zinc, etc. that I take as I feel they are beneficial. I won’t take berberine as that would probably interfere. How does one titrate the dosage of a medication that comes in only one dosage (3 mgs) to mitigate any negative side effects? Thanks for any insights.

    • Hi Tina,

      I discuss how to correclty and safely dose saxenda and other GLP-1 agonists for optimal weight loss in my weight loss guide. If you use too much medication too quickly then you risk losing efficacy of the medication long term, so there is a certain way you need to be increasing your dosing to make sure the weight loss continues.

      • Thank you! I just picked up my Saxenda and LDN today, and I got my test results. According to the HbA1C, I am insulin resistant at 5.9 🙁 The leptin result wasn’t in yet. My cortisol was 379 (in a range of 119-618) from blood drawn around 8:30 a.m. Not sure if that’s okay or not. I also signed up for your 60-day Metabolism reset guide, and have read your recommendations for dosing, and the dietary guidelines. I am curious about something else. I had a DNA fitness test some months back, and based on the results, it was recommended that I follow a low-fat regimen. I should limit saturated fat to max. 6% of my total calories daily, and monounsaturated fatty acids to 15% of total calories and polyunsaturated fatty acids to 12% of total calories. Also, it stated I should eat 45% carbs (vegetables, fruits legumes, seeds and GF grains) and 22% lean proteins (fish, chicken, turkey). Do you think these DNA tests have any merit or would these recommendations work better for someone whose metabolism isn’t broken? Your guidelines recommend lots of fats. What if one is both insulin and leptin resistant. Which plan should they follow, because the recommended guidelines are a bit different for each one? Thanks again.

  11. After a severe injury doing Cross Fit and not being able to properly exvercise for almost 3 years, I gained 50 lbs.No matter what I did that has worked previously during my life, I could not lose the weight and I was very disgusted and felt horrible. I tried several things prescription & OTC,in addition to daily excercise but nothing was working. My family doctor, God bless her, recommended Saxenda. At first I was skeptical, but at that point I was on a low dose BP med & was prediabetic having migraines several times a month and was exhausted most of the time. I work a full time on call 24-7 career, have 2 children (at that time they were 7 & 17), & a husband and I was 49 yrs old. So, I was up for trying anything to get my health back! The first 3-4 weeks I had some nausea, & some constipation but that eased off fairly quickly. Around month 4, I had some upper stomach pains which eased when I backed the dosage down and slowly titerated it back up.I only lost 15 lbs the first 6 mos, BUT I was ONLY taking the Saxenda.I started it July 1, 2015. In January 2016, I felt much better physically and got back into the gym. By May, I’d lost another 35 lbs,for a total of 50 lbs in 10 months.I’d made myself (& my Dr) a promise that by my 50th birthday, I’d have the weight off & I did it!In fact, by my birthday that Aug, I’d lost another 5 lbs.for a total loss of 55 lbs in 13 mos with the help of Saxenda.I absolutely believe it targeted all of the issues that I was experiencing that were hindering my weight loss efforts. I also am dedicated to my gym workouts and running as well, so in tandem, this has been a success for me and I have maintained my weight loss and have felt better than I have in years!! My Dr says I’m her poster child for Saxenda! I’m so thankful for her and for this medication. It helped me get my life back on track for me and my family!!

  12. Hello Again, Dr. Childs: I signed up for your 60-day Metabolic reset, but I still have questions that are not addressed in your guidelines or videos. I stated Saxenda and LDN July 24 and have dropped 11 pounds. I am up to 1.8 mg of Saxenda and 2 ml of LDN daily. I don’t feel hungry, but I am stuggling to consume enough calories, and feel I have to force myself to eat. What should I do to increase my caloric intake? I don’t want to eat too little and cause even more damage. Also, I feel very tired since starting these meds and have not felt energetic enough to exercise. Does the tiredness go away at some point? Or should I start taking the Saxenda at night before bed? I would like to add intermittent fasting over the weekends with HCG injections. I can get HCG, however, how many mls of bacteriostatic water should I mix to reconstitute the vial? Additionally, I would like to order some supplements, like the probiotics and adaptagens you offer, but I am in Europe and your site doesn’t ship outside the US. Do you have any substitutes you could recommend? I’ve included my email address if you prefer to reply that way. Your guidance is most appreciated.

  13. I started Saxenda April 4, 2017, following dosing instructions, a Mediterranean diet, and moderate exercise. Starting a 218 pounds and now at 190, equals a 28 pound loss. So far so good. A few mild side effects that past quickly. I consider myself fortunate that my work place supports Saxenda use, so my monthly cost is $20. So having been giving this fabulous opportunity, plan to continue with Saxenda and my life style. I swim laps 3-4 times a week and now use the stairs 3 times a week (to the 5th floor). It feels good to have loose clothing, it will feel good to walk my first 5k this fall. It feels good to just have more energy and it feels good to feel better. It will take time to reach my goal weight and that is OK. Each month I set small goals, 3-4 pounds, and walk a little farther. I swear I heard the theme song from Rocky, after climbing the 5 flights of stairs the 1st time. I will post again with more results in a few more months. I wish each you the strength to continue onto the path of better health and good results.

  14. Hello,

    I know this works by working on a metabolic level, but can you take this if you are on Synthroid for Hypothyroidism? I was told that this can cause Thyroid Cancer so I was curious.
    Thanks!

  15. Hi Dr. Childs,

    Thank you so much for this post! This is the first time I have read anything regarding the impact of Saxenda on hormones and it was very informative. Can anyone tell me what seems to be the best time to inject Saxenda (morning, midday evening)? I have not been taking it very long and I am just curious what seems to be the optimal time 🙂
    Thank you!!!!

  16. Hello Dr Childs, I started taking the saxenda following learning about it on your website. I have been taking straight T3 for 3 years which enabled me to loose 3.5 stone having gone from under 8 stone person to 14 stone (with Auto Immune) thyroid, adrenals problem. However, recently weight creeping back on. My bloods showed high reverse T3 very low morning cortisol, leptin, glucose and insulin, v. low test, DHEA basically everything is out. My resting pulse is high 80-90 bpm on the T3 (SR). However, after taking saxenda for 3 days I thought I was going to have a heart attack. My pulse was so fast I was getting in a panic in middle of the night, out of breathe etc. I have also been getting pains in my sternum/rib area for past few years ( like muscle spasms) – but this was before the saxenda so am having an MRI but my doctor says its not my heart. My doctor thinks I have something wrong with my spine/nerves.

    To cut a long story short, I have the saxenda in the fridge, really want to keep taking it but I can’t have my heart race that fast its too worrying.

    I did feel really healthy apart from that for the 3 days. Like I had more energy and less brain fog, body aches.

    I read on the saxenda website saxenda can cause very fast heart rate in mostly women aged between 30 to 45 range but only for first 1 month then it starts to reduce. Women were given certain medications/supplements to stop the affects on the heart short term. Such as beta blockers, valum, muscle relaxants, Vitamin D and they all worked to prevent the high heart rate whilst they weaned on Saxenda.

    I am off to my doctor to ask for beta blockers then hopefully I can start taking saxenda again. I was thinking to try to reduce my dose of T3 aswell. Am on 37.5mg.

    Have any of your patents had the fast heart rate with saxenda. Could it be due to the effects of T3 and saxenda together.

    Just wanted to let you know of my experience and get your thoughts. Thank you

    • Hi Laurie,

      Your heart rate is most likely due to your T3 dose, not Saxenda. Thyroid hormone can be dosed based on weight, so as you lose weight your effective dose of T3 may now be too high.

  17. I have been on it for 75 days. Starting weight 203 lost ten pounds. Some days I will be 191 then day later back to 193. Am I losing enough to stay on it or am I wasting my money. I know I could do better on my eating. I walk every night also. Thanks

  18. I recently started Saxenda and have to admit after reading all the negative side effects I waited 3 weeks. After reading your article I started 4 days ago. I have had no side effects so far and feel really good. Have list 5 lbs already and have a new energy. If you are doing ok on .6 can I stay on that dose or do I need to increase as stated.
    Thanks

    • Hi Phil,

      Most of my patients tolerate the medication really well, I just don’t think most physicians know how to use it safely or correctly. I don’t agree that you should increase the dose according to the schedule the pharmacy provides, but that is up to you and your physician as each person is different. I use the medication quite differently than most which is why I have such good success with it.

  19. I started using Saxenda in May. I am a 5’9″ woman, age 55 and I weighed 174 pounds. I was not truly overweight, but needed to lose a few pounds and change my eating habits. Dieting was not working. I was exercising. My blood pressure was slightly elevated and I was pre-diabetic. As of October 8th, I have lost 27 pounds and have had no side effects from the medication. I have reached (surpassed) my weight loss goal and do not know if I need to continue the medication. My concern is that if I stop the drug, I will quickly gain the weight back. What happens when you stop Saxenda? Thank you.

    • Hi Risa,

      It depends on how you lost the weight on Saxenda. If you let it suppress your appetite and you just reduced the amount of calories you consumed then the weight may come back after you stop using it. If the medication helped you lose weight without changing the amount of food that you consumed then you should be fine.

      • Saxenda has suppressed my appetite and I eat much less, and yes, I have dropped weight. So what then should I do to ensure the weight stays off? I don’t want to go through another round of weight regain. That happened after I did HCG injections. I lost 45 pounds and gained it all back plus some. I thought this regimen (provided one does not go back to eating the SAD) ensured the weight would stay off.

  20. I’m encouraged to see that Saxenda can be used for the period of weight loss. I’ve seen conflicting information. My concern is that I’ll have a good loss, discontinue the medication and gain all the weight right back! I’m hoping that changes in my eating and exercise habits will become routine and the drug will no longer be needed in the end.

    • Hi Vanessa,

      Saxenda can certainly cause sustained weight loss but only if it’s used correctly. The majority of my patients discontinue it without any issues.

  21. I have been taking Saxenda for only 1 week and I have lost 11 lbs. I am taking it for problems with sugar and to help me lose weight.

  22. I have been on the 0.6 dose for a week and have zero change. I eat 900-1200 calories a day and walk in the evenings. I am 41 5’4 195 pounds and so far this medicine does nothing at all and I only pay $50 since my insurance covers it…I am disappointed

  23. I’ve been on Saxenda for a little over two weeks. I’m Hashimoto’s, Lupus, PsA, and Celiac. I am following Keto. I’ve lost about 16 pounds. I’m thrilled. I’ve never been a big eater and have been so upset at my weight gain with the Hashimoto’s and prednisone. I was always about 110-115 pounds. 5’2…I’ve shrunk. I gained about 80 pounds. I get nauseous but take a Zofran and I feel better. I know losing the weight will help me emotionally and physically. Drink water!

  24. I’m scared I won’t have the money to buy it. I am on it 2 weeks. I feel like I’m losing I know I am not eating as much… I was already rejected by my insurance I will appeal it. Hope I can get it another way.

  25. What if one has been using Saxenda for a few months at the maximum dose (along with LDN) and one has reached a plateau? What should they do? Please don’t say “there’s more info in my weight loss guide,” because I purchased your weight loss guide (and watched the videos) and there isn’t. Thank you.

    • Hi Tina,

      The information is actually in the guide! 🙂 Basically you would now need to start “layering” therapies on top of each other. So concurrent use of multiple medications, hormones, etc.

      You might also consider switching GLP-1 agonists which can work for some people as well or re-testing your hormone status to see what has changed during your weight loss. Some individuals may need more personalized recommendations (it just depends on how much weight they have to lose and what medical conditions they have).

      Some videos may have been added since you last looked but this information is in there.

      • Is there a specific video that deals with plateauing? because I know you mentioned doing one in another video, but I can’t see it. I am taking Saxenda, LDN and HCG on intermittent fasting days, though the dosage has been lower than you recommended. I an also taking your thyroid-adrenal formula. I have been under a lot of stress the past few months. Maybe that has had an effect. Should I switch to Victoza, maybe? I need to lose about another 38 pounds to be at my goal. Which hormones should I re-test? Thank you!!

  26. Can Saxenda affect your heart? I don’t have any known heart issues bit I take 2 bp pills as well as birth control pills & xanax..Just wanna make sure it’s safe to take while I’m on these other medications because I’m sort of afraid but I’m so ready to start the saxenda???

  27. Thank you for the comprehensive overview! I have always been confused about leptin and it’s role in weight loss. Should we take supplements? I have been on Saxenda and have hit a plateau; my doctor states that it doesn’t work for everyone but the physiology of the body is the same for all….essentially insulin, leptin and glucagon have the same function in our bodies. I understand we are different and require specific levels. I look forward to any explanation or solutions for the plateau.

  28. Thank you for explaining this whole process being a biology major you helped me understand this process. I have done fantastic and lost like 38 pounds!!! I unfortunately in the last 3 months not lost anything else …I still need to loose about 20 more and I noticed in your article maybe I did something wrong with the dosing …I do work out pretty intensely 5-6 days a week so it’s still obviously my eating …good news is I haven’t gained but 5 pounds on and off in this last 3 month ( thru the holidays even!!)..

    so My question is can I take a “drug holiday” like for 2 weeks or so and maybe that might hit the “reset” button and it start to work again like it did when I started ??

    I just really really want to finish this journey in weight loss and this medicine for the first time
    In my life I understood what it meant to feel full…thank you sooo much in advance ..and appreciate your article!!

  29. I have used Saxenda for 2 years. It works. I have lost over 40lbs and I have kept it off. I wonder, however, if I can now stop using it without fear that the weight will go back on. Assuming I maintain the healthy habits and exercise regime that I now consistently follow, is there a physiological benefit of the treatment. I worry about long term side effects. I do experience daily hypoglycemic moments in the afternoon which have become annoying.

    • Hi Dan,

      It’s probably not a good idea to continue the medication long term, but you would need to weigh the benefits vs the risks in such a case. I would discuss that with the physician who prescribed it.

  30. I started this on March 2. I’ve lost 11lbs. I’m amazed. I literally have no side effects other than heartburn. I’m not sure how it will work. My insurance covered half. With a coupon it was $400. I have a 3 month script. I’m curious if it continues to work..
    My only “complaint” is I have zero appetite. I have to force myself to eat and it makes me gag
    I’m a foodie so this is crazy.

  31. I have been on Saxenda for 2 weeks, I am type II Diabetic. No weight loss yet but my blood sugars are way down for the first time in 6 years. I am trying a high protein low carb diet. The only side affects so far are a little nausea, mild stomach pain and constipation. After reading all of this very helpful information I am encouraged and hopeful.

  32. Wow! Thank you so much for explaining this in a way that I can finally understand. I have pseudotumor cerebri and have lost about 80 pounds. But about 6 months ago the weight loss stopped and I have slowly managed to gain back 10 pounds. I now need to lose about 40 pounds. My doctor prescribed saxenda and I’ve been using it for a little over a week. But, honestly, I just couldn’t understand how it worked. This article helped so much. Even though no one has mentioned this, I have it in my head that this is dangerous for people who do not have diabetes. Reading what you provided has helped put my mind at ease. I look forward to reading more from you. And to see where my new journey takes me.

  33. On week 3 have lost 7cms around my tummy. Have not checked weight. My appetite has decreased, I exercise 15 to 20 minutes a day, finding ways to make food fun. Have a few side effects but nothing that stops me. From not having private insurance paying the full price of $387 is also a good motivator.
    If I can’t lose weight this way then, then I truly have no more options.
    I have my fingers crossed.

  34. Hello,
    I’m an LPN and I suffer from obesity and those drug rep meals and donuts in the break room just keep putting on the pounds!!! I have my first sample pen from my Doctor and started my first dose. Currently fighting with the insurance company but it’s hopeful cause I’ve tried contrave and belviq xr and have failed with both. I have high hopes and praying my insurance company comes through! I have 200 pounds to lose and I just need that jump start motivation!! But I guess my question is if I’m currently taking Birth control pills should I not take them together? I saw they could interact with Saxenda. But anyways I really enjoyed your blog about Saxenda!! It def helped me understand it more.

  35. I started Saxenda about 3 weeks ago. I am up to 1.8 now. No nausea but my body is telling me somethings not right. I am hypo thyroid take hormones and Cymbalta for nerve pain. It seems these drugs are not working as well as they have been. Could the Saxenda be keeping the other drugs from their potency?

    • Hi Cindy,

      When talking about medications and side effects the answer is almost always a yes/maybe. The best way to tease out if it’s happening in your body is with the help of a knowledgeable physician

      Hope this helps!

  36. I started Saxenda on April 30th, 2018

    It has completely suppressed my appetite to the point that I do not feel like looking at food and I don’t want to eat much.

    Basically, I eat 1 egg a few tablespoons of peanut butter and some cheese daily but that is it.

    I have done water fasting in the past and this medication is just completely taking away my hunger so would it be ok to water fast or maybe do intermittent fasting while using this?

    My plan was to continue with Keto (low carbs high fat) which I have done on and off over the years and managed to lose and keep 45 lbs off.

    Would you consider this ok?

    I want to do intermittent fasting combined with low carb.

    Thanks

    • Hi Maud,

      This type of plan will most likely lead to metabolic damage and weight gain long-term, I would recommend against this type of dieting (calorie restriction).

  37. I have been on Saxenda for over a year and have lost 110 pounds. My doctor told me today that I need to get off of it now. I’m scared to death. I don’t want to gain the weight back. I am disabled and am not able to exercise. I have figured out in the last 3 months how to maintain with the Saxenda, I don’t want to give it up.

    • Hi Stacie,

      As long as the weight didn’t come off as the result of calorie restriction, and you follow a slow titration off of the medication, then you should be good to go.

  38. I know you recommend various types of intermittent fasting. I was wondering what you thought of the One Meal A Day (23:1) type of fasting, where one fasts 23 hours and then eats one big meal that includes all the macros. I hear more and more about it. Is that something that you would recommend for your patients or anyone taking Saxenda. Thanks.

  39. Hi, do you know how Saxenda works along with birth control? I have heard birth control increases your appetite I’m currently on the full 3 units of Saxenda but started Birth control so I’m wondering how these two will go along each other.

    • Hi Mary,

      You would need to consult with your physician to be sure because there are so many different types of birth control. In addition, it depends on what you are using it for.

    • Hi Donna,

      It could be due to dosing, not using other therapies or simply that it’s the wrong medication for you.

    • Hi Carolyn,

      If you use Saxenda appropriately then you shouldn’t regain your weight back. I discuss how to use it correctly in this article.

  40. I just started Saxenda 2 days ago but am having terrible nausea and vomiting with it on the lowest dose of .6 per day. Will this go away with a few more days of use or should I tell my Dr. and try something else? I am already losing weight which is great but feel horrible and am unable to work from nausea and vomiting so not sure risk/reward is there at this point unless the side effects will subside. Did anyone have this when they first started? Does it fade as your body gets used to the drug?

    • Hi Jaime,

      From my perspective, vomiting is an unacceptable side effect of Saxenda/Victoza. A little bit of nausea is okay and to be expected, but once you start vomiting I think it’s potentially dangerous. In the case of mild nausea, though, in most cases, this side effect will subside over time.

  41. I have been on saxenda for a month and lost 17 lbs. I have thyroid problems and tried all kinds of diets and nothing worked. Saxenda works for me. Very pleased with how working.

  42. This was the most comprehensive assessment I have read about Saxenda and was very helpful. I have lost 26kilos and despite the low grade nasuea I remain enthusiastic about the medication. I went off of it after losing the weight and noted that the weight began to creep back. After regaining 6kilos (3 months) I resumed the medication and immediately saw the weight creep off. In 2 months I have shed the regained weight and am on a further downward trend. Is Saxenda safe to continue taking for years? Nothwithstanding the cost, it seems it would be as good for maintenance as initial reduction. I can’t seem to get a clear or comfortable answer from Novo Nordisk.

    • Hi Dan,

      No one really knows if Saxenda is safe to take indefinitely but I tend to think it’s probably not a good idea. I suspect that the longer you take this medication the more likely you are to experience negative side effects. With that in mind, it’s important to realize that, in many cases, the benefit of weight loss may outweigh the potential negative consequences. We know that obesity is associated with an increased risk of cancer, heart disease, stroke, Alzheimer’s etc.

  43. I have been on it for 3 months and seen really no change in my body, I do have a loss of appetite (my quantities have diminished). I would love to see some change, especially because of my hipper tension. I am at a 3 now. What can I change to see a change in myself?

    • Hi Lorena,

      You’ll probably need to adjust your diet and make sure you are exercising as well. It also doesn’t work for everyone so it is possible that it just isn’t the right medication for you.

  44. This is great information – thank you! This has been the only med that’s worked for me after 3 different ones. I’m curious though what happens (biochemically speaking) when you stop taking Saxenda. Any thoughts you can share?
    I’ve been using Saxenda for 5 weeks and am down 15 pounds. The nausea went away after 5 days. I was told to increase the dosage each week and now I’m up to 3mg daily.

    • Hi Beth,

      I have developed my own way of using it, which I describe in this post, and when used in the way I recommend the entire goal is to be able to stop the medication and keep the weight off. But that only works if you can reverse the resistant syndromes that potentiate weight gain (leptin and insulin resistance) while you use it. So, if you just use it as a weight loss tool by itself and don’t address these issues, there’s a high chance you’ll regain the weight you lose once you stop taking it.

  45. Dr. Childs,
    First of all, thank you for all you do for us!
    I have Hashimoto’s and I’m on Naturethroid, Liothyronine, and LDN, and I’ve been AIP since 2015. After a very stressful year and a half, I gained (very quickly) 50 lbs. The gaining has finally stopped, I started Keto on top of AIP (its doing nothing), I’m not terribly hungry, but I’m not losing.
    (As background, I do also have high SHBG, low-ish cortisol (improving), and I think strong estrogen/progesterone levels for a 50 year old.)
    I tested my fasting insulin (3.2) and leptin (68.6). So seems I don’t have an insulin resistance problem but I do have a leptin resistance problem. Is that even possible? And would Saxenda be good for me to try given the insulin vs. leptin levels? I’m getting desperate. I think I could convince my doctor to prescribe it.

  46. Hi Dr Childs,

    I found it very difficult to find a Dr in Australia that will actually measure Leptin. However, I persevered and did find one. My Leptin is 160 (Aust range is 5 to 11) which I know is ridiculously high. I have about 30kg to lose. I have paid for your program, and I am very good at sticking to such regimes, so I don’t think it will be too difficult. I took your info to my Dr and am now on Saxenda. I realise everyone is different, but how long could I expect to see results with such high Leptin levels? I have tried so many things which have never worked and it gets really discouraging.

    My thyroid is OK, my P4/E2 Ration is 33.3 (saliva testing) and my cortisol isn’t too bad.

    I want to have realistic expectations so I don’t feel disappointed.

    • Hi Sarah,

      Most people, even with severe leptin resistance, should see weight loss by the 4-8 week mark. Weight loss may be slower with leptin resistance that high, but you should still see some movement by that time.

  47. I’ve been using this for over a month at first I had an bad reaction to my injection site on my stomach. So, I now object in my thigh & it’s much better. I’m using my dosage as instructed and I’ve lost 30lbs. Now I did make a lifestyle change eating low calories a day and a strict workout routine. My question is how do I stop the feeling of nausea. It doesn’t seem to get any better!!! Not only that, I’m always tired and fatigue too. I’m an athletic person and exercising and healthy eating gives me energy just not with this med. I struggle to find energy daily and I fight the horrible pain in my stomach daily. Any suggestions?

    • Hi Crystal,

      I would be careful with your calorie restriction. If you lose weight due to that method then it will come back once you stop taking the medication. In regards to nausea, that is usually dose dependent. If you adjust your dose it should subside.

  48. Hi ,
    I had a sleeve gastrostomy done in 2013 and lost 32 kg in 1year but slowly regaining the weight since 2016 and I gained 15kg . My doctor started me on Saxenda 2 weeks ago and I am taking 3mg dose now . During the 1st week , I lost 1.5kg but now I am gaining back the 1.5kg already . May I know if this should be happening ? I am not eating much at all since post op. I am concerned with my Low metabolism rate of 1100kcal and the body compensation strategy . I have tried all slimming product including duromine and Saxenda is my last hope ! Any advice ?

  49. I started Saxenda January 1, 2018 for a weight loss pilot program through my insurance. I started at 247 size 22 and am now 203, size 16. I’m 47 and have been a yo-yo dieter my entire life and saxenda has been a game changer. The benefit of losing the weight is having more energy and stamina to exercise and enjoy it. Some nausea I’m the beginning, specifically if I ate too much. It allows me to feel full after eating little. I do notice that I have to watch my blood sugar because it will dip low. I’m going to be on it another year and I have convinced my husband and son to try it. So thankful for it!

  50. I am 58 and weighed in at 188 before I started Saxenda. March 28 I began taking Saxenda and have lost 45 lbs! I combined Saxenda with exercise and it worked beautifully. I was rarely hungry but continued to eat small healthy meals.

    I am still taking Saxenda but have recently noticed I am starting to crave sweets and I feel hungrier than I used to. Is this typical?

    If I continue to exercise, can I stop taking the medicine without gaining the weight back?

    Thanks for all the great information!

    • Hi Paula,

      It depends on how you lost the weight. If you lost it through calorie restriction (from appetite suppression) then the weight may come back once you stop taking the medication.

  51. I have been on weight loss regime for almost a year with very slow progress, my endocrinologist suggested Saxenda approx 3 months ago, since I was already on weight loss routine, I haven’t lost any tremendous amount of water loss during the early weeks while starting with therapy as most of the patients lose 20pounds etc in a couple of weeks. Fat loss doesn’t occur overnight ,it’s a slow and gradual process specifically while muscle building works in play at the same time(if we are combining with weights, resistance training n cardio etc besides diet methods ie keto or high protein or low carb routines etc), it’s difficult to see much of a change on the scale However inches loss can help you see the difference besides your improved energy levels.
    In these couple of months, I have successfully seen few inches coming down and still going strong. Although appetite is back and I don’t feel full for a longer duration as it was being experienced in the starting months however it does help me control my cravings and specifically no longer looking for sugar /carbs cravings like before. Much happier with the help this medication certainly provides, worth every penny and effort put in place. Hope this shall help me achieve my targeted fat loss in the long run.

  52. Hi, Childs!
    I have a PCOS and menstrual cycles not regular it doesn’t come sometime 3months and a lot of thick hair on my face and fatty liver and also a high level of androgens. I always feel a craving to eat. So which one is good for me Victoza or Saxenda? I used before metformin but it’s didn’t help me and I did everything to lose weight but it could help me. I really need your advice.
    Thanks

  53. I have been using saxenda for about a month. I have lost 10 pounds. I have tried moving to the 3.0 dose but the nausea and heartburn have been just awful. Even at 1.8 the heartburn is barley tolerable

  54. I have been on Saxenda for the past month and have lost 5 kilos but have now stalled losing weight. I currently take 1.2mg per day and am on the Ketogenic diet. Any advice would be greatly appreciated. I am not obese but am overweight and am a Type 2 Diabetic on insulin.

  55. I have been using Saxenda for 2 years. I have lost 28 kilos and have stopped the yo-yo effect of many different diet regimes. My blood sugar levels have reached a sustained level so low that my doctor is going de-classify me as a diabetic. I don’t have any side effect symptoms and I find that I can eat anything I want but the quantities have dropped dramatically over the years. I also have less of a taste for alcohol and rarely drink my favorites, scotch and wine without a sense of feeling denied. This change in lifestyle has been amazing.

  56. I have been reading your information. I have been on saxenda for 7 weeks. I have only lost 4 pounds. I follow the diet and can see that I am
    Losing inches. Should I stop taking this medicine? Not sure if weight will come off over time. Thanks in advance.

    • Hi Laura,

      There is a special way that I use Saxenda which is different from the typical recommended use. There are also many other therapies which I layer on top of Saxenda use for better results. I don’t believe I have discussed this information on my blog before but I will add it to future blog posts.

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