Why am I not losing weight on Saxenda?

Like many other health concerns, people looking to lose weight may require the help of approved medications to manage their journey. One of these medications, Saxenda, is an effective tool for many people, and when a healthcare provider prescribes this treatment, it’s only natural to expect it will work as intended. Unfortunately, this is not always the case.

If you’re taking Saxenda and not losing weight, it’s easy to become frustrated. Learning more about how this medication works and what could cause Saxenda not to work as expected is a great first step in finding the right solution for you.

The FDA (US Food and Drug Administration) approved Saxenda (generic name liraglutide) to be used alongside diet and exercise to help with weight loss and management. Saxenda is part of a class of weight loss drugs called GLP-1 receptor agonists and is an injectable given once daily in the upper arm, abdomen, or thigh. 

Your body naturally creates an appetite hormone called glucagon-like-peptide-1 (GLP-1) that influences your hunger levels. As a GLP-1 receptor agonist, the active ingredient in Saxenda regulates your appetite hormones, which influences how full you feel. In turn, this helps control cravings and calorie intake. Eating fewer calories can lead to weight loss (Novo Nordisk, 2022).

Saxenda is approved for adults with an initial body mass index (BMI) of:

• 30 or more (obese), or 

• 27 or more (overweight) with at least one weight-related health condition, such as hypertension (high blood pressure), type 2 diabetes, or high cholesterol

Saxenda is also approved for kids aged 12 and older with a body weight above 60 kg (about 132 pounds) with an initial BMI of 30.

Medications like Saxenda may be an option on your weight loss journey. Here’s what you need to know if your healthcare provider has recommended this treatment for you.

Understandably, this is one of the top questions on people’s minds after starting Saxenda. Although the answer to this question varies by individual, specific timing benchmarks based on clinical research could be helpful to keep in mind.

How much weight can you lose in a month with Saxenda?

If you take your medication as prescribed and stick to healthy eating and exercise habits, most people can expect to have lost some weight by the end of their first month on Saxenda. Specifically, one study of this treatment found that some people taking Saxenda as prescribed were able to lose close to 4% of their starting weight within the first four weeks versus just 1% of people taking the placebo (Pi-Sunyer, 2015).

Although it’s natural to want to lose as much weight as quickly as possible, it’s important to remember that medications take time to produce tangible results. By one year of the same study, 63% of people in the Saxenda group had lost at least 5% of their original starting body weight, while 33% lost as much as 10%. These results are significantly higher than what people taking a placebo were able to achieve (just 26% and 10%, respectively) (Pi-Sunyer, 2015).

Most people know that achieving and maintaining a healthy weight is a critical priority for those living with obesity—but, unfortunately, there are many misconceptions and mistruths about what exactly is needed to reach and stay at a healthy weight. 

As anyone on a weight loss journey can attest, there are fewer things more frustrating than hitting that dreaded “plateau” where weight loss seems to slow or, worse, experiencing weight gain. Several factors could be at play if you’re taking Saxenda and not losing weight, including:

• Diet—Saxenda is approved in conjunction with a low-calorie diet, so if you haven’t adjusted your diet accordingly, that could work against the weight loss you might otherwise be achieving.

• Exercise—In addition to diet, increased physical activity is needed for Saxenda to be effective in helping people lose weight and keep it off. It’s essential to maintain regular levels of activity to sustain weight loss. 

• Medications—Certain medications can affect how well Saxenda works and vice versa. Always tell your healthcare provider about all medicines, including prescription and over-the-counter medicines, vitamins, and herbal supplements. 

Additionally, although this may not be fully in your control, research has also found that people who lose weight on Saxenda early on in their treatment journey are the most likely to be successful in keeping the weight off (Fujioka, 2016). 

Why am I gaining weight on Saxenda?

Experiencing a plateau is one thing, but weight re-gain after weight loss is a significant problem in treating obesity. If you’re gaining weight on Saxenda, you may feel alarmed or confused, but it’s important to know that there are ways to control the potential for weight regain. Often, it boils down to ensuring you’re sticking to structured lifestyle changes. 

With respect to diet for weight management, make sure you’re sticking to foods high in nutrients and low in calories. Nutritious foods that meet these criteria include (NIH, 2021):

• Fruits and vegetables

• Whole grains

• Legumes, nuts, and seeds 

• Lean proteins like seafood, skinless poultry, or egg whites

• Calcium-rich foods like low-fat yogurt and cottage cheese

When it comes to exercise, research suggests that sticking to the World Health Organization’s recommendations. 150 minutes per week of moderate-intensity aerobic physical activity, 75 minutes per week of vigorous-intensity aerobic physical activity, or an equivalent combination of both can help people on Saxenda see the results they’re looking for and avoid gaining back the weight. In fact, getting your heart rate up with exercises like running, cycling, or even brisk walking, along with Sandexa, may help you lose around 20 pounds and keep it off for an entire year (Lundgren, 2021).

To get the best results with Saxenda, you will want to ensure you’re taking the treatment exactly as your provider prescribes. This means taking your medicine at the right doses, eating a healthy diet, getting plenty of movement in, and staying in close contact with your healthcare provider if you start experiencing difficulties while taking Saxenda.

One of the biggest challenges for people starting Saxenda is the risk of side effects and feeling like they want to stop taking your treatment because of it. Some of the most common side effects of Saxenda include (Novo Nordisk, 2022):

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Headache

• Allergic reaction at the injection site

If you are experiencing severe side effects and are considering taking less of your medication, speak with your healthcare provider about the best options for addressing side effects without diminishing the effects of Saxenda.

Although many people are quick to blame individuals for their inability to lose weight, it’s important to understand it’s not as easy as eating less and working out more. So long as your healthcare provider recommends this weight loss medication, you can trust that Saxenda can work for you. 

Losing weight is no small task, and it’s easy to become discouraged—particularly for people taking medications like Saxenda and not losing weight. If you’re concerned about Saxenda not working for you, the best course of action is to speak with your healthcare professional about factors that might be influencing your ability to lose weight. 

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Current version

September 12, 2022

Written by

Allison Gilchrist

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.