Why Saxenda Failed Where Wegovy Succeeded: The Weight Loss Drug Evolution
Before Wegovy made headlines, there was Saxenda. Same idea, earlier technology, modest results. If your GP is still offering Saxenda in 2024, here's what they might not be telling you: it's like being offered a iPhone 6 when the iPhone 15 exists. Still works, but why would you?
Understanding Saxenda's story helps explain why newer drugs work better—and why some people still choose it anyway.
The First GLP-1 for Weight Loss
Saxenda (liraglutide) launched in 2015 as the first GLP-1 agonist specifically for weight loss. Revolutionary then, almost quaint now.
The numbers tell the story:
Average weight loss: 8-10% body weight
Daily injection required
56% lost >5% body weight
Only 25% lost >10%
Compare to Wegovy (15-17% loss) or Mounjaro (21-22% loss). Saxenda suddenly looks like bringing a knife to a gunfight.
Why Saxenda Requires Daily Injection
Here's the crucial difference: half-life.
Saxenda's half-life: 13 hours. Gone within two days. Needs daily top-up.
Wegovy's half-life: 7 days. Weekly injection maintains steady levels.
It's not just convenience—steady levels mean better efficacy and fewer side effects.
Who Still Prescribes Saxenda?
Legitimate reasons exist:
Cost-conscious prescribing: Saxenda costs £100-150 monthly vs £250-350 for Wegovy. For NHS budgets, that matters.
Specific populations: Adolescents (licensed from age 12), lower BMI patients (licensed from BMI 27), and needle-phobic (tiny daily needle vs larger weekly).
Failed newer drugs: Some genuinely respond better to Saxenda. Biology is individual.
Availability: When Wegovy/Mounjaro are out of stock, Saxenda often available.
The Daily Injection Reality
Patients describe it:
"Like diabetics with insulin—becomes routine" "Annoying but manageable" "Easy to forget, especially travelling" "More needle anxiety despite smaller needle"
Compliance rates: 68% at one year (vs 85% for weekly injections).
Side Effect Profile
Saxenda side effects peak and trough daily:
Morning nausea (post-injection)
Evening hunger (wearing off)
Weekend struggles (forget morning dose)
Weekly injections provide steadier experience.
Real Results Comparison
3-month results:
Saxenda: 5-6kg
Wegovy: 10-12kg
Mounjaro: 14-16kg
Plateau point:
Saxenda: Month 4-5
Wegovy: Month 8-9
Mounjaro: Month 10-12
Saxenda users hit ceiling faster and lower.
When Saxenda Makes Sense
Despite limitations, consider Saxenda if:
Budget is tight: Saving £150 monthly matters for long-term treatment.
Modest goals: Need to lose 10-15kg, not 30kg.
Daily routine suits: Some prefer daily ritual to weekly.
Needle anxiety: Tiny needle genuinely helps some.
Starting point: Some GPs start with Saxenda, upgrade if needed.
Combination Approaches
Emerging protocols:
Saxenda daily + Metformin
Saxenda with intensive lifestyle programme
Saxenda as bridge during Wegovy shortage
Evidence limited but logical for specific situations.
The Orlistat Alternative
If considering Saxenda for cost, consider Orlistat:
£30-50 monthly
Different mechanism (blocks fat absorption)
Modest results (5-7% weight loss)
Unpleasant side effects if eat fat
No injection required
For some, the cheapest option that works beats expensive options.
Making Financial Sense
Cost per kg lost (based on averages):
Saxenda: £150-200
Wegovy: £180-220
Mounjaro: £140-170
Orlistat: £100-150
Mounjaro, despite higher cost, offers best value per kg lost.
The Prescription Reality
Why GPs default to Saxenda:
NICE guidelines: Saxenda appears in more pathways. Established in formularies. Lower acquisition cost.
Risk aversion: Longer safety record. Fewer unknowns. Comfortable prescribing.
Patient expectation: Many request "something cheaper than Ozempic."
Push back if you want newer options—you're entitled to discuss alternatives.
The Bottom Line
Saxenda is Windows 95—functional, proven, but superseded. For specific situations (adolescents, extreme budgets, needle phobia), it remains valuable. For most adults seeking significant weight loss, newer options deliver superior results.
Don't accept Saxenda just because it's offered first. Ask about alternatives. The difference between 8% and 20% weight loss is transformative.
Need honest guidance about ALL weight loss medications? WhatsApp our GPs for unbiased consultation. We'll discuss every option, including costs, explaining what fits your situation—not pushing the most expensive. Book within 24 hours.
FAQs
Can I switch from Saxenda to Wegovy? Yes, easily. Stop Saxenda, wait 2-3 days, start Wegovy at lowest dose. Most report immediate improvement in efficacy and convenience. No washout period needed.
Why is Saxenda still prescribed if it's inferior? Cost, licensing (adolescents), availability, and some patients genuinely prefer it. "Inferior" doesn't mean "ineffective"—8% weight loss is still clinically significant.
Is generic Saxenda available? Not yet. Patent expires 2026. Generic versions will dramatically reduce cost, possibly reviving interest. Until then, branded only.
Can I take Saxenda twice daily for better effect? No. Studied and doesn't improve efficacy, just increases side effects. If Saxenda isn't enough, switch medications rather than increase frequency.
Should I try Saxenda before Wegovy? Unless cost is prohibitive, no. Starting with less effective treatment wastes time and money. Go straight to what works best unless contraindicated.
