According to the World Health Organization (WHO), obesity has nearly tripled since 1975. This has led to a steep rise in obesity-related complications—such as diabetes and heart disease—among the general population. Conversely, getting to a healthy weight range can improve overall health outcomes for adults with excess weight. Unfortunately, because genes make up 80% of our body weight, exercise and diet alone may not always be effective in inducing and maintaining weight loss.

Weight loss medications have been shown to be an effective, complementary treatment to lifestyle modifications. They work on a biological level to support and sustain healthy weight loss. Of these medications, liraglutide—a glucagon-like peptide-1 (GLP-1) receptor agonist—is one of the market's newer FDA-approved weight loss treatments and is available under two brand names:

• Victoza: Available as a 1.8 mg daily-dose formulation

• Saxenda: A 3.0 mg once daily subcutaneous injection

How liraglutide became a weight loss medication

The FDA first approved Victoza for the treatment of type 2 diabetes in 2010. Soon after, users of the drug began reporting increased weight loss, in addition to an improved glycemic profile. Initial clinical trials found this effect to be dose-dependent, which means increased dosages led to greater weight reduction.

Subsequent, larger-scale studies confirmed the efficacy of liraglutide in inducing weight loss. As a result, the FDA approved Saxenda injections (the 3.0 mg formulation) for weight loss in 2014.

Here at NOVI Health, we’ve successfully used liraglutide in tandem with health coaching for our patients with chronic disease and have found its effect on weight loss promising. We break down everything you need to know about liraglutide in this article. Read on to learn more.

How does liraglutide work?

Liraglutide is structurally similar (sharing a 97% amino acid sequence) to GLP-1—a polypeptide incretin hormone. The L-cells of the gastrointestinal tract secrete GLP-1 in response to food. This triggers a complex cascade that leads to:

• Increased insulin release

• Lowered plasma glucagon concentration

• Delayed gastric emptying

• Appetite suppression

Liraglutide mimics the effects of GLP-1, given their similar structures. In other words, by acting on GLP-1 receptors in the central nervous system (CNS) and gastrointestinal tract, it suppresses appetite and delays gastric emptying, promoting a sense of fullness. This, in turn, leads to weight loss.

In addition, Saxenda has a lower risk of hypoglycemia than most other anti-diabetic treatments. This is because it regulates the increase in insulin in proportion to the glucose content of food. 

Who is liraglutide suitable for?

Liraglutide is a safe and effective adjunct treatment to lifestyle modifications for obesity and diabetes. The American Heart Association, American College of Cardiology, and The Obesity Society recommend its use in individuals having a BMI greater than:

Saxenda, in particular, has been proven effective for individuals living with obesity and diabetes who’re at risk for cardiovascular disease. That is why we recommend and use Saxenda as the liraglutide medication here at NOVI Health.

Is Saxenda safe and effective for weight loss?

Four drugs, other than GLP-1 agonists, are currently FDA-approved for weight loss. These include:

• Orlistat

• Lorcaserin

• Combinations of phentermine/topiramate

• Naltrexone/bupropion

While all of them can induce weight loss, the effect is not equal. A recent meta-analysis shows liraglutide to be among the most effective at triggering and maintaining weight loss. The reasons for this aren't entirely clear. However, experts believe this is likely due to liraglutide’s relatively safe side-effect profile and its multi-prong mechanism of action.

Additionally, users of Saxenda also report greater satisfaction and fewer episodes of hypoglycemia. This likely stems from its simplified dosing regimen and concurrent improvements in critical parameters such as HbA1c and fasting blood glucose levels (FBGs).

How to incorporate Saxenda for sustainable weight loss

Lifestyle modifications are the cornerstone of any weight loss program. However, recent studies show that this may be far from the ideal approach without complementary pharmaceutical therapy.

We understand that taking medications for weight loss may seem counterintuitive to some. However, scientific literature overwhelmingly supports their use. On average, diet and exercise-only weight loss programs produce a 5% reduction in body weight. When combined with Saxenda prescriptions, though, the percentage reduction in body weight soars to 10%. Think of them as a safe, readily available treatment that can lay the foundation for you to build upon.

Saxenda weight loss medications work well because they work in multiple ways to address the underlying biology related to obesity. In other words, liraglutide reworks the body's metabolism—inducing sustainable weight loss. In a study involving individuals with obesity who’re non-diabetic, users of the drug reported lower food intake and decreased hunger levels. Thus, Saxenda not only helps induce weight loss but also reduces food cravings, easing the process for you. You no longer have to rely on willpower to resist cravings. 

For those who aren’t convinced, well, the results speak for themselves. A randomized control trial of 564 non-diabetic obese individuals proved that liraglutide 3.0 mg was more significant for weight loss than lifestyle interventions alone. On top of that, the results were consistent over the short and long term. In another trial involving 3,731 patients, the Saxenda group lost 7.4% of body weight versus 3% with placebo at 56 weeks.

*Results based on clinical trials. Individual outcomes may vary.

The benefits of the drug extend to individuals with diabetes too. For example, the largest trial of its nature—the SCALE obesity and prediabetes study—evaluated the effect of Saxenda on overweight and obese individuals with prediabetes or diabetes. The study showed that participants reported statistically significant weight loss by the end of 56 weeks. On top of that, Saxenda also boosted weight loss by 6% in 422 subjects who had previously only relied on exercise and diet alone. 

Saxenda side effects

Saxenda, like any other medication, is not free from side effects. Luckily, these side effects are usually relatively mild and limited to:

• Nausea

• Headaches

• Fatigue

• Stomach pain

• Dizziness

• Children may also experience the occasional fever or upset stomach

More serious side effects with Saxenda can also occur, but these are rare. Examples include:

• Acute pancreatitis—inflammation of the pancreas

• Gallstones and other gallbladder abnormalities

• Increased heart rate—the clinical significance of this remains unknown

• Anaphylactic (allergic) reactions

• Depression

Given the possible associations between GLP-1 receptor agonists and thyroid abnormalities, doctors advise against their use in patients with a family history of medullary carcinoma of the thyroid or MEN (multiple endocrine neoplasias).

Other contraindications include pregnancy. Saxenda is also not recommended in lactating mothers or patients taking insulin or other GLP-1 receptor agonist.

How to access Saxenda in Singapore

Saxenda (liraglutide) is a prescription-only medication. You’ll need to speak to your healthcare provider to understand and determine whether Saxenda is suitable for you. 

The price of a Saxenda injection in Singapore ranges between S$130 and S$160. Each dose lasts for 5 days. The total cost over a month averages out to around S$700.

Looking for a safe and proven weight loss method? NOVI Optimum Plus is our weight loss program that uses GLP-1 medication, such as Saxenda, in tandem with a scientific dietary and exercise program to help you lose weight and keep it off for good. Book your consultation today.