Why am I not losing weight on Saxenda?

In this article:

• Saxenda and weight loss
• Why isn’t Saxenda working?
• What to do if Saxenda isn’t working
• Patience and consistency
• When to talk to your doctor

In this article

• Saxenda and weight loss
• Why isn’t Saxenda working?
• What to do if Saxenda isn’t working
• Patience and consistency
• When to talk to your doctor

Between 2019 and 2023, the number of American adults without Type 2 diabetes who used a glucagon-like peptide-1 receptor agonist (GLP-1) rose more than 700%, and for good reason: These weight loss drugs are very effective.

Saxenda (liraglutide) is one such medication, a daily injectable that is FDA approved for people with obesity or those who are overweight. While many people have success with the drug, it’s possible that you’ve found yourself disappointed that your weight loss isn’t progressing the way you’d like. 

There are several reasons Saxenda may not be working for you, including dosage, lifestyle factors, and underlying medical conditions, including the medications used to treat them. Understanding what your roadblock is could be the key to reaching a healthy weight. 

Understanding how Saxenda works

Saxenda is a GLP-1 receptor agonist, which means it binds to GLP-1 receptors, also known as “appetite hormones.”

“GLP-1 is a natural gut hormone that ‘talks’ with your brain, helping you to feel full sooner and slowing down how quickly food leaves your stomach,” says Erika Gray, Pharm.D., founder and chief medical officer at ToolBox Genomics.com. “This medicine is designed to act like natural GLP-1, helping people lower the amount of calories they eat.”

Very basic weight loss math states that if you burn more calories than you consume, you should lose weight. Saxenda regulates blood sugar levels and helps you eat less, contributing to a potential caloric deficit.

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Why isn’t Saxenda working for you? The common culprits

There are a few common reasons that Saxenda may not be giving you the weight loss results you hope for: 

1. Unrealistic expectations

If you expect to lose significant weight quickly or see results in just a few weeks, you may be feeling let down. The Saxenda website itself states that adults taking the medication should lose only roughly 4% of their body weight in the first four months. 

2. Too low a dose

It’s very common with GLP-1s to start on a low dose of the medication and increase it to find the correct amount of the drug for the results you want. Most people start Saxenda with 0.6 mg and increase the dose by 0.6 mg per week. Having an incorrect dosage of Saxenda could affect the amount of weight you lose.

3. Inconsistent or incorrect use

Saxenda can be taken at any time of day, though missing multiple doses could lead to inconsistent results. Additionally, if you incorrectly inject the medication, it may not be effective at all. 

4. Dietary missteps

If you’re on a high-calorie diet or one that is imbalanced with a lot of processed foods, you may struggle to lose weight. Mismanaged nutrition may mean you are consuming more calories than you burn, which can lead to weight gain.

5. Lack of exercise

The oversimplified recipe for significant weight loss is to consume fewer calories than you burn. If you do not burn enough calories throughout the day, weight loss becomes next to impossible. Inactivity can contribute to an imbalance between calories burned versus consumed. In addition, muscle tissue is more metabolically active than fat tissue; muscle can actually burn calories at rest in addition to during exercise. It’s important to incorporate an exercise regimen in any weight loss plan. 

6. Poor sleep

Sleep deprivation is the cause of many things: cranky mornings, dark circles under your eyes, and, unsurprisingly, challenges with weight loss. A review of 10 studies found that better, longer sleep has been linked to weight loss success. Poor sleep, whether that means disrupted sleep or not enough sleep, was linked to an increase in snacking.

7. High stress

People who experience stress may be more likely to gain weight because stress increases cortisol production. Cortisol is the enemy of weight loss because it promotes fat storage, slows metabolism, and increases appetite. 

8. Underlying medical conditions or medications

There are some medical conditions that can make weight loss difficult, such as polycystic ovarian syndrome, hypothyroidism, and Cushing’s syndrome. People experiencing hormonal changes or depression may also find weight loss challenging. In addition, some medications can contribute to weight gain due to various mechanisms, such as corticosteroids, certain antipsychotics, and some antidepressants. 

What to do when Saxenda isn’t delivering results

Before throwing in the towel on Saxenda, check if there are steps you can take to enhance your weight loss. 

Set reasonable goals

Work with your healthcare provider to determine a reasonable goal for your weight loss. During a 56-week trial, liraglutide was shown to help people experience an average weight loss of between 5% and 10% of their body weight. Calculate what that means for you over the same timeframe, and work with your doctor to establish key milestones. 

Know your dosage

Saxenda dosage changes every week, starting at 0.6 milligrams and increasing each week until you hit 3 milligrams. Know your prescription and use the medication correctly. The Saxenda website states that the injection should be made under the skin in your stomach, upper leg, or upper arm. Do not use the same site repeatedly; rotate the spot you use. 

Maintain a healthy diet

It all starts with a balanced diet and a solid meal plan that targets a lower calorie intake. If necessary, work with a dietitian to determine where you should make changes.

“Decrease the amount of processed foods in your diet and focus on increasing the amount of lean proteins, fiber, whole grains, and healthy fats, like avocado, nuts, olive oil,” says Dr. Gray. 

In addition to getting on a reduced-calorie diet, try these tips:

• Keep a food journal: One study found that participants who tracked their food were more likely to lose more weight than those who didn’t.
• Avoid certain foods: “Foods people can do their best to avoid include sugary foods and drinks, alcohol, and very high-fat food,” Dr. Erika Gray explains.
• Drink water: Plenty of H20 has proven effective for people with weight loss goals; one study suggests consuming 1.5 liters (or 50 ounces) a day to see results. 

Incorporate exercise

A study that followed roughly 200 people for eight weeks found those who paired liraglutide with physical activity lost more weight than those using a placebo or exercising alone. Even more significantly, those who used the drug and had an exercise regimen were the only ones who experienced improvements in their fitness levels and their insulin sensitivity.

If you’re struggling with knowing where to start with exercise, you can work with a personal trainer to tailor a plan. Or, keep it basic: The Centers for Disease Control and Prevention recommend 150 minutes of moderate activity or 75 minutes of vigorous activity each week and two days of strength training. That could look like:

• A brisk 30-minute walk five days a week and two days of strength training
• A vigorous 20-minute jog four days a week and two days of strength training
• Two days of moderate-to-vigorous exercise for about 45 minutes and two days of strength training

Get better sleep

All adults, especially those seeking sustainable weight loss, should get between seven and nine hours of sleep a night. Easier said than done, right? Here are a few simple ways you can work toward improving your sleep quality:

• Go to bed around the same time every night so your body’s circadian rhythm is regulated.
• Avoid caffeine after noon, as it’s known to cause sleep disturbances.
• Keep your room dark and cool; the ideal temperature for sleep is between 60 and 67 degrees Fahrenheit.

Manage stress 

A small study of 45 adults found that those who participated in an eight-week stress management program had lower body mass index (BMI) and even improved dietary habits. 

While you don’t need to necessarily jump into a program, you can find ways to lower your stress levels. For example, you can meditate, exercise, and journal. If you’re experiencing serious stress and anxiety, seek help from a professional.

Talk to your healthcare provider

If you’re struggling to determine why you aren’t losing weight on Saxenda, seek medical advice from your provider. There may be underlying health conditions causing your weight loss plateau. A healthcare provider is best equipped to talk about your medical history, lifestyle changes, and other factors that could affect weight loss. 

The importance of patience and consistency

If you’re serious about your weight loss goals, it’s understandable that you’re ready for change, and you’re ready for it now. It’s great to be eager, but remaining consistent in your habits is key to long-term success in weight management.

One study evaluated nearly 200 people enrolled in a yearlong program to lose weight alongside behavioral changes. Those who experienced a lot of variability in their weight loss early in the program had worse long-term outcomes than those whose weight loss was more consistent.

Patience is also crucial, not only for your peace of mind but also for your health.

“Just as weight gain did not happen overnight, we can’t expect weight loss to, either,” says Jennie Stanford, MD, an American Board of Obesity Medicine Diplomate. “In fact, suboptimal nutrition is a risk of rapid weight loss, particularly with medications.” 

When to talk to your healthcare provider

A qualified healthcare professional is one of the most important assets you have when you are taking a weight loss medication like Saxenda, Ozempic, or Wegovy. Not only can they help you determine the right drug and dosage, but they are also your touchpoint for any issues you may have along your weight loss journey.

RELATED: Saxenda vs. Wegovy for weight loss

For example, if you experience Saxenda side effects, your healthcare provider can help determine which are expected and which are more worrisome. Common side effects include nausea, dizziness, constipation, headaches, and pain at the injection site. Usually, these side effects become less intense as your body adjusts to the medication within the first few weeks of taking a new dose. 

There are more serious side effects, however, that require immediate medical attention, according to Dr. Erika Gray:

• Severe, constant pain in the belly that spreads to your back
• Pain in the upper right belly along with fever, yellowing skin, and/or pale stools
• Swelling of the face, lips, or tongue, trouble breathing, and/or rash shortly after injecting
• Fast or intense heartbeat for seemingly no reason
• Excessive diarrhea or vomiting leading to being unable to retain fluids
• Dangerously low blood sugar (this is a high risk for those on diabetes medications like glipizide or insulin)
• A neck lump, hoarseness, or difficulty swallowing that appears after starting the injections

“It’s important to tell your provider of any family history of thyroid cancer, as this medication may increase the chance of it developing,” Dr. Erika Gray warns.