Saxenda alternatives: What can I take instead of Saxenda?

In this article:

• What can I take instead of Saxenda?
• What can I take instead of Saxenda?
• Compare Saxenda alternatives
• Over-the-counter weight loss alternatives
• Natural alternatives to Saxenda
• How to switch to a Saxenda alternative
• Choosing the right path for weight loss

In this article

• What can I take instead of Saxenda?
• What can I take instead of Saxenda?
• Compare Saxenda alternatives
• Over-the-counter weight loss alternatives
• Natural alternatives to Saxenda
• How to switch to a Saxenda alternative
• Choosing the right path for weight loss

Saxenda (liraglutide) is a GLP-1 agonist medication that’s commonly prescribed for weight management in people with a body mass index (BMI) of 30 or more—or 27 or more with another weight-related condition. But it’s not a perfect fit for everyone. Some people might find it ineffective. Some might experience too many side effects. Others might discover that their insurance plan provides better coverage for other drugs. No matter what’s sent you in search of a Saxenda alternative, there are several viable options.  

What can I take instead of Saxenda?

Historically, the Food and Drug Administration (FDA) hadn’t approved many medications specifically for weight loss, but the list has started to expand in recent years. The most direct comparisons to Saxenda are other GLP-1 agonists, which can treat obesity and Type 2 diabetes by helping patients control their blood sugar. Outside the GLP-1 umbrella, however, you might consider certain appetite suppressants, central nervous system stimulants, lipase inhibitors, or combination agents. 

Top Saxenda alternatives

The following are some of the most common alternatives to Saxenda.

1. Zepbound (tirzepatide)

“If someone wants an alternative that still works in the same way, then I recommend tirzepatide first,” says Austin Shuxiao, MD, founder and medical director of Peach IV. And that’s because it could be more effective. GLP-1 drugs like Saxenda and Zepbound both mimic the GLP-1 hormone, which helps regulate appetite and blood sugar. 

However, Zepbound is classified as a dual GIP/GLP-1 agonist. It also mimics another hormone called GIP, which influences insulin secretion and lipid metabolism—so it might outperform GLP-1 drugs. In fact, a 72-week study found that tirzepatide patients lost 20.2% of their body weight, while those taking semaglutide (Ozempic, Wegovy) only lost 13.7%. Additionally, Zepbound lasts longer in the body than Saxenda, so instead of a once-daily dose, it only requires one injection per week. 

2. Wegovy (semaglutide)

Wegovy might have a different active ingredient than Saxenda, but as another GLP-1 drug, it functions similarly. Both drugs influence gastric emptying and blood sugar, and both can cause similar gastrointestinal side effects like nausea, vomiting, and constipation. However, while Saxenda is a once-daily injection, Wegovy is once weekly, so it might appeal to people who prefer fewer doses. Additionally, a head-to-head study from 2022 found that patients who took semaglutide lost more weight over 68 weeks than those who took liraglutide. 

3. Qsymia (phentermine–topiramate)

According to Jennifer Brown, MD, medical and health writer at MyObesityTeam, “The most effective prescription weight loss medication, outside of GLP-1s, is Qsymia.” It’s a combination of a stimulant (phentermine) and an anticonvulsant (topiramate) that can reduce appetite and increase feelings of fullness. 

The issue is that it can be harder to get than Saxenda.  “The phentermine component is a controlled substance, making it a little more challenging to prescribe,” Dr. Brown says. It is also only available through a Risk Evaluation and Mitigation Strategy (REMS) program, in which pharmacies must be certified to dispense the medication. Common Qsymia side effects include dry mouth, constipation, paresthesia (abnormal skin sensation), depression, and tachycardia (increased heart rate). Because it can affect the heart, healthcare providers may advise against it if you have a cardiovascular condition.

4. Contrave (naltrexone–bupropion)

Contrave is two drugs in one: Naltrexone, an opioid antagonist used for opioid and alcohol dependence, and an antidepressant called bupropion. Together, naltrexone’s influence on the brain’s reward system and bupropion’s effect on dopamine and norepinephrine may help reduce appetite and cravings. In clinical trials, patients taking Contrave lost an average of 8.1% body weight after 56 weeks, compared to 4.9% with a placebo (inactive treatment). 

Unlike Saxenda, Contrave carries warnings for an increased heart rate and blood pressure, as well as seizures and liver damage. Plus, due to the bupropion component of Contrave, the FDA issued a black box warning about an increased risk of suicidal thoughts and behaviors—although this warning applies to all antidepressants. That said, under the care and supervision of a healthcare provider, it can still be a safe and effective treatment. 

5. Adipex-P (phentermine)

By itself, the central nervous system stimulant phentermine is still an incredibly popular weight loss drug. In fact, it’s one of the most commonly prescribed anti-obesity drugs in the US—and it works, too. One 2021 study found an average 8%–11% weight loss, although the effectiveness may depend on the dosage. Adipex-P is an oral medication, so it’s easier to take than Saxenda, and it’s often cheaper too, especially when you use the generic form. 

Phentermine is a controlled substance and is only FDA-approved as a short-term treatment (several weeks)—although some healthcare providers may prescribe it off-label for longer. It might also increase the risk of elevated heart rate and blood pressure, so it’s not ideal for people with existing heart issues. 

6. Xenical (orlistat)

Xenical is a lipase inhibitor, so it acts on the enzymes responsible for breaking down fats and storing them in the body. Studies have associated orlistat with an 8% body weight reduction, yet a head-to-head study between orlistat and liraglutide found liraglutide more effective overall. 

However, Xenical can be much less expensive than Saxenda. And as an oral medication—taken three times per day—could be preferable to people who don’t like injections. Like Saxenda, its most common side effects are gastrointestinal and include nausea and vomiting. However, people who take Xenical may also experience cramping, gas, oily stools, and fecal incontinence—side effects that do not typically occur with Saxenda.

Compare Saxenda alternatives
Drug name	Average retail price*	SingleCare price*	Savings options
Saxenda (liraglutide)	$1,802 for 5, 3 ml of 18mg/3ml pens	$1,213 for 5, 3 ml of 18mg/3ml pens of brand-name Saxenda	Saxenda coupons
Zepbound (tirzepatide)	$1,524 per 4, 0.5 ml of 5mg/0.5ml pens	$950 for 4, 0.5 ml of 5mg/0.5ml pens of brand-name Zepbound	Zepbound coupons
Qsymia (phentermine–topiramate)	$277 for 30, 7.5-46 mg capsules	$79 for 30, 7.5-46 mg capsules of brand-name Qsymia	Qsymia coupons
Contrave (naltrexone–bupropion)	$842 for 120, 8-90 mg tablets	$613 for 120, 8mg/90mg tablets of brand-name Contrave	Contrave coupons
Adipex-P (phentermine)	$114 for 30, 37.5 mg tablets	$10 for 30, 37.5 mg tablets of generic phentermine	Adipex-P coupons
Xenical (orlistat)	$926 for 90, 120 mg capsules	$631 for 90, 120 mg capsules of generic orlistat	Xenical coupons
Alli (orlistat OTC)	$99 for 120 capsules	$93 for 120 capsules	Alli coupons
Lomaira (phentermine)	$114 for 90, 8 mg tablets	$63 for 90, 8 mg tablets of brand-name Lomaira	Lomaira coupons

*Average cost at the time of publication. Drug prices fluctuate and vary by pharmacy and location. 

Over-the-counter weight loss alternatives 

Americans spend over $2 billion per year on weight-loss dietary supplements, but it’s unclear whether these OTC options are helpful—and they might even be harmful. 

Some people might swear by certain dietary supplements, claiming to shed pounds fast, but there’s very little research to back it up. In fact, some of these products have been linked to liver failure and other serious issues, while the FDA has found others to be contaminated with undeclared chemicals.

There’s currently only one FDA-approved over-the-counter weight loss medication, and that’s Alli—an OTC version of orlistat. As noted above, research has shown some efficacy, although it might not be as effective as prescription alternatives. And some of the potential side effects of orlistat, such as oily stools and fecal incontinence, make this drug an unattractive alternative for some people.

No matter which OTC supplement has caught your eye, it’s best to run it by a healthcare provider before trying it. They can let you know if it’s safe or not. 

Natural alternatives to Saxenda

Some of the most tried-and-true weight loss treatments are natural ones, particularly diet and exercise. That’s why many healthcare providers encourage patients to implement an exercise and healthy eating plan to go along with weight loss medications. 

Even small amounts of aerobic exercise—as little as 30 minutes per week—have been linked to modest weight loss, with greater benefits seen with more exercise. And a 2023 study showed that consuming processed carbs like sugars and refined grains is associated with weight gain. “Protein has greater satiety than fiber, fat, or carbs,” Dr. Shuxiao says. And “resistance training is key as building lean muscle mass will keep metabolism higher, allowing you to burn more calories naturally throughout the day.”

Yet there are a lot of unhelpful or even unhealthy fad diets out there, so it’s best to focus on cutting calories while eating a well-rounded diet. “The particular diet plan doesn’t matter as much as eating fewer calories,” Dr. Brown says. “I particularly like the Mediterranean diet because of its other health benefits. The diet chosen is one that the patient is most likely to adhere to over the long haul.” You may also benefit from consulting a registered dietitian to help you with an eating plan that is sustainable and fits your lifestyle.

As far as vitamins for weight loss go, there’s minimal scientific evidence for their effectiveness. “My approach with patients is to counsel them about the lack of good data and review any known side effects with them,” Dr. Brown says. “If there’s a particular supplement they want to try, I advise them to give it a month to see if they lose weight. If they haven’t, it’s not worth paying for.” But not all supplements are safe for everyone, so always check with your healthcare provider before trying any.

How to switch to a Saxenda alternative

Regardless of why you want to stop taking Saxenda, it’s important to consult a healthcare provider before making any medication changes. The drug isn’t addictive, so there’s no risk of withdrawal if you stop taking it suddenly, but if you’re still trying to lose weight, you’ll also want to have an alternative lined up. 

If you’re switching to another GLP-1 agonist, Dr. Shuxiao says you should allow a one-week washout period beforehand. And Dr. Brown adds that, “a new medication must be started at the lowest dose and titrated up per the manufacturer’s recommendations to avoid potential side effects.”

Choosing the right path for weight loss

There’s no one-size-fits-all approach to losing weight. Everyone has different conditions, abilities, lifestyles, and preferences, so different drugs or natural solutions may work better for you than others. A healthcare provider can determine whether a GLP-1 medication, appetite suppressant, stimulant, or lipase inhibitor might be best. No matter which path you take, healthy eating habits and regular physical activity are essential—not just for your weight loss journey, but your overall health as well.