Wegovy vs. Saxenda: What's the difference?

Obesity is a complex yet worldwide health issue that is currently impacting thousands of individuals. It is generally caused by when extra calories are stored in the body as fat. If an individual has a high-calorie intake but does not use all of this energy through physical activity, that extra energy will be stored in the body as fat.

According to the NHS, the average physically active male needs approximately 2,500 calories and physically active female requires around 2,000 calories per day.

There are many reasons why obesity develops and some of them include:

• Eating large amounts of fast food or processed food - these foods are high in fat and sugar and contain excessive calories

• Eating fewer home-cooked meals and more restaurant/takeaway food - this food can be higher in fat than home-cooking

• Drinking too much alcohol - alcohol contains a lot of calories

• Eating larger portions than necessary

• Comfort eating

• Underactive thyroid gland

• Cushing's Syndrome

• Certain medications such as steroids, some antidepressants etc

• A side effect of stopping smoking

• Genetic conditions such as Prader-Willi syndrome

Prescription medication is available to aid weight loss. These include weight loss injections and tablets. These medicines play a huge role in supporting weight loss and can be very impactful on a person's health and lifestyle.

Losing excess weight and modifying your food intake can have a significant impact on weight-related medical problems such as high blood pressure, and high cholesterol, and cardiovascular diseases such as heart attack and stroke etc.

The two current weight loss injections that are taking the weight loss world by storm are Saxenda and Wegovy. Wegovy is a once weekly injection whilst Saxenda is a daily injection. They both work by making an individual feel fuller, quicker and longer, decreasing their overall calorie intake.

An Overview of Wegovy

Wegovy is indicated as an adjunct to a calorie-controlled diet and increased physical activity for chronic weight management. Wegovy is a weight loss injection that contains the active ingredient Semaglutide. Semaglutide is part of a group of drugs called GLP 1 receptor agonists. These drugs work by making the stomach empty slower, also known as gastric emptying, and therefore regulate appetite. Wegovy is manufactured by the Danish pharmaceutical company Novo Nordisk.

Wegovy is a licensed weight loss treatment that is FDA-approved. Semaglutide works by mimicking the hormone glucagon-lie peptide-1 which targets an area of the brain that plays a part in regulating appetite. It is a once-weekly dose, taken on the same day at around the same time. You should aim to stick to the dosing schedule as fluctuations in day and time can lead to harmful side effects such as pancreatitis.

Wegovy works by making you feel fuller, quicker and longer, giving you a feeling of early fullness. The maximum dose of Wegovy is 2.4mg and works on a monthly titration basis. A study was conducted in 2021; 'A new weight loss drug for chronic weight management'. The study found that semaglutide was found to be superior in reducing a participant's body weight when compared with a placebo. Other successes such as decreasing waist circumference and BMI (body mass index) were observed.

In a 68-week trial, patients taking Wegovy achieved around 15% weight loss or around 35 pounds of body weight reduction. This shows a significantly greater weight loss in patients who take Wegovy compared to those just on lifestyle modifications.

How much weight you lose depends on how well you implement a healthy lifestyle. If you eat fewer calories and do more exercise, you will see the beneficial effects.

Wegovy must not be thought of as a magic pill. It will not do the work for you if you do not work with it. It is important to have a reduced-calorie diet to support your weight loss journey.

Wegovy Dosing Schedules

The starting dose for Wegovy is 0.25mg once a week for four weeks. The dose increases every four weeks until you reach a maximum dose of 2.4mg.

Doses are: 0.25mg, 0.5mg, 1mg, 1.7mg, 2.4mg.

You should not increase your dose of Wegovy too early unless you have been advised to do so by a doctor.

As with all drugs, Wegovy does have side effects. Common side effects include:

• Nausea

• Vomiting

• Headaches

• Diarrhoea

• Constipation

• Stomach ache/ abdominal pain

• Tiredness

Using Wegovy inappropriately and not sticking to the dosing regimen leads to an increased risk of pancreatitis (inflammation of the pancreas). This can occur if you are not injecting weekly and are injecting more than once a week. Your risk of pancreatitis can also increase if you do not titrate the dose and believe you will be acceptable to start on a higher dose despite not taking it before or having more than a few weeks break in treatment.

An Overview of Saxenda

Saxenda is a licensed weight loss treatment that has been available to purchase for several years. It works similarly to the Wegovy but is a daily injection rather than weekly. Saxenda is a weight loss injection that helps regulate hunger and demonstrates clinically significant weight loss. Saxenda contains the active ingredient Liraglutide. Liraglutide is part of a group of drugs called GLP 1 receptor agonists. Similar to Semaglutide, Liraglutide works on stomach emptying, reducing appetite and helping you to lose weight.

Saxenda has a quick onset of action and begins to work right away which can aid appetite reduction in a few days. You should start to see weight loss results in a matter of a few months. You can expect to lose at least 5% of your initial weight after 17 weeks of treatment, although, this can vary from person to person depending on their lifestyle, how well they are eating and how much exercise they are doing regularly.

Research suggests Liraglutide has a significant effect on weight loss in a higher number of patients than comparative drugs such as Orlistat. It also has a positive effect on cardiovascular health.

Common side effects of Saxenda include:

• Nausea

• Vomiting

• Headache

• Diarrhoea

• Constipation

• Redness or inflammation at injection sites

For an extensive list of side effects, please see the patient information leaflet.

Saxenda cannot be used in pregnant or breastfeeding women. The active ingredient Liraglutide can cause foetal harm.

Saxenda is a weekly titration weight loss medication used to support weight loss. Patients would start the dose at 0.6mg and increase in weekly increments of 0.6mg until they reach a maximum dose of 3mg. When you initially start Saxenda, your pen will last around 17 days. When you reach 3mg, your pen will last 6 days.

How to use Saxenda

Check the fluid before injection - it must be clear and free of particles. If your medication is coloured, cloudy or has particles in it, do not use it and contact your provider immediately.

• Attach a new needle to the pen. A new needle must be used for each dose.

• Turn the dose selector until you have selected the correct and appropriate dose

• Remove the needle cap and insert the needle into the skin at a straight angle (90 degrees)

• Press the dose button and hold the pen into the skin for six seconds

• Remove the pen from the skin and dispose of the needle in a sharps bin.

Saxenda can be injected into the upper arm, abdomen or thigh, though, the abdomen is preferred. You should vary the site of injection on the chosen body part to prevent scarring or bruising to the area.

Buying Saxenda and Wegovy

Both Wegovy and Saxenda can be purchased through Quick Meds via our private weight loss clinic. They are not over-the-counter medications and cannot be purchased without an in-depth consultation online and with our clinical pharmacists. Requirements must be met for the weight loss medication to be prescribed.

Saxenda and Wegovy can be requested online via the Quick Meds website. We require you to fill out an online questionnaire which is then assessed by our clinical pharmacists. This may be followed up with a call to discuss the drug in question and any key information you may require to safely use the treatment.

These treatments are available on the NHS but only through a specialist for weight management and the waiting list may be quite long.

Comparative Analysis: Wegovy Vs. Saxenda

Dosing

Wegovy: A once-weekly injection

Saxenda: A daily injection

Effectiveness

Wegovy: A very potent GLP 1 receptor agonist, approx 15% average weight loss

Saxenda: A potent GLP 1 receptor agonist, approx 7% average weight loss

Cost

Wegovy: Pricing varies, but you only need one pen per month.

Saxenda: At the treatment dose, you'll require six pens per month, which can cost anywhere from £70 - £100 per pen.

Side effects

Wegovy: Common side effects include; nausea, vomiting, constipation, diarrhoea

Saxenda: Common side effects include; nausea, vomiting, constipation, diarrhoea

Patient experiences

Wegovy: Once weekly injection, is far more convenient, and more effective and patients generally find it better in terms of ease of use compared to Saxenda.

Saxenda: The daily injection can become tedious but overall has a good effect on weight loss and appetite. Eventually, you come to a plateau after several months of use. Mild side effects.

Expert Opinions and Recommendations

Semaglutide and Liraglutide have already had a significant impact on the lives of many patients who have sought treatment through Quick Meds.

If you are having difficulties losing weight and need assistance, Wegovy or Saxenda may be the treatment you need.

Conclusion

Both Wegovy and Saxenda have their advantages and disadvantages and there may be personal reasons as to why you would prefer one over the other. Ultimately, the patient decides to choose a treatment that is best suited to them and their lifestyle.

The future of Obesity treatment is uncertain but we anticipate even greater things than what we currently have.