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Liraglutide / Saxenda

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Liraglutide was approved by the FDA for weight loss in late 2014. It’s a newer class of drugs better known for its ability to improve blood-sugar control. Liraglutide is also known by two other names, Victoza and Saxenda. Victoza is a medication that was actually designed to treat type II diabetes, but it has also been FDA approved to treat weight loss under a different name, Saxenda. What makes these two medications different is how they are dosed. 

For purposes of explaining how both these medications work, we’ll talk about them both under the name Liraglutide

Benefits and Effectiveness of Liraglutide

  • Helps slow food leaving your stomach
  • Helps prevent your liver from making too much sugar
  • Helps the pancreas produce more insulin when your blood sugar levels are high
  • Can help control blood glucose
  • Can reduce hyperglycemia, especially after meals
  • Can reduce fasting insulin and fasting glucose
  • Can reduce hemoglobin A1c
  • Can decrease appetite and caloric intake, while inhibiting weight gain
  • Has been shown to lower triglyceride levels and oxidative stress from high LDL
  • Has been shown to help induce weight loss in obese patients with higher dosing
  • Helps decrease leptin and increase leptin sensitivity
  • Can increase the conversion of white fat to brown fat

The addition of Liraglutide to calorie restriction significantly augmented weight loss and improved insulin resistance, systolic blood pressure, glucose, and triglyceride concentration in this population at high risk for development of type 2 diabetes and cardiovascular disease.

What is Liraglutide?

Liraglutide is a medication that falls into the GLP-1 agonist class of drugs. GLP-1 stands for Glucagon-like peptide 1. GLP-1 is secreted when we consume carbohydrates and fats. It stimulates release of insulin, suppression of glucagon, slower gastric emptying, and increased satiety (fullness). Liraglutide affects these receptors and causes changes to various hormones involved in regulating body weight: insulin, glucagon and leptin.

Leptin

Leptin is a hormone that is produced by your body's fat cells. It is supposed to tell your brain that — when you have enough fat stored — you don't need to eat and can burn calories at a normal rate. Leptin's main role is long-term regulation of energy, including the number of calories you eat and expend, as well as how much fat you store in your body. People who have a lot of excess weight also have high levels of leptin.

Our brains should know that we have plenty of energy stored. Sometimes our leptin signaling doesn’t work and we develop leptin resistance. This is when we have an abundance of leptin, but the brain doesn't see or recognize it. When your brain doesn't receive the leptin signal, it mistakenly thinks that your body is starving even though it has plenty of energy stored. This condition is now believed to be one of the main biological contributors to obesity.

Leptin can determine if you lose weight and how much. GLP-1 agonists like Liraglutide can help lower leptin resistance. It does this by helping to change the biochemistry of the body and at the same time decrease the rise in leptin resistance once you start losing weight. This helps to naturally reduce your appetite, increase your metabolism and increase fat burning capacity. Correcting this allows for weight loss to occur and more importantly helps you keep off the weight that you have lost. 

Insulin

Liraglutide also helps reduce insulin resistance. Insulin resistance is when cells in your body start resisting or ignoring the signal that insulin is trying to send out—which is to help glucose enter our cells from the bloodstream. Insulin is also a very important hormone involved in weight loss. High insulin levels make it almost impossible for your body to burn fat.

Insulin blocks an enzyme called hormone-sensitive lipase (HSL). This hormone is responsible for the mobilization of fatty acids from fat cell stores. If levels of insulin are high, it blocks this enzyme. Studies show that HSL is decreased in patients with type 2 diabetes mellitus, and this may be a consequence of elevated insulin levels.Excess insulin also has the added problem of promoting fat storage. 

​Liraglutide helps sensitize the body to insulin levels and helps to lower blood glucose levels. It also helps reduce fasting insulin and glucose levels. Once insulin levels are stabilized to normal levels this may also improve other hormone imbalances (testosterone for example) which will naturally result in weight loss and a reduction in symptoms associated with those imbalances.

GLP-1 agonists like Liraglutide help reduce insulin resistance and lower blood sugar. This then activates hormone-sensitive lipase and results in more fat burning activity over time. 

Glucagon

Glucagon helps increase blood sugar levels while insulin lowers blood sugar levels. They are opposites. For hormone-sensitive lipase (fat burning enzyme) to be activated, insulin and glucagon (from glycogen stores) need to be at relatively low levels. High glucagon can also interfere with normal glucose control which in turn can alter how your body burns energy. ​

Liraglutide and other GLP-1 agonists help reduce glucagon levels while simultaneously reducing insulin resistance. Both of these changes promote more normal blood glucose levels and help promote proper liver metabolism of glucose and help adipose tissue burn fat. ​Glucagon is just as important in the regulation of glucose levels in the body. Treating both insulin and glucagon leads to normal glucose levels and weight loss.

Liraglutide (Saxenda & Victoza) helps naturally improve your metabolism over time, probably through its effects on leptin levels. Leptin feeds back to your hypothalamus and helps set your body set point - the number of calories your body burns which in terms alters your appetite.

Remember, our body is constantly trying to match the number of calories you burn to the number of calories that you consume. 

Dosing: Saxenda vs Victoza

Saxenda and Victoza are the exact same medication. Both medications use the same active ingredient, which is Liraglutide. Liraglutide is the reason that these medications both work. Where they differ is in dosing and how they are FDA approved.

Victoza is FDA approved for type II diabetes in the following dosages:

  • 0.6mg per day
  • 1.2mg per day
  • 1.8mg per day

Saxenda is FDA ​approved for weight loss at the following dosages: 

  • 3.0mg per day

The main difference between the two is just the dose and what they are approved to treat. What's important is when to increase your dose, how often you increase the dose, and when to dose the medication. The benefits listed above are only achieved at a certain minimum dose and this dose is different for each person. 

The medication comes in a pre-filled pen or a multi dose vial and is injected into your body once each day, at any time of the day. We will work with you to reach the correct dose.

Side Effects of Liraglutide

In clinical trials, the most common side effects observed in patients treated with Liraglutide (Victoza or Saxenda) were nausea, low blood sugar, diarrhea, constipation, vomiting, headache, decreased appetite, upset stomach, fatigue, dizziness, and abdominal pain.

In addition, some patients who took Liraglutide reported serious side effects including pancreatitis, gallbladder disease, renal impairment, and suicidal thoughts. Liraglutide can also raise heart rate. You should stop taking it if you notice an increase in your resting heart rate that continues over time.

How Transformyou can help

Transformyou offers a free consultation for anyone looking into their medical weight loss options. In the consultations, we work together to develop a medical weight loss plan that is safe and effective for you. Schedule your consultation today!

Transformyou serves patients in the Phoenix AZ metro area including Tempe, Chandler, Gilbert, Mesa, Scottsdale, Ahwatukee, Peoria, Glendale, Avondale, and Fountain Hills. All patients always work directly with one of our physicians to ensure patient safety and confidentiality.