Saxenda and Wegovy are both GLP-1 medications approved for weight loss. They work in similar ways. But they're different drugs with different schedules, different results, and different trade-offs.
Here's how they compare.
The Quick Answer
Wegovy generally produces more weight loss than Saxenda. It's also once a week instead of daily. But Saxenda has been around longer, may cost less with insurance, and some people tolerate it better.
If your insurance covers both, Wegovy is usually the stronger choice. If only Saxenda is covered, it's still a very effective medication.
What They Are
Saxenda contains liraglutide. It's a GLP-1 medication made by Novo Nordisk. You inject it once a day. It was approved for weight loss in 2014.
Wegovy contains semaglutide. It's also made by Novo Nordisk. You inject it once a week. It was approved for weight loss in 2021.
They're from the same company but they're different drugs. Semaglutide is newer and more potent than liraglutide.
Weight Loss Results
Saxenda
In clinical trials, people on Saxenda lost an average of 5-8% of their body weight over one year.
That means a 200-pound person would lose about 10-16 pounds on average. Some people lost more. Some lost less. About 60% of participants lost at least 5% of their body weight.
Wegovy
In the STEP trials, people on Wegovy lost an average of 15-17% of their body weight over 68 weeks.
That means a 200-pound person would lose about 30-34 pounds on average. About 86% of participants lost at least 5% of their body weight. About one-third lost 20% or more.
The Difference
Wegovy produces roughly 2-3 times more weight loss than Saxenda on average. This isn't a small difference. It's significant.
That said, individual results vary. Some people do better on Saxenda than the average. Some do worse on Wegovy. Your body's response matters more than trial averages.
Dosing Comparison
Saxenda (daily)
- Week 1-4: 0.6 mg daily
- Week 5-8: 1.2 mg daily
- Week 9-12: 1.8 mg daily
- Week 13-16: 2.4 mg daily
- Week 17+: 3.0 mg daily (maintenance dose)
The slow ramp-up helps your body adjust and reduces side effects. The target dose is 3.0 mg per day.
Wegovy (weekly)
- Month 1: 0.25 mg weekly
- Month 2: 0.5 mg weekly
- Month 3: 1.0 mg weekly
- Month 4: 1.7 mg weekly
- Month 5+: 2.4 mg weekly (maintenance dose)
Same idea — slow ramp-up. The target dose is 2.4 mg per week.
Daily vs Weekly: Which Is Better?
Weekly (Wegovy) advantages:
- One injection instead of seven
- Easier to remember
- Less "needle fatigue"
- More stable medication levels in your body
Daily (Saxenda) advantages:
- If you have a bad side effect day, it clears your system faster
- More flexibility to skip a dose if needed
- Some people prefer the daily routine
Most people prefer weekly. But daily isn't a dealbreaker.
Side Effects
Both medications cause similar side effects. The most common:
- Nausea
- Diarrhea
- Constipation
- Vomiting
- Headache
- Fatigue
Saxenda side effect rates (from clinical trials):
- Nausea: about 42%
- Diarrhea: about 31%
- Constipation: about 21%
- Vomiting: about 16%
Wegovy side effect rates (from clinical trials):
- Nausea: about 44%
- Diarrhea: about 32%
- Constipation: about 24%
- Vomiting: about 25%
The rates are similar. Wegovy has slightly higher rates of some side effects, likely because it's more potent. But the difference is small.
For most people, side effects are worst during the first few weeks and after dose increases. They improve over time.
Cost
This is where things get complicated.
Saxenda
- List price: about $1,300-$1,400 per month
- Often covered by insurance for weight loss (older drug, more plans cover it)
- Novo Nordisk savings card may reduce cost to as low as $25/month for eligible patients
Wegovy
- List price: about $1,300-$1,500 per month
- Insurance coverage is improving but still inconsistent for weight loss
- Novo Nordisk savings card may reduce cost to as low as $25/month for eligible patients
- Medicare generally doesn't cover Wegovy for weight loss alone
The reality: Your actual cost depends entirely on your insurance. Some people pay $25/month for either medication. Others pay full price. Check with your plan.
Who Might Choose Saxenda
- Your insurance covers Saxenda but not Wegovy
- You've tried Wegovy and didn't tolerate it well
- You prefer daily injections
- You want a medication with a longer safety track record (Saxenda has been used since 2014)
- Cost is lower for you with your specific insurance plan
Who Might Choose Wegovy
- You want the most weight loss possible
- You prefer weekly injections
- Your insurance covers it
- You've tried Saxenda and didn't lose enough weight
- You want the additional heart health benefits shown in the SELECT trial
Can You Switch Between Them?
Yes. Your doctor can help you transition from one to the other.
Switching from Saxenda to Wegovy: You'll start Wegovy at the lowest dose (0.25 mg) and work your way up, even if you were on a high dose of Saxenda. This is because the drugs are different and your body needs to adjust.
Switching from Wegovy to Saxenda: Similarly, you'll start Saxenda at the lowest dose (0.6 mg) and ramp up.
Don't switch on your own. Your doctor will guide the transition.
The Bottom Line
Wegovy produces more weight loss than Saxenda. It's also more convenient with weekly dosing. If you have a choice and your insurance covers it, Wegovy is usually the better option.
But Saxenda is still an effective weight loss medication. If it's what your insurance covers or what your body tolerates better, it's a solid choice.
Your action items:
- Check which medication your insurance covers and at what cost
- Talk to your doctor about which makes more sense for your situation
- Don't compare your results to trial averages — your body is your own
- Give any GLP-1 at least 3-6 months before deciding it's not working
- Focus on habits (protein, exercise, sleep) alongside the medication for best results
The best GLP-1 is the one you can access, afford, and tolerate.
This article is for informational purposes only and does not replace medical advice. Always talk to your healthcare provider about which medication is right for you.
Products that can help
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- Sharps disposal container — safe disposal for used injection needles
- Alcohol prep pads — clean injection sites before each shot
- Injection site rotation chart — keep track of where you inject each week