However, these other medications have not yet proven in research to aid in weight loss as effectively as liraglutide.
For patients on the drug for its original purpose — improving blood sugar levels —liraglutide works in three specific ways:
- It slows down the rate at which food leaves your stomach and empties into your small intestine for further digestion, which helps to prevent blood sugar spikes after eating.
- It helps to prevent your liver from producing and releasing too much sugar (glycogen).
- It helps your pancreas produce more insulin.
The aspect of the stomach emptying more slowly is what leads to weight loss in people who do not have diabetes.
“In clinical practice,” explained Camilleri, “measurement of stomach emptying at five weeks may serve as a biomarker to determine which patients should continue on the treatment and which patients might be better candidates for other weight loss treatments.”
The most notable side effect reported by patients is nausea, but this is also what helps people lose weight due to the nausea’s reducing effect on appetite.
“It is essential to titrate the dose up slowly, over five weeks,” said Camilleri, “and to ‘pause’ for patients to become less nauseated with treatment dose before escalating by 0.6 milligrams every week.”
Camilleri adds that taking liraglutide if you don’t have diabetes doesn’t seem to result in hypoglycemia (low blood sugar).
Besides their names, the only true difference between Saxenda and Victoza is in the dosages — both of which are delivered via injection with Novo Nordisk’s Flexpen device.
For patients prescribed the drug under the name Victoza for diabetes management, doses in a Flexpen can be adjusted gradually up to as high as 1.2 milligrams per day. When prescribed specifically for weight loss, Saxenda can be adjusted up 3 milligrams per day.
Some insurance coverage may require a note from the doctor, says Camilleri, explaining that all other weight loss approaches to achieve “clinically meaningful weight loss” have failed, especially when other obesity-related comorbidities are present.
Can drug help non-obese patients?
The company’s clients include patients with type 2 diabetes and prediabetes.
“I’ve been using liraglutide with my patients since 2005,” Robinson told Healthline. “In terms of the GLP-1 drugs, it’s become the ‘go-to’ for weight loss.”
In her practice, Robinson says she sees success when using liraglutide in patients with prediabetes who need to lose a little weight, reduce their HbA1c (glycated hemoglobin test), and in a sense, “re-set themselves.”
“It’s not a miracle drug, but it does make it easier for people to lose weight because they aren’t as hungry between meals. And they feel full more quickly, to the point that if they do overeat they will feel sick,” explains Robinson.
If a patient is experiencing strong symptoms of nausea, Robinson continues their current dose for at least two weeks, giving their body time to adjust to the medication before making another increase.