A real global scourge, overweight and obesity increase the risk of contracting many diseases, including diabetes and cardiovascular diseases. Beyond a characteristic lack of breath, even at a moderate stage, overweight can lead to various health disorders, such as high blood pressure, increased levels of bad cholesterol, joint disorders… Weight loss is therefore the Holy Grail for many people, and one of the drugs to achieve this is Saxenda. Here are the essentials about this new drug.
Saxenda: everything you need to know about this drug to lose weight
Since September 2015, a new slimming drug has been authorized in France. Presented under the name of Saxenda, it is indicated to accompany a low-calorie diet and regular physical activity. A true slimming drug, it is administered in the form of daily injections in people who suffer from overweight or obesity. While Saxenda is not always effective for everyone, studies have shown that prescription injections can be effective in achieving and maintaining a healthier weight.
Saxenda comes in a pen pre-filled with solution for injection, to be administered once a day, at any time of the day. In particular, it may be indicated in obese patients (whose BMI or body mass index is greater than 30). The same goes for people who have a BMI of 27 or higher, and suffer from a weight-related condition such as type 2 diabetes, high cholesterol or high blood pressure. It should be remembered, however, that regardless of the patient's state of health, the use of Saxenda as a slimming drug must be accompanied by a change in lifestyle, such as the adoption of a healthy diet and the practice of regular physical activity.
Unlike dietary supplements for weight loss, Saxenda is therefore a prescription injectable drug that the ANSM has authorized since 2015. When used in conjunction with a low-calorie diet and intense physical activity, Saxenda can help some overweight adults lose weight and avoid any risk of being overweight in the future. Recommended only in adults, this drug is protected by a patent filed by Novo Nordisk laboratories for a period of up to 2023. Novo Nordisk is a multinational pharmaceutical company headquartered in Denmark. It also has several offices in the United States, France and Europe.
Composition Saxenda : Analysis of the slimming drug
Behind Saxenda, we find a compound already marketed for the treatment of type 2 diabetes: liraglutide (trade name: Victoza). Liraglutide has therefore recently obtained a European marketing authorization (MA) to provide its benefits in case of obesity or overweight, with at least one other cardiovascular risk factor.
Thus, the active substance of the drug is liraglutide. This is, as a reminder, the same active ingredient in the drug Victoza without insulin. There is also a similar drug marketed under the name Trulicity, used to help speed up weight loss.
What is liraglutide?
Liraglutide is an active ingredient that enhances the effects of glucagon peptide-1 (GLP-1) receptors, which has led to its prescription for the treatment of type 2 diabetes. It differs from other drugs with similar activity in that it appears to be associated with weight loss rather than weight gain. Although this mechanism is unclear, Saxenda's actions on GLP-1 can lead to weight loss by boosting energy expenditure and inhibiting appetite.
Effectiveness of liraglutide: what does science say?
Several studies have been devoted to the slimming effect of liraglutide, including a first trial on the effectiveness of the active substance in diabetic patients. In study participants, the 1.8 mg injection had a superior effect than placebo in terms of weight loss, while another 3 mg injection offered a much better result. Half of patients receiving 3 mg lost at least 5% of their body weight in 56 weeks.
The second study on the effectiveness of liraglutide involved obese and pre-diabetic subjects. This time, the 3 mg dose was compared to a placebo and 1/3 of the people treated with liraglutide lost 10% of their weight in 56 weeks.
During a maintenance trial, obese and overweight subjects who adopted a diet and exercise program in addition to 3 mg of Saxenda per day lost more weight than the placebo group.
Finally, body weight and sleep apnea were improved in those who received 3 mg of Saxenda compared to placebo.
In sum, the benefits of liraglutide on weight loss have been repeatedly demonstrated in thousands of subjects. The populations studied included obese and overweight people with and without diabetes.
How does Saxenda work?
The active ingredient in Saxenda, liraglutide is part of a pharmacological class distinct from other weight management products currently available in France. As a reminder, liraglutide is an analogue of glucagon-like peptide-1 (GLP-1) or GLP-1 receptor agonist. This is an active substance that has already proven itself in the treatment of type 2 diabetes under the trade name Victoza, at lower doses. On the other hand, for use in a slimming treatment, the recommended dose is 3 mg, to be administered as a daily injection.
Clearly, liraglutide is a synthetic hormone that reproduces the actions of an intestinal hormone produced in the body in response to food intake in order to stimulate insulin secretion. True, the mechanism of action of liraglutide is not fully understood, but it seems that this drug can inhibit the secretion of glucagon. It thus slows down gastric emptying, increases the feeling of satiation and reduces cravings and snacking.
Saxenda's mechanism of action
According to current scientific data, liraglutide stimulates weight loss by changing eating behavior without increasing energy expenditure. Indeed, the administration of liraglutide 3 mg increases the feeling of satiety while decreasing the feeling of hunger and food consumption, which naturally leads to a reduction in food intake.
While liraglutide is known to delay gastric emptying, this action is modest and diminishes over time, contributing very little to weight loss. According to animal studies, the action of liraglutide on appetite is biased by stimulation of the GLP-1 receptor located in the hypothalamus.
Is Saxenda really effective for weight loss?
So far, we have 5 clinical trials that demonstrate the effectiveness of Saxenda in weight loss. Carried out in total on 5,800 obese or overweight patients, these studies showed a significant decrease in the weight of the study population, compared to those receiving a placebo (or dummy treatment). At the same time, all study participants adopted an adapted diet and practiced physical activity on a regular basis.
Saxenda dosage: how to take this slimming drug?
Saxenda comes in the form of a pen pre-filled with solution for injection. It should be administered subcutaneously in certain parts of the body, either in the abdomen, in the thigh or in the upper arm. It should be noted, however, that this medication should not be administered intravenously or intramuscularly.
Saxenda side effects: What are the side effects?
In clinical trials, the most common adverse reactions observed in patients treated with Saxenda included: nausea, hypoglycemia, diarrhoea, constipation, vomiting, headache, loss of appetite, dyspepsia, fatigue, dizziness and abdominal pain.
However, some patients who took Saxenda reported serious side effects, including pancreatitis, gallbladder disease, kidney failure and suicidal thoughts. Note that Saxenda can also increase the heart rate. Of course, you should stop taking it if you notice an increase in your resting heart rate that continues over time.
In summary, symptoms of hypoglycemia associated with saxenda side effects may include:
- excessive sweating,
- fatigue or weakness,
- feelings of hunger,
- or palpitations.
Other less serious side effects may also appear:
- a headache,
- upset stomach or vomiting,
- a feeling of excessive satiety,
- irritation on the part of the body that was injected,
- stomach aches,
- irritation in the nose or throat…
Finally, other more or less serious side effects can appear very rarely:
- allergic reaction of the anaphylaxis type,
- allergic reaction of the angioedema type,
- slowed heart rhythm disorder,
- abnormal liver function,
- acute inflammation of the pancreas,
- acute renal failure,
- allergic reaction to drugs,
- slow heart rhythm disorder (atrioventricular block),
- blockage of bile discharge,
- cancer of the large intestine,
- inflammation of the gallbladder,
- hepatitis or inflammation of the liver,
- acute abdominal pain,
- kidney disease leading to reduced kidney function,
- medullary thyroid cancer,
- necrotizing pancreatitis (tissue inflammation in the pancreas),
- orthostatic hypotension,
- papillary thyroid cancer,
- rapid pulse,
- frequent itching,
- water retention…
When is Saxenda prescribed?
Saxenda is a slimming drug available only by prescription. It is intended for adults with a BMI of 30 kg/m2 or more (obesity). But it can also be indicated to adults with a BMI of 27 to 30 kg / m2 (overweight) and who suffer from several complicated related to their weight (high blood pressure, hypercholesterolemia, sleep apnea …).
It should also be noted that Saxenda may be indicated in case of pre-diabetes. In this situation, liraglutide in the form of Victoza will be preferred to treat type 2 diabetes.
In which cases is Saxenda contraindicated?
Saxenda is obviously contraindicated in children, or in women who are expecting or breastfeeding their baby. It is also not recommended to take liraglutide, in the form of Saxenda or Victoza, if there is a history of medullary thyroid cancer or multiple endocrine neoplasia type 2. It should also be noted that this drug for weight loss is contraindicated in patients who have or have had a serious hypersensitivity reaction to the active substance or to any of the components of the drug.
Some precautions to know about the drug Saxenda
As we will have understood, Saxenda and Victoza have as active substance the same liraglutide. These two medicines should therefore not be taken at the same time: you should not take Saxenda if you are taking antidiabetic treatment with Victoza.
Similarly, Saxenda should not be used with other GLP-1 receptor agonist drugs. The same applies to drugs that contain insulin. In addition, it is not known whether Saxenda is reliable and effective when taken with other prescription, over-the-counter or herbal weight loss products. In addition, it is not certain that this slimming drug can be safely indicated in people who have had pancreatitis.
If you experience any of the following symptoms, call your doctor immediately: difficulty swallowing food, shortness of breath, swelling in the neck… Moreover, it is important to respect all appointments with your doctor. Only the healthcare professional can perform certain tests to assess your body's response to the weight loss medication.
You should know that the Saxenda label was updated in 2018: it now contains new warnings in the field of cardiovascular health. In addition, the official website has been updated to include warnings about some serious side effects, including possible thyroid tumors.
Are there alternatives to Saxenda?
If Saxenda is not recommended in the management of your body weight, be aware that there are other medication solutions available by prescription, such as:
- the Didrex,
- the Tenuate,
- the Lorcaserin,
- Naltrexone and bupropion extended-release,
- and Xenical
It should be noted that the drugs on this list do not have the same mechanisms of action on the human body. Some are safe for long-term use, while others are simply safe for short-term use. Saxenda, for its part, is recognized as reliable for long-term use.
Saxenda: our opinion on the drug to lose weight
It must be recognized that Saxenda is not as effective on weight loss as bariatric surgery, an operation consisting in restricting the absorption of food in order to decrease the daily caloric intake (loss of 20-40% of the initial weight). However, bariatric surgery is only recommended in cases of very serious or even fatal obesity. Saxenda, on the other hand, has a much higher efficiency than all pharmacological solutions available on the market.
In comparison, Xenical, the only other drug authorized in France, allows to have a loss of 3% of body mass over 12 months, not to mention a more expensive cost and significant side effects. Across the Atlantic, there are 3 new authorized molecules, which also do not offer edifying results, with only a loss of 4-6% of weight and considerable side effects.
According to doctors specializing in weight loss, liraglutide certainly does not cure obesity, because patients treated with it remain obese after treatment. However, the benefits of losing weight by even 5 to 10% are already more than enough, as they will make medical conditions, such as diabetes, easier to treat.
Finally, it should be emphasized that the active ingredient of Saxenda does not only make you lose weight. According to the New England Journal of Medicine, treatment with liraglutide reduces the risk of getting type 2 diabetes, dyslipidemia or high blood pressure. All these benefits thus translate into a significant reduction in the risk of cardiovascular disease. And at the same time, Saxenda exerts a positive influence on sleep apnea syndrome and on the risk of osteoarthritis in the knee and hips.
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