Saxenda is a brand-name prescription medication containing liraglutide (3 mg/3 mL solution for subcutaneous injection). It’s a GLP-1 receptor agonist (glucagon-like peptide-1), mimicking a hormone that regulates appetite and blood sugar. Developed by Novo Nordisk, it’s FDA-approved specifically for chronic weight management in adults and children aged 12+ with obesity or overweight conditions with related health issues (e.g., hypertension, type 2 diabetes, dyslipidemia).

Key Uses (FDA-Approved Indications):

• Weight loss and maintenance in combination with a reduced-calorie diet and increased physical activity.
• Not for cosmetic weight loss; requires BMI ≥30 (obese) or ≥27 (overweight) with comorbidities.
  (Note: The same drug, liraglutide at a lower dose [1.2–1.8 mg], is sold as Victoza for type 2 diabetes management.)

How It Works:

• Appetite suppression: Slows gastric emptying, increases satiety signals in the brain.
• Blood sugar control: Stimulates insulin release, reduces glucagon (evidence from clinical trials like SCALE Obesity and Prediabetes).
• Average weight loss: 5–10% of body weight over 56 weeks (per STEP trials meta-analysis in NEJM, 2021).

Dosage & Administration:

• Use pre-filled pen; inject into abdomen, thigh, or upper arm.
• Max dose: 3 mg/day. Taper if discontinuing to avoid rebound.

Evidence of Effectiveness:

• SCALE trials (phase 3, >4,800 patients): 63–64% achieved ≥5% weight loss vs. 27–40% placebo (Lancet, 2015).
• Sustained results with lifestyle changes; head-to-head vs. semaglutide (Wegovy) shows slightly less efficacy (5–15% vs. 15–20% loss).

Common Side Effects (≥5% incidence):

Serious Risks (Black Box Warning):

• Thyroid C-cell tumors: Rodent studies showed risk; human data limited but monitor for symptoms (lump in neck, hoarseness). Contraindicated in personal/family history of medullary thyroid carcinoma (MTC) or MEN 2.
• Pancreatitis: Acute cases reported (0.3%); stop if suspected.
• Gallbladder disease: Cholecystitis in 1.5% vs. 0.5% placebo.
• Hypoglycemia: Risk with insulin/sulfonylureas.
• Suicidal thoughts: Rare behavioral changes noted.

Contraindications & Warnings:

• Avoid in: MTC/MEN 2 history, severe GI disease, pregnancy (Category C; animal fetal harm).
• Drug interactions: Slows absorption of oral meds (e.g., birth control, antibiotics).
• Cost: ~1,700/month (US, without insurance); patient assistance programs available.

Monitoring & Lifestyle:

• Monthly check-ins for first 16 weeks; discontinue if <4% weight loss.
• Combine with 500 kcal/day deficit diet + 150 min/week exercise for best results (per ADA guidelines).

Sources: FDA label (updated 2023), Novo Nordisk prescribing info, JAMA reviews (2022–2024), clinicaltrials.gov (NCT01272219 et al.)