The best Saxenda alternatives for weight loss

Saxenda is an FDA-approved glucagon-like peptide-1 (GLP-1) receptor agonist used for chronic weight management in adults and adolescents with obesity or weight-related conditions.

In 2014, Saxenda (liraglutide) became the first once-daily GLP-1 injection approved by the FDA for long-term weight management. In early studies, people lost about 8% of their body weight in over 56 weeks. Ten years later, GLP-1 agonists have become a popular tool for weight loss.

Saxenda is so popular that it’s often hard to find. There may be other reasons you may be considering an alternative to Saxenda including the need for more significant weight loss that is available with other popular GLP-1 medications like Wegovy and Zepbound.

Looking for Saxenda alternatives? Explore top prescription drugs, OTC, and natural substitutes for weight loss, including Wegovy, Ozempic, Zepbound and more.

What is Saxenda?

Saxenda is a glucagon-like peptide-1 (GLP-1) medication with the same active ingredient as Victoza (approved for type 2 diabetes), liraglutide. It’s used for chronic weight management in combination with a reduced-calorie diet and increased physical activity in adults with obesity or overweight.

Saxenda is also FDA-approved for use in adolescents (12-17 years old) who meet the following requirements:

• Those who weigh over 132 pounds and are considered obese based on the adult body mass index (BMI)
• Obese, or overweight, with at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol

The active ingredient in Saxenda is liraglutide, a type of GLP-1 receptor agonist. Liraglutide works by mimicking a hormone in the body that helps control blood sugar levels and appetite, leading to significant weight loss.

Saxenda is a daily injection approved for weight loss. Approved in 2014, Saxenda (liraglutide) was the first GLP-1 medication approved for weight loss in adults with obesity or overweight with at least one weight-related health condition, such as high blood pressure or high cholesterol. It is also approved for certain children 12 and older with obesity.

Saxenda, being an older GLP-1 medication, has some downsides compared to newer weight loss medications like Zepbound and Wegovy. For example, it’s taken daily instead of weekly, and you might lose less weight with it.

In a 56-week clinical trial, people taking Saxenda 3 mg once a day lost an average of 18 lbs, while those using a placebo injection only lost 8 lbs. It has also shown heart health benefits for people with diabetes or those at high risk of heart disease.

Why consider Saxenda alternatives?

You may consider alternatives to Saxenda for the following reasons:

• High cost or insurance issues: Saxenda can be pricey, and not all insurance plans cover it. Even with coverage, co-pays can be high, making other options more affordable.
• Side effects: Common issues like nausea, vomiting, or injection site discomfort may make it hard to continue using Saxenda.
• Different effectiveness needs: Some people may not see the weight loss results they want with Saxenda and might benefit from a medication that works differently or has stronger effects.
• Preference for pills: If you dislike weight loss injections or find them inconvenient, oral medications could be a better fit.
• Availability problems: Ongoing shortages mean you might need a backup option to continue your weight-loss plan without interruption.

Top prescription alternatives to Saxenda

The closest options to Saxenda are other GLP-1 medicines, which help treat obesity and type 2 diabetes by controlling blood sugar. Other choices include appetite suppressants, stimulants, fat blockers, or combination drugs.

Here are some of the most common alternatives to Saxenda.

Wegovy (semaglutide)

Wegovy is a once-weekly prescription medication approved for long-term weight loss in individuals 12 years of age and older. Some people find Wegovy weekly injections easier to use than Saxenda daily injections, and it may help you lose more weight.

Saxenda (liraglutide) and Wegovy (semaglutide) are GLP-1 receptor agonists that help reduce appetite and food intake.

A head-to-head 2022 study found that people taking semaglutide lost more weight in 68 weeks than those taking liraglutide.

The Wegovy injection pen works a bit differently from the Saxenda pen. Wegovy pens are single-use and come prefilled with one dose each. Saxenda pens have several doses inside, and you need to choose your dose every time you use it.

Wegovy has proven heart benefits for people with heart disease. For adults who are overweight or obese, it can help reduce the risk of heart attack, stroke, and death from heart problems. Saxenda is not approved for this purpose.

Saxenda costs around $1,800 per month for a five-pen monthly supply. Wegovy ranges from $1,349 to $1,835 per month, with typical cash prices around $1,349. Both drugs offer manufacturer savings cards that can reduce your monthly cost to as low as $25 with commercial insurance coverage.

Ozempic (semaglutide – off-label for weight loss)

Saxenda contains liraglutide, while Ozempic contains the active ingredient semaglutide, a different but similar GLP-1 receptor agonist. Semaglutide is generally more effective and longer-acting.

Saxenda and Ozempic are both GLP‑1 receptor agonists, meaning they work by mimicking a natural hormone that helps control appetite and blood sugar. However, there are key differences between them. Saxenda is FDA-approved specifically for weight loss and is taken daily by injection, while Ozempic is approved for type 2 diabetes but is often used off-label for weight loss and is injected just once a week. In terms of effectiveness, Ozempic tends to show greater weight loss results, about 12–16% of body weight lost over time, compared to 6–8% with Saxenda.

When it comes to cost, Ozempic is generally cheaper. The average retail price for Saxenda is around $1,300 per month, while Ozempic is typically $900–$950 per month. With insurance and manufacturer savings cards, both medications may be available for as little as $25 per month, but the price can vary based on your insurance coverage and eligibility. Overall, Ozempic may offer more convenience and better results at a lower price, but Saxenda remains a strong option for those specifically seeking an FDA-approved weight-loss treatment.

Zepbound (tirzepatide)

Both Saxenda and Zepbound are injectable medications designed for weight management, but they differ in dosage schedule and effectiveness. Saxenda contains liraglutide and is administered daily, while Zepbound (tirzepatide) is injected once weekly, offering a more convenient schedule.

In terms of weight loss, clinical trials show Zepbound often delivers higher results, with patients typically losing 15–20% of body weight over about 72 weeks, compared to around 8% with Saxenda over 56 weeks.

When comparing costs, Saxenda’s list price in the U.S. is about $1,350 per month, while Zepbound’s list price is slightly lower, around $1,060–1,086 per month.

For self-paying patients, Zepbound’s cost can be further reduced using manufacturer savings cards, which lower the cost for eligible patients to $499/month without insurance. Both drugs also offer savings through commercial insurance plans, where copays may be reduced to as little as $25/month.

Mounjaro (tirzepatide – off-label for weight loss)

Saxenda and Mounjaro (used off-label for weight loss) are both injectable medications that help manage weight by mimicking natural hormones to control appetite and digestion. Saxenda contains liraglutide and is FDA-approved specifically for weight loss.

Mounjaro, which contains tirzepatide, is approved for type 2 diabetes but is commonly used off-label for weight loss. It is taken once a week, offering greater convenience.

In terms of effectiveness, Mounjaro has shown superior results, with clinical trials reporting 15–20% weight loss over about 72 weeks, compared to Saxenda’s average 6–8% weight loss over one year.

When it comes to cost, Saxenda typically costs around $1,349 per month without insurance, while Mounjaro is usually less expensive, costing an average of about $1,023 per month. However, with insurance and manufacturer savings cards, both may be available for as little as $25 a month, depending on eligibility.

Overall, Mounjaro may be more effective and convenient, but it is not officially approved for weight loss, which can affect insurance coverage. Saxenda, while less effective and more inconvenient to use (daily injection vs. weekly injection), has official FDA approval for weight management.

Contrave (bupropion/naltrexone)

Contrave is an oral pill made of two medicines: naltrexone, used for opioid and alcohol dependence, and bupropion, an antidepressant. Naltrexone affects the brain’s reward system, and bupropion changes certain brain chemicals, which together can help lower appetite and cravings.

In studies, people taking Contrave lost about 8.1% of their body weight after 56 weeks, compared to 4.9% with a placebo.

After the first week, Contrave is taken twice a day with food, but not with a high-fat meal. This is different from Saxenda, which is injected once a day and doesn’t need to be taken with food.

You shouldn’t take Contrave if you have seizures, uncontrolled high blood pressure, or regularly use opioids for pain.

Unlike Saxenda, Contrave can raise heart rate and blood pressure, and may cause seizures or liver problems. Because it contains bupropion, it also carries an FDA black box warning for a higher risk of suicidal thoughts, which applies to all antidepressants. Still, with a doctor’s guidance, it can be a safe and effective option.

Qsymia (phentermine/topiramate)

Qsymia combines a stimulant (phentermine) and a seizure medicine (topiramate) to help lower appetite and make you feel full.

Depending on the dose, people taking Qsymia lose about 5% to 10% of their body weight, which is similar to Saxenda. However, Qsymia can cause side effects like tingling, dry mouth, and changes in taste. It can also make it harder to sleep if taken too late, so it’s best to take it in the morning.

Common side effects include dry mouth, constipation, tingling skin, low mood, and a fast heartbeat. Because it can affect the heart, doctors may not recommend it for people with heart problems.

Qsymia is only available through a special safety program because of the risk of birth defects. If you can get pregnant, you’ll need a pregnancy test before starting and then every month. You’ll also need to use reliable birth control while taking it.

Like Contrave, Qsymia isn’t suitable for everyone. It’s not recommended if you have glaucoma or an overactive thyroid, and it can interact with other medicines, including birth control pills. Always review your medications before switching. Depending on your insurance, Qsymia may also cost less than Saxenda.

Xenical (orlistat)

Xenical is a lipase inhibitor, meaning it blocks the enzymes that break down and store fat in the body. It is an oral capsule taken 3 times a day.

It works by stopping your body from absorbing fat, so you take it with any meal that has fat. You can take Xenical during the meal or within an hour after eating.

Studies show it can lead to about 8% weight loss, but in a direct comparison in a head-to-head study, liraglutide worked better overall.

Xenical is often much cheaper than Saxenda and comes as a pill, which may appeal to people who prefer not to have injections.

Like Saxenda, it can cause stomach-related side effects such as nausea and vomiting, but it may also cause cramping, gas, oily stools, and trouble controlling bowel movements, effects that usually don’t happen with Saxenda.

Phentermine (short-term option)

Phentermine is a central nervous system stimulant and one of the most popular weight loss medications.

A 2021 study found people lost about 8%–11% of their body weight, depending on the dose. Adipex-P, a common brand-name, is taken by mouth, making it easier to use than Saxenda, and the generic version is often much cheaper.

Phentermine is a controlled drug and is only FDA-approved for short-term use (a few weeks), though some doctors may prescribe it for longer. It can raise heart rate and blood pressure, so it’s not the best choice for people with cardiovascular problems.

Plenity

Plenity is another option for weight management, but it’s not a medication. It’s an FDA-approved prescription medical device. It works by taking up space in your stomach to help you feel full faster.

Plenity comes as capsules with plant fiber and citric acid. You take 3 capsules with 16 oz of water, 20 minutes before lunch and dinner. In your stomach, the ingredients expand when mixed with food and water, making you eat less. If you have trouble swallowing pills, Plenity may not be right for you.

In a 24-week study, people taking Plenity lost about 6% of their body weight, compared to 4% in those not taking it. About 27% of people on Plenity lost 10% or more of their starting weight.

Saxenda and Plenity can both cause side effects like nausea, gas, bloating, and constipation, but these often improve over time. Eating more slowly with Plenity can help reduce discomfort.

Since it’s a medical device, Plenity isn’t sold in regular pharmacies, so your prescription may need to be sent to a special pharmacy that can provide it.

Here’s a comparison table of Saxenda vs. its alternatives:

Over-the-counter (OTC) and supplement alternatives

Americans spend over $2 billion a year on weight-loss supplements, but it’s unclear if they work, and some can be harmful. A few have been linked to serious problems like liver failure, and the FDA has found some contaminated with hidden chemicals.

The only U.S. Food and Drug Administration-approved over-the-counter weight loss drug is Alli, a lower-dose version of orlistat. It can help, but it’s less effective than prescription options and may cause side effects like oily stools.

Always check with a doctor before trying any OTC supplement to make sure it’s safe.

Berberine

Berberine, a natural compound found in plants like European barberry, Phellodendron, tree turmeric, and Oregon grape, is known to improve insulin sensitivity and lower blood glucose. It works similarly to GLP-1 medications by boosting metabolism. While clinical trials on its ability to reduce appetite and promote weight loss are still growing, studies show it may help with weight loss and reduce waist circumference. However, it is important to consult with a healthcare provider for medical advice on the right dosage and to avoid potential side effects.

A study on people with metabolic syndrome showed that berberine improved insulin resistance and reduced waist circumference.

In another study, berberine showed similar results to metformin in improving blood sugar control. To get the best results, patients should take about 1.5 grams of berberine per day.

Although research on its weight loss benefits is still growing, studies suggest that berberine may help with weight loss and reduce waist size. It is important to consult a healthcare provider for the right dosage and to avoid side effects.

Apple cider vinegar

Often promoted for weight loss, it may help some people feel full and support healthy blood sugar levels. However, research is limited, and the results tend to be small. It’s usually taken diluted in water or as capsules, but it can cause stomach upset or damage tooth enamel if taken in high amounts or undiluted.

Glucomannan

A plant-based fiber that absorbs water and expands in your stomach, helping you feel full sooner and eat less. It works best when taken with plenty of water, about 30 minutes before meals. While it’s generally safe, it can cause gas, bloating, or constipation in some people.

Green tea extract

Contains antioxidants called catechins, along with a small amount of caffeine, which may help slightly boost metabolism and fat burning. Some studies show modest weight loss benefits, but results vary. It’s generally safe in moderate amounts, though high doses can cause stomach upset or, in rare cases, liver problems.

Caffeine

Found in coffee, tea, and many energy drinks or supplements, caffeine can temporarily increase metabolism and help burn more calories. It may also improve exercise performance. However, too much can cause jitteriness, anxiety, rapid heartbeat, or trouble sleeping.

Probiotics

Probiotics are “good” bacteria that support a healthy gut, which may play a role in weight management. Some research suggests they can help reduce belly fat, improve digestion, and lower inflammation, though results vary depending on the probiotic strain.

They’re found in fermented foods like yogurt, kefir, kimchi, and sauerkraut, as well as in supplements. Probiotics are generally safe, but they may cause mild gas or bloating when you first start taking them.

Natural and lifestyle-based alternatives

Some of the most reliable ways to lose weight are natural, especially healthy eating and regular exercise. Even small amounts of activity, like 30 minutes of aerobic exercise a week, can help, and greater benefits are seen with more exercise.

A 2023 study showed that eating fewer processed carbs, getting enough protein, and doing resistance training can boost metabolism and help burn more calories.

Fad diets are often unhelpful or unhealthy, so it’s better to focus on eating fewer calories with a balanced diet, such as the Mediterranean diet. The best plan is one you can stick to long-term, and a registered dietitian can help you create a plan that works for your lifestyle.

• High-protein, low-glycemic diets: Eating more protein and choosing low-glycemic foods (like whole grains, legumes, and non-starchy vegetables) can help you feel full longer, reduce blood sugar spikes, and support steady energy.
• Intermittent fasting: Limiting eating to certain hours of the day or certain days of the week may help reduce calorie intake and improve insulin sensitivity, which can mimic some of the appetite-control effects of GLP-1 medications.
• Strength training & HIIT: Building muscle through strength training and doing high-intensity interval training (HIIT) can boost your metabolism, helping you burn more calories even at rest.
• Behavioral therapy & mindful eating: Working on your eating habits and being more aware of hunger cues can help prevent emotional or mindless eating, making weight loss more sustainable.

Who should not take Saxenda? Contraindications and warnings

Saxenda comes with a box warning about the possible risk of thyroid tumors. People with a personal or family history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia type 2 (MEN 2) should avoid this medication.

Saxenda can increase heart rate, which may cause problems for people with heart disease or high blood pressure. It also carries risks like pancreatitis (inflammation of the pancreas), gallbladder disease, kidney problems, and suicidal thoughts or behaviors. Low blood sugar (hypoglycemia) is another risk, especially for people taking other diabetes medications.

Get medical help right away if your side effects last or get worse. You should seek emergency care if you have signs of an allergic reaction, like hives, swelling in your face or throat, or trouble breathing.

Always tell your doctor or pharmacist about all over-the-counter medications, supplements, and vitamins you take.

How to choose the right Saxenda alternative

When picking a Saxenda alternative, think about these factors:

• Budget & insurance coverage: Some options are cheaper or more likely to be covered by insurance.
• Preferred administration: Decide if you’d rather take a pill or have an injection.
• Side effect tolerance: Different medicines have varying side effects; choose one that you can handle.
• Underlying health conditions: Certain drugs may be better or worse if you have conditions like diabetes or thyroid problems.

FAQs

Is Wegovy better than Saxenda?

Yes, studies show that Wegovy helps people lose more weight on average than Saxenda. This is because Wegovy works more effectively and is administered once a week instead of daily.

Can I switch from Saxenda to Ozempic?

Yes, you can switch from Saxenda to Ozempic, but you should only do it under a doctor’s guidance. Your doctor will tell you the right dose and timing for a safe switch.

Are natural alternatives as effective?

Natural alternatives are less proven to work as good as medications, but they can still help some people. Diet, exercise, and lifestyle changes may give good results, especially for long-term health.

What’s the cheapest Saxenda alternative?

Phentermine is often a cheaper alternative to Saxenda, but it’s only for short-term use and needs a prescription. Some over-the-counter supplements may cost less, but their results are not well-proven.

Do Saxenda alternatives have fewer side effects?

Side effects can be different for each Saxenda alternative. Some may cause fewer problems, while others may have similar or even stronger side effects.

Conclusion

Saxenda (liraglutide) is an FDA-approved subcutaneous injection used for chronic weight management in adults with obesity or overweight and related health conditions.

Natural alternatives can help with weight loss, but they may not work as quickly or effectively as Saxenda.

Combining the right medication, natural alternatives, diet, and exercise, with continuous monitoring, will help achieve long-term success in your weight loss goals.

Always speak to a healthcare professional before making any significant changes to your health regimen to ensure safety and effectiveness.

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