Reasons You’re Not Losing Weight on Saxenda

Gaining weight while taking the weight loss medication Saxenda feels frustrating and confusing when this medication promises the opposite result. Many patients experience this unexpected issue despite following their treatment plan carefully. Saxenda contains liraglutide, which typically works by decreasing appetite and slowing digestion to promote weight loss. Weight gain during treatment might signal tolerance development, lifestyle factors overriding the medication’s effects, or underlying health conditions. Several strategies can help address this problem and get your weight loss journey back on track.

Understanding How Saxenda Works

If you find that Saxenda is not burning off those pounds straight off the bat, you’ll need to exercise some patience. It is first important to understand how the medication works.

It takes time to lose weight on Saxenda. Clinical studies show that the average weight loss for adult users is around 7.4% of body weight over 56 weeks. Some may even start losing weight as quickly as the first two to four weeks, with some individuals seeing early weight loss of 2% to 4%.

For the medicine to work, it is also essential to follow a long-term, reduced-calorie diet and exercise program as prescribed by your doctor. The dose is initially slowly increased over 4 to 5 weeks to prevent side effects like nausea, vomiting, diarrhea, and constipation. Most patients start losing weight within 2 to 4 weeks of treatment. If Saxenda is prescribed to you, it is important to consult your dietitian about weight loss plans that can help you stick to your goals.

Signs Saxenda Has Stopped Working

Recognizing when Saxenda is no longer effective helps you address issues promptly before significant weight regain occurs. Watch for these telltale indicators that your medication may not be working as intended:

• Increased hunger has returned. One of Saxenda’s primary benefits is appetite suppression. If you notice your hunger levels increasing significantly or returning to pre-medication levels, this suggests the medication’s effectiveness may be waning. Pay particular attention to between-meal hunger and nighttime cravings.
• Cravings have intensified. Beyond general hunger, specific cravings for high-calorie foods, especially carbohydrates and sweets, might indicate Saxenda’s appetite-regulating effects are diminishing. These cravings can be particularly powerful triggers for overeating.
• Weight has plateaued or increased. After initial success, a plateau lasting several weeks or actual weight gain despite maintaining your diet and exercise routine represents a clear sign that something has changed with your treatment’s effectiveness.
• Portion sizes have increased. If you find yourself gradually returning to larger portion sizes or needing more food to feel satisfied, this demonstrates reduced satiety effects from the medication.
• Side effects have diminished. While the reduction of side effects like nausea seems positive, it can sometimes indicate your body has developed tolerance to the medication.
• Eating behaviors have reverted. If you’ve returned to previous eating patterns like snacking between meals, eating quickly, or consuming larger amounts in one sitting, Saxenda may have lost its regulatory influence.

If you identify multiple indicators above, consult your healthcare provider to discuss adjustments to your treatment plan rather than waiting until significant weight regain occurs, which can hinder your weight loss progress.

Common Reasons for Weight Gain on Saxenda

Several factors can contribute to unexpected weight gain while taking Saxenda, even when you’re following treatment guidelines. Understanding these potential culprits helps target solutions more effectively, as not all people lose weight at the same rate or in the same way:

• Medication tolerance development: Your body may develop tolerance to Saxenda over time, making it less effective at suppressing appetite and slowing digestion. This physiological adaptation can occur regardless of proper usage.
• Insufficient dosage: If you haven’t reached the full therapeutic dose of 3mg daily, you might not experience Saxenda’s complete appetite-suppressing effects. Some patients respond better at maximum dosage.
• Inconsistent medication administration: Missing doses or taking Saxenda at irregular times reduces its effectiveness. The medication works best with steady blood levels maintained through consistent daily injection.
• Poor dietary choices overwhelming medication effects: While Saxenda reduces hunger, it can’t completely override the impact of consuming high-calorie, processed foods. Even smaller portions of highly caloric foods can lead to weight gain.
• Lack of caloric adjustment: As you lose weight initially, your caloric needs decrease. Failing to adjust your caloric intake downward can lead to plateaus or weight regain, even with Saxenda’s help.
• Static exercise routine: Your body adapts to consistent exercise patterns over time, burning fewer calories for the same activities. Without progressive increases in intensity or variety, exercise benefits diminish.
• Medical interference from other medications: Certain medications, including some antidepressants, steroids, beta-blockers, and insulin, can counteract Saxenda’s weight loss effects or independently contribute to weight gain.
• Stress-induced eating: High stress levels trigger cortisol production, which increases appetite and cravings for comfort foods. This can override Saxenda’s appetite suppression.
• Emotional eating patterns: Eating driven by emotions rather than physical hunger can circumvent the appetite-regulating effects of Saxenda, especially if emotional eating was a pre-existing pattern.
• Age-related metabolic changes: Natural metabolic slowdown with aging may offset some benefits of the medication, requiring additional adjustments to maintain weight.
• Hormone fluctuations: Changes in hormones due to menstrual cycles, perimenopause, menopause, or other conditions can temporarily counter the medication’s effects.

Identifying which factors are affecting your treatment can help you develop targeted strategies to address weight gain and restore Saxenda’s effectiveness.

Underlying Medical Conditions Affecting Saxenda

Certain health conditions can interfere with Saxenda’s effectiveness or independently contribute to weight gain despite medication. Several medical issues can undermine your weight loss efforts and cause you to regain lost weight while taking liraglutide:

Thyroid disorders, particularly hypothyroidism, significantly impact metabolism. Even mild thyroid dysfunction can cause weight gain or prevent weight loss by slowing metabolic rate. If you’re experiencing fatigue, cold intolerance, dry skin, and weight gain on Saxenda, request thyroid function testing.

Insulin resistance and type 2 diabetes complicate weight management and can reduce Saxenda’s effectiveness. While Saxenda may help improve insulin sensitivity, pre-existing severe insulin resistance might require additional interventions alongside this medication.

Polycystic ovary syndrome (PCOS) creates hormonal imbalances that promote weight gain and make weight loss more challenging. The insulin resistance common in PCOS can counteract some of Saxenda’s benefits, requiring comprehensive management of the syndrome alongside weight loss efforts.

Cushing’s syndrome, characterized by excess cortisol, causes distinctive weight gain primarily in the face, neck, and trunk. This condition directly opposes Saxenda’s effects and requires specific treatment.

Chronic inflammation from various conditions increases insulin resistance and affects fat storage mechanisms. Addressing the underlying inflammatory condition may be necessary before Saxenda can work effectively.

Sleep apnea disrupts normal hunger hormone regulation, potentially overriding Saxenda’s appetite-suppressing effects. Treating sleep apnea often facilitates weight loss success.

Medications for other conditions, particularly psychiatric medications, steroids, and beta-blockers, can cause weight gain that overwhelms Saxenda’s effects.

If you suspect an underlying condition, comprehensive testing by your healthcare provider can identify issues requiring treatment alongside your weight management plan.

Lifestyle Factors Contributing to Weight Gain

Even with Saxenda’s help, certain lifestyle factors can sabotage your weight loss efforts and lead to unexpected weight gain. Addressing these elements often makes the difference between someone who loses weight and someone who struggles to see results:

• Sleep deprivation fundamentally alters your hunger hormones. When you don’t get sufficient sleep (typically 7-9 hours nightly), your body increases ghrelin (the hunger hormone) while decreasing leptin (the satiety hormone). This hormonal imbalance creates powerful hunger that can override Saxenda’s appetite-suppressing effects. Additionally, fatigue leads to seeking quick energy from high-calorie foods and reduces motivation for physical activity.
• Chronic stress elevates cortisol levels, which increases appetite, particularly for high-calorie comfort foods. Stress also disrupts sleep, creates emotional eating patterns, and can lead to skipped doses of medication. Implementing stress-reduction strategies like meditation, deep breathing, or regular enjoyable activities can support Saxenda’s effectiveness.
• Inadequate water intake is often overlooked but surprisingly impactful. Dehydration commonly masquerades as hunger, leading to unnecessary caloric consumption. Additionally, proper hydration supports metabolic processes and helps manage the constipation sometimes associated with Saxenda.
• Insufficient protein consumption can leave you hungry despite Saxenda treatment. Protein creates greater satiety than carbohydrates or fats, helping extend the medication’s appetite-suppressing effects. Aim for at least 0.8-1 gram of protein per pound of body weight daily, spread throughout your meals.
• Alcohol consumption presents multiple problems: it adds empty calories, reduces inhibitions around food choices, interferes with quality sleep, and forces your liver to process alcohol instead of burning fat. Even moderate drinking can significantly impact your results on Saxenda.
• Sedentary behavior between exercise sessions limits calorie expenditure. Many people compensate for structured exercise by moving less throughout the day, resulting in minimal net calorie deficit. Focus on increasing overall daily movement beyond scheduled workouts.
• Social and environmental eating triggers can prompt consumption even without physical hunger. Restaurant outings, workplace treats, family celebrations, and holiday traditions often center around high-calorie foods that can override Saxenda’s benefits.

Addressing these lifestyle factors creates an environment where Saxenda can work optimally, preventing unexpected weight gain during treatment.

Breaking Through a Saxenda Plateau

Weight loss plateaus are common during treatment with Saxenda, but they don’t mean the medication has failed. Implementing strategic adjustments can help restart your weight loss progress:

• Consult with your healthcare provider about dosage optimization. Some patients require the full 3mg dose to see continued results. If you haven’t reached the maximum dose, discuss progression with your provider. If you’re already at the maximum, they might recommend timing adjustments or complementary approaches.
• Track food intake meticulously using a journal or app. “Calorie creep” often occurs unconsciously as small portion increases or added snacks accumulate over time. Detailed tracking reveals patterns and opportunities for adjustment.
• Reassess your calorie needs. As you lose weight, your body requires fewer calories for maintenance. What created a deficit earlier in your journey may now be maintenance calories. Consider reducing intake by approximately 100-200 calories to restart progress.
• Change your exercise routine to prevent adaptation. Your body becomes efficient at familiar activities, burning fewer calories for the same workout. Introduce new activities, increase intensity, add interval training, or incorporate strength training to challenge your body differently.
• Evaluate your protein and fiber intake. These nutrients increase satiety and support metabolism. Aim for at least 25–30% of your calories from protein and 25–30g of fiber daily.
• Address sleep quality and stress levels. Poor sleep and high stress increase hunger hormones that can override Saxenda’s effects, hindering your weight loss progress.
• Consider intermittent fasting approaches. Simple timing changes like a 12-14 hour overnight fast can help some people break through plateaus.
• Measure inches, not just pounds. Sometimes your body composition is improving (losing fat, gaining muscle) even when the scale doesn’t move.

Plateaus are normal—view them as opportunities to refine your approach rather than indicators of failure.

Maximizing Saxenda’s Effectiveness

To get the most benefit from Saxenda and lose weight on Saxenda, implement these proven strategies that enhance the medication’s effectiveness:

1. Timing your injections consistently helps maintain steady blood levels of the medication. Select a time that works with your daily routine—morning works well for many patients because nausea, if it occurs, can subside throughout the day. Whatever time you choose, aim to administer Saxenda within the same one-hour window daily.
2. Proper storage and administration ensure medication potency. Unused pens should be refrigerated between 36°F and 46°F (2°C to 8°C). The pen in current use can remain at room temperature (below 86°F/30°C) for up to 30 days. Never freeze Saxenda, and discard pens that have been frozen. Rotate injection sites between your abdomen, thigh, or upper arm to prevent tissue changes that could affect absorption.
3. Focusing on nutrient-dense, low-calorie foods amplifies Saxenda’s benefits. Prioritize vegetables, fruits, lean proteins, and whole grains while minimizing processed foods, refined carbohydrates, and added sugars. This approach provides essential nutrients while supporting calorie reduction.
4. Balancing macronutrients optimizes satiety. Include protein (25-30% of calories), healthy fats (20-35%), and complex carbohydrates (40-50%) at each meal. This combination stabilizes blood sugar and extends the feeling of fullness between meals.
5. Practicing portion control remains important even with Saxenda’s appetite suppression. Use smaller plates, measure servings initially, and eat slowly to recognize fullness cues. Be particularly mindful of calorie-dense foods like nuts, oils, and nut butters, which can add significant calories in small volumes.
6. Incorporating regular physical activity supports weight maintenance. Aim for at least 150 minutes of moderate-intensity exercise weekly, with additional strength training 2-3 times weekly. Activity doesn’t need to happen in long sessions—three 10-minute walks daily provide benefits.
7. Tracking non-scale victories maintains motivation through plateaus. Monitor improvements in energy levels, clothing fit, sleep quality, mood, blood pressure, blood sugar, and mobility rather than focusing exclusively on weight.
8. Practicing mindful eating techniques helps you recognize true hunger versus emotional or habitual eating. Before eating, rate your hunger on a scale of 1-10, and stop eating when you reach a comfortable 6 or 7 rather than feeling full.

These combined approaches create an environment where Saxenda can work optimally to prevent weight regain.

When to Consider Alternative Weight Loss Approaches

If you’ve been gaining weight or seeing no results on Saxenda despite following recommendations, it may be time to explore alternatives. Most providers recommend evaluating Saxenda’s effectiveness at the 16-week mark. If you haven’t lost at least 4% of your body weight by this point, guidelines suggest discontinuing the medication.

Other GLP-1 receptor agonists like semaglutide (Wegovy, Ozempic) provide alternatives with potentially different outcomes. Some patients respond better to one weight loss medication than another within the same class.

Different medication classes altogether—like Qsymia (phentermine-topiramate) or Contrave (naltrexone-bupropion)—work through alternate mechanisms and might be more effective for your body chemistry.

Comprehensive medical weight management programs combining multiple approaches often yield better results than medication alone.

For those with significant obesity and related health conditions, bariatric surgery provides the most effective long-term solution when medications aren’t sufficient.

Discuss these options openly with your healthcare provider if Saxenda isn’t delivering the expected results.

Healthy Alternatives

Now that we have covered some of the possible reasons that you are not losing weight on Saxenda, it is important to outline alternatives that are both safe and healthy. Following the advice of a qualified dietitian is an excellent place to start and achieve a slimmer, healthier you, whether or not you are using a weight loss medication. They might advise you to take the following steps:

Try Nutrient-Dense Foods

We must lay special emphasis on foods that have high nutrients and low calories. These can include but are not limited to, fruits and vegetables. Lean proteins, such as fish, poultry, and eggs, are an excellent way to lose and subsequently manage the pounds. Whole grains are a powerful tool in the fight against excess weight.

Make sure you take full advantage of healthy fats that are derived from nuts, seeds, avocados, and olive oil. These provide essential nutrients to the body and keep the consumer feeling full for longer while consuming fewer calories. 

Keeping a limit on processed or high-calorie foods keeps those weight-gaining elements out of our systems. Added sugars are another substance to keep out of the old system. Examples of such foods are baked products, fried foods, sugary drinks, white bread, and pasta. 

The general aim should be to take in at least 21–38 grams of fiber depending on your age and at least .8 to 1 gram of protein per pound of body weight every day.

Stay Hydrated

Make sure you drink plenty of water throughout the day. Keeping your body plenty hydrated not only helps curb hunger but also boosts the metabolism. 

Proper hydration is essential for overall health and can aid in maintaining a healthy weight. Drink up and feel the difference!

Eat Intuitively

Avoid restrictive diets as you will find them difficult to sustain. The changes made to eating habits need to be gradual and manageable. It is likely that you will stick to these better consumption habits that can help you in the long run. 

Styles of eating including intuitive eating, the Mediterranean, DASH, and flexitarian are seen as fine examples of healthy diets. Their results are based on evidence and align with core weight loss principles.

Get Weight Loss Support

Saxenda is one option when it comes to aiding weight loss and battling obesity. However, it is not the end of the road if you’re not losing weight on Saxenda. There are plenty of natural and perhaps even healthier alternatives to help drop the excess weight. Remember, weight loss comes down to more than just eating less and moving more. A healthy diet, allied with the right exercise might be just what you need to achieve lasting results.

In case you are finding it difficult to get off to the right start, why not seek the help of a professional dietitian? At Dietitian Live, our team of professionals can help you determine if Saxenda is the best way forward for your weight loss journey, or whether you should be pursuing more natural methods. Book an appointment with us today so we can help you come up with a diet plan to suit your weight, needs, and overall lifestyle. 

FAQ About Weight Gain on Saxenda

Why am I gaining weight after initially losing on Saxenda?

Initial weight loss followed by regain often indicates tolerance development to the medication. Your body adapts to liraglutide’s effects over time, potentially reducing its appetite-suppressing properties. Other common causes include “calorie creep” (gradually increasing portion sizes or adding snacks), reduced physical activity, or changes in other medications. Keep a detailed food and activity journal to identify patterns, and discuss dosage optimization with your healthcare provider.

How long should Saxenda take to work before I see results?

Most patients see initial weight loss (2-4%) within 2-4 weeks of starting Saxenda. Significant weight loss (at least 5%) typically occurs around the 8-week mark. However, these timelines assume you’ve reached the full therapeutic dose of 3mg daily, which requires a 4-5 week titration period. If you haven’t experienced any weight loss by week 16, guidelines suggest Saxenda may not be effective for you.

Can I develop tolerance to Saxenda?

Yes, tolerance to Saxenda can develop over time. Your body may stop losing weight, plateauing for a time. If you notice increasing hunger, cravings, or weight gain after a period of successful treatment, discuss this with your healthcare provider. Sometimes, changing up your diet or exercise routines can help address tolerance or plateauing.

Should I increase my dosage if I’m gaining weight?

Never adjust your Saxenda dosage without medical guidance. If you’re experiencing weight gain and haven’t reached the maximum dose of 3mg daily, your provider might recommend completing the titration schedule. If you’re already at the maximum dose, increasing beyond this point increases side effect risks without proven benefits. Your provider might instead suggest timing adjustments or complementary strategies.

What foods should I avoid while taking Saxenda?

While taking Saxenda, limit foods that can overwhelm the medication’s effects or trigger digestive side effects. These include high-fat processed foods (which can worsen nausea), simple carbohydrates (which may spike hunger), alcohol (which adds empty calories and reduces inhibitions around eating), sugary beverages, fried foods, and highly processed snacks. Focus instead on lean proteins, vegetables, fruits, whole grains, and healthy fats that support satiety.

How much exercise do I need while on Saxenda?

Guidelines recommend at least 150 minutes of moderate-intensity aerobic activity weekly (30 minutes, five days weekly) plus strength training twice weekly. However, if you’re experiencing weight gain on Saxenda, you might benefit from increasing duration to 200-250 minutes weekly or incorporating high-intensity interval training. Remember that everyday movement also counts—aim for 7,000-10,000 steps daily for optimal results.

Will my insurance continue to cover Saxenda if I’m not losing weight?

Insurance coverage policies typically require documented weight loss to continue covering Saxenda. Most plans require at least 4% weight loss by 16 weeks and continued weight loss or maintenance thereafter. If you’re gaining weight, discuss this with your provider before your next insurance authorization—they may need to document mitigating factors or recommend alternative treatments your insurance will cover.

What are the signs I should stop taking Saxenda?

Consider discontinuing Saxenda if you experience severe or persistent side effects, have gained significant weight despite proper usage, show signs of allergic reaction, develop pancreatitis symptoms (severe abdominal pain, vomiting), or haven’t lost at least 4% of your body weight after 16 weeks. Always consult your healthcare provider before stopping any prescribed medication.

Can stress cause weight gain even while taking Saxenda?

Yes, chronic stress produces cortisol, which increases appetite, promotes fat storage (especially around the abdomen), and can override Saxenda’s appetite-suppressing effects. Additionally, stress often triggers emotional eating patterns and disrupts sleep, further complicating weight management. Implementing stress-reduction techniques is essential for optimal results with Saxenda.

How do sleep patterns affect Saxenda’s effectiveness?

Poor sleep significantly impacts Saxenda’s effectiveness by disrupting hunger hormones—increasing ghrelin (hunger hormone) while decreasing leptin (satiety hormone). This hormonal imbalance can create powerful hunger signals that override medication effects. Additionally, fatigue from sleep deprivation reduces physical activity and increases cravings for high-calorie, carbohydrate-rich foods. Prioritizing 7-9 hours of quality sleep supports Saxenda’s weight management benefits.

Understanding Your Saxenda Weight Gain Journey

Weight gain on Saxenda happens for various reasons including medication tolerance, diet changes, reduced physical activity, or underlying health issues. Tracking your food intake, maintaining regular exercise, consulting your healthcare provider about dosage adjustments, and addressing potential medical conditions can help overcome this obstacle. Your weight loss journey might require adjustments along the way, but with proper medical guidance and lifestyle modifications, you can address the causes of weight gain and potentially resume progress toward your health goals.