Saxenda vs Wegovy: STEP 8 Head-to-Head and Label Compared
The short answer
Wegovy (semaglutide) beat Saxenda (liraglutide) in the one head-to-head trial: STEP 8 found 15.8% weight loss against 6.4% at 68 weeks in adults without diabetes. Wegovy is a weekly injection stepped up to 2.4 mg; Saxenda is a daily injection stepped up to 3 mg in five weeks.
Saxenda and Wegovy are both prescription injections for weight management from Novo Nordisk. Saxenda is liraglutide, given every day. Wegovy is semaglutide, given every week. Both activate the GLP-1 receptor, and the two were tested head to head in the STEP 8 trial. This page lines up the two US labels and reads that trial. It is a research reference, not medical advice.
Saxenda vs Wegovy at a glance
| What | Saxenda (liraglutide) | Wegovy (semaglutide) |
|---|---|---|
| Maker | Novo Nordisk | Novo Nordisk |
| Frequency | Once daily, any time of day, with or without food | Once weekly |
| Weight indication | Reduce excess body weight and maintain the reduction in adults and in patients aged 12 and over weighing more than 60 kg with obesity, and in adults with overweight plus one weight-related condition (Saxenda label, rev. 2/2026) | The same for adults, plus adolescents aged 12 and over with obesity (Wegovy label, rev. 6/2026) |
| Other indications | None listed | Lower the risk of major cardiovascular events in adults with established heart disease and obesity or overweight; noncirrhotic MASH with stage F2 to F3 fibrosis (accelerated approval) |
| Starting dose | 0.6 mg daily for one week | 0.25 mg weekly for 4 weeks |
| Escalation | 1.2, 1.8, 2.4 then 3 mg daily, one step a week | Every 4 weeks: 0.5, 1, 1.7, then 2.4 mg |
| Maintenance | 3 mg daily | Usually 2.4 mg weekly; 7.2 mg (Wegovy HD) where more weight reduction is indicated |
| Early stopping rule on the label | Adults: discontinue if 4% weight loss is not reached by 16 weeks | Not in the Wegovy sections we read |
| Forms | Pen delivering 0.6, 1.2, 1.8, 2.4 or 3 mg | Single-dose pen, single-dose syringe, FlexTouch pen, and a once-daily tablet |
| Boxed warning | Risk of thyroid C-cell tumors | Risk of thyroid C-cell tumors |
Both labels say not to combine the drug with other GLP-1 receptor agonists or with other products containing the same ingredient.
The head-to-head trial: STEP 8
STEP 8 randomised 338 adults with overweight or obesity and no diabetes to semaglutide 2.4 mg once weekly, liraglutide 3.0 mg once daily, or matching placebo, all with diet and activity advice, for 68 weeks. The comparison between the two drugs was open label; each was blinded against its own placebo (JAMA 2022).
| Outcome at week 68 | Semaglutide 2.4 mg (Wegovy) | Liraglutide 3.0 mg (Saxenda) | Pooled placebo |
|---|---|---|---|
| Mean weight change | -15.8% | -6.4% | -1.9% |
| Lost at least 10% | 70.9% | 25.6% | |
| Lost at least 15% | 55.6% | 12.0% | |
| Lost at least 20% | 38.5% | 6.0% | |
| Stopped because of adverse events | 3.2% | 12.6% | |
| Gastrointestinal events | 84.1% | 82.7% |
The difference between the two drugs was -9.4 percentage points (95% CI -12.0 to -6.8; P<0.001), and semaglutide produced significantly more weight loss at every threshold. The two drugs had a similar rate of gastrointestinal events, mostly mild to moderate. Cautions: the trial was small, ran at 19 US sites, and was open label between the two active drugs. The semaglutide dose was the 2.4 mg Wegovy dose, not the 7.2 mg option now on the label.
Side effects on the two labels
| Reaction | Saxenda (placebo) | Wegovy 2.4 mg (placebo) |
|---|---|---|
| Nausea | 39.3% (13.8%) | 35% (13%) |
| Vomiting | 15.7% (3.9%) | 16% (6%) |
| Diarrhea | 20.9% (9.9%) | Listed as common; rate not reproduced here |
| Constipation | 19.4% (8.5%) | 19% (8%) |
| Stopped because of adverse reactions | 9.8% (4.3%) | 6.8% (3.2%) |
Sources: Table 2 and the discontinuation paragraph of the Saxenda label and the obesity trials table of the Wegovy label. The percentages come from different trials, so use them to see the shape of each profile.
Why the daily drug is still discussed
Liraglutide was the earlier GLP-1 drug and has the longer record. Daily dosing gets to its full dose faster (about five weeks to 3 mg, against 16 weeks to 2.4 mg of semaglutide in STEP 8). The trade is an injection every day and, on the evidence above, less weight loss. Prices and coverage change often, so none are printed here; for semaglutide see semaglutide cost without insurance.
Compounded and research-grade semaglutide
Wegovy and Saxenda are the FDA-approved products. Compounded and research-grade semaglutide are a different category; see compounded semaglutide and the semaglutide dosage guide. The calculator turns a semaglutide vial into a syringe mark; it does not cover liraglutide, which comes as a prefilled pen.
Calculate your draw for semaglutide
Working from a semaglutide vial? Enter the vial strength, the bacteriostatic water you added and your dose, and get the exact mark on the syringe. Free, no signup.
Open the semaglutide calculator peptulator.com, the Bureau's independent toolFor the other weekly weight-loss injection see Zepbound vs Wegovy, and for the brand pair on the diabetes side Ozempic vs Wegovy.
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Build your stack, 2 minutesFrequently asked questions
Is Wegovy better than Saxenda?
For weight loss in the one head-to-head trial, STEP 8, yes: semaglutide 2.4 mg cut body weight by 15.8% at 68 weeks against 6.4% for liraglutide 3.0 mg in adults with overweight or obesity and no diabetes. The trial was small and open label between the two active drugs.
What is the difference between Saxenda and Wegovy?
Saxenda contains liraglutide and is injected once a day. Wegovy contains semaglutide and is injected once a week. Both are from Novo Nordisk, both activate the GLP-1 receptor and both are labelled for weight management; Wegovy also carries cardiovascular and liver indications.
Do Saxenda and Wegovy have the same side effects?
The profiles are similar: nausea, vomiting, diarrhea and constipation lead both labels, mostly during dose escalation. In STEP 8, 84.1% on semaglutide and 82.7% on liraglutide had a gastrointestinal event, and 3.2% against 12.6% stopped because of adverse events.
Can you switch from Saxenda to Wegovy?
Both labels advise against using more than one GLP-1 receptor agonist at a time. How and when to switch is a decision for a prescriber, and the labels set the starting dose.
Sources (checked 6 November 2026)
- Saxenda prescribing information, Novo Nordisk, revised 2/2026. Checked 6 November 2026.
- Wegovy prescribing information, Novo Nordisk, revised 6/2026. Checked 6 November 2026.
- Rubino et al, Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes (STEP 8), JAMA, 2022. Checked 6 November 2026.
Label figures are from the Saxenda label revised February 2026 and the Wegovy label revised June 2026. Labels and trial records change; the leaflet in your box and your prescriber come first. Educational content, not medical advice.