Saxenda and Victoza are two separate prescription treatments with completely different medical goals despite containing the same active ingredient. While Saxenda was developed specifically to support weight loss in obesity management, Victoza was designed to regulate blood sugar in patients with type 2 diabetes. Both options are powerful medical tools used by physicians to bring metabolic diseases under control and help patients achieve a healthier body. These formulations, which act through hormonal mechanisms, create an important driving force during the process of reorganizing eating habits. While reaching a healthy body weight, it is vitally important for these pharmacological supports to be planned with a personalized approach and correct timing.

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What Are the Main Differences Between Saxenda and Victoza?

Problems such as excess weight and diabetes are based on complex hormonal and biological foundations and go far beyond being merely a matter of willpower. When we eat, certain hormones are secreted from the intestines. One of the best-known of these hormones, GLP-1, sends satiety signals to the brain and stimulates the pancreas to support blood sugar regulation. However, the natural hormone produced by the human body is very short-lived and is broken down within minutes, losing its effect. Scientists developed a compound called “liraglutide” to maintain this effect throughout the day. Both Saxenda and Victoza contain this compound.

The distinction between these two formulations becomes clear through the medical conditions they target and the dosage amounts they contain. Victoza is a lower-dose option developed primarily to control type 2 diabetes. While helping balance blood sugar, it may also cause some weight loss as a side effect. Saxenda, on the other hand, is specifically designed at a higher dose for obesity and weight management. The higher dose aims to stimulate the appetite centers in the brain more strongly and create a more pronounced feeling of fullness.

The distinguishing features of Victoza are as follows:

It has a lower dose
It is focused on type 2 diabetes
It comes in a single package
The turning button extends

The distinguishing features of Saxenda are as follows:

It has a higher dose
It is focused on obesity
It comes in a multiple package
The turning button does not extend

The injection pens of the two medications also have different mechanical designs to prevent incorrect use by patients. In addition, according to medical rules, using the option intended as a diabetes medication for weight loss is generally not recommended. Reaching the high levels the body needs to trigger weight loss is difficult and impractical with pens designed for diabetes. These two formulations should not be used interchangeably without physician supervision.

How Much Weight Loss Is Expected with Saxenda and Victoza Treatments?

Expecting magical and immediate results from this type of medication treatment may be misleading for patients undergoing therapy. The liraglutide compound has the potential to produce meaningful results when combined with a regular nutrition program and increased physical activity. Treatment always begins with a very low dose so that the body can adapt to the medication and possible nausea can be minimized. As the weeks progress, this dose is gradually increased in an attempt to reach the targeted peak level.

Some general conditions that patients may experience during and after dose escalation are as follows:

Reduced appetite
Smaller portions
Early satiety
Mild nausea
Temporary constipation

During clinical follow-up, a gradual reduction in weight is expected in a significant proportion of patients during the first months of treatment. However, there is a general rule used in medicine to measure the success of this process. If the patient has completed the first four months of treatment, approximately 16 weeks, and reached the highest dose but has not lost a certain percentage of their initial weight, generally around 4% or 5%, it is considered that the medication has not produced a sufficient biological response in that individual. In such cases, stopping the medication and evaluating different alternatives may be a more sensible step to prevent financial and emotional exhaustion.

After months of use, significant levels of weight loss may be recorded in individuals who respond positively to the medication. However, this success is the result not only of the medication but also of the new activity routine and portion control the person has introduced into their life. The medication acts as support that makes dieting easier by providing a feeling of fullness during this challenging process of change.

Why Is Weight Regained When Saxenda and Victoza Are Discontinued?

One of the most sensitive issues in medical weight management treatments is the period after the medication is discontinued. Rather than being permanent solutions that change obesity at a cellular or anatomical level, these medications function as powerful aids that support the body while they are being used. When the externally injected compound is eliminated from the body, the brain is deprived of the artificial satiety signals, and the human body’s thousands-of-years-old survival mechanisms come into play.

Human evolution is programmed to store fat when food is abundant and preserve energy by slowing metabolism when food is restricted. When weight is lost rapidly, the body perceives this as a threat of starvation. As soon as the medication is discontinued, there may be a marked increase in the levels of ghrelin, the hormone secreted from the stomach that stimulates hunger. In addition, the body tends to slow the resting metabolic rate in order to adapt to reduced energy intake.

Some reactions that may occur in the body after the medication is discontinued are as follows:

Increased ghrelin
Slowed metabolism
Increased appetite
Constant hunger
Low energy

Because of these hormonal and metabolic changes, most people who discontinue the medication begin returning to their previous eating habits. Gradually regaining the lost weight over the course of months is quite common. Therefore, medication treatments are often considered methods that require continuous use and lose a large part of their effect when discontinued. In order to maintain weight after stopping the medication, the person must continue the new eating habits with enormous willpower, which is extremely difficult under hormonal pressure.

Why Can Gastric Botox Be More Effective Than Saxenda and Victoza Treatments?

For people who have spent a large part of their lives moving between diet lists, weight loss medications, and cycles of losing and regaining weight, non-surgical options that are more comfortable and longer-lasting than medications may be necessary. Gastric Botox is an endoscopic procedure that slows the contraction rate of the stomach without a surgical incision and helps the patient eat less and feel full earlier. While medication methods circulate throughout the entire body through the bloodstream and cause systemic side effects, gastric Botox has the potential to structurally reshape the body’s local satiety map by directly intervening in the stomach muscles.

When botulinum toxin is applied to certain regions of the stomach during the endoscopic procedure, the activity of the centers that trigger appetite and hunger is locally reduced. In this way, after the procedure, the patient begins to experience a natural feeling of fullness because the stomach empties more slowly, without needing an external injection every day. Food remaining in the stomach for a much longer period may significantly prolong the feeling of satiety. Gastric Botox focuses on producing directly in the stomach, through an incision-free, internal, and local mechanism, the effect that medications attempt to create by stimulating the brain through daily external injections.

Some physiological changes provided by gastric Botox are as follows:

Prolonged gastric emptying time
Local suppression of the feeling of hunger
Early and long-lasting satiety signals
Effortless reduction in portion sizes
Protection from systemic medication side effects

Observational studies show that patients who undergo gastric Botox may achieve a significant advantage in quality of life and comfort in matters such as appetite control and portion reduction compared with those who use daily medical injections. Results such as slowing the progression of diabetes, balancing blood pressure, and reducing the overall metabolic burden are frequently reported. This explains why gastric Botox is considered a powerful and reliable alternative for individuals with advanced weight problems or those who are afraid of surgical operations. Prolonging gastric emptying has the capacity to significantly weaken the body’s attempt to return to old and harmful eating habits.

At Which Body Mass Index Values Should Saxenda and Victoza Be Used?

When determining treatment pathways, medical professionals closely examine the person’s height-to-weight ratio, existing chronic diseases, and previous diet attempts. At the foundation of this evaluation is a calculation called “Body Mass Index” (BMI). BMI is a numerical value obtained by dividing weight by the square of height and is a guiding tool for determining metabolic risk groups.

Some parameters considered in treatment planning are as follows:

Body mass index
Waist circumference
Presence of diabetes
Blood pressure status
Previous treatments

If the person’s BMI is below 30 and additional diseases such as diabetes are medically under control, interventions that alter the anatomy may not be necessary at this stage. For individuals in this group, correcting eating habits, expanding physical activity, and using medications such as Saxenda when necessary may be a sufficient approach. However, if the person’s BMI remains between 30 and 35 and no results have been achieved despite long-term diet and medication attempts, non-surgical local treatment options begin to be considered.

If the person’s BMI is above 35 and this condition is accompanied by metabolic problems such as insulin resistance, type 2 diabetes, sleep apnea, or high blood pressure, the medical perspective changes. From this point onward, the extent of the disease may be considered to have exceeded the limits of what medical medications alone can overcome. In order to slow the progression of internal organ fat accumulation and atherosclerosis and improve the patient’s quality of life, it is recommended that individuals in this group be evaluated for gastric Botox procedures, which are considered a reliable method without assuming the risks associated with surgery. Gastric Botox may function as a highly safe and practical solution for people who are afraid of anesthesia and surgery, do not want a scalpel or incision procedure, or have different medical obstacles.

Can Saxenda and Victoza Be Used for Weight Gain After Gastric Botox?

Although a large proportion of individuals who undergo gastric Botox manage to reach and maintain their ideal weight in their new lives, no procedure is magical or works perfectly under all circumstances. Research shows that gradual weight regain may begin months or years later in some patients who cannot make their eating habits permanent after the Botox procedure. Even if the individual’s gastric emptying rate has been slowed with Botox and weight has been successfully lost, completely changing habits in the brain and emotional eating tendencies may take time.

Some factors that may trigger weight gain are as follows:

Constant snacking
High-calorie liquids
Insufficient protein
Physical inactivity
Emotional eating

Returning to old eating habits after the procedure may cause the feeling of fullness in the stomach to be ignored and appetite to increase again. In such cases, undergoing another Botox procedure is not always the first preferred option. At this stage, the active ingredients of medications such as Saxenda and Victoza may serve as a very valuable rescue bridge.

Because gastric Botox does not disrupt the anatomical structure of the digestive system, it does not reduce the absorption of any medication taken orally. Moreover, since treatments containing liraglutide are administered through subcutaneous injection, they enter the bloodstream directly, reach the brain, and help suppress the patient’s rising appetite again. This medical support may allow the patient to refocus on the diet, regain motivation, and lose the weight gained without requiring any surgical intervention.

Which Reliable Methods Are Used If Weight Cannot Be Lost Despite Saxenda and Victoza Support?

The person may have previously tried methods such as dietitian support and injection treatments but still failed to achieve success. If previous weight has been regained as a result of fatigue caused by daily injections, systemic side effects that exhaust the entire body, or the yo-yo syndrome that develops when the medication is discontinued, medical solutions may become completely insufficient. The highly effective approach that comes into play at this stage and does not involve surgical risk is called “gastric Botox.”

Compared with injection treatments, gastric Botox is a non-surgical process that preserves organ integrity and works locally by targeting the stomach. It is considered a much more comfortable option because it eliminates the stress of the patient having to inject medication every day and the associated high lifelong costs.

Some of the advantages provided by gastric Botox during this process are as follows:

The procedure is endoscopic and completely incision-free and non-surgical
Systemic organ side effects such as those caused by medications do not occur
It eliminates the need for daily subcutaneous injections
Gastric emptying time is safely and locally prolonged
It is performed under sedation in 15-20 minutes, and the patient is discharged on the same day

If the patient has not achieved the desired permanent result from medication treatments such as Saxenda and Victoza, or if intense hunger returns and the weight is regained as soon as the injections are discontinued, the contraction rate of the stomach may be slowed with gastric Botox, allowing the feeling of early satiety to be strongly re-established. Since the procedure does not cause organ loss as surgeries do, it also eliminates the need for major and risky surgical procedures.

Dr. Ahmet Bekin

Op. Dr. Ahmet Bekin was born in Istanbul in 1983. He graduated from the Faculty of Medicine at Kocaeli University in 2006 and completed his specialty training in the Department of General Surgery at Istanbul University Çapa Faculty of Medicine in 2011. After his specialization, he worked in the fields of hernia surgery, reflux surgery, obesity surgery, advanced laparoscopic surgery, and robotic surgery. In addition, he received training in endocrine surgery, oncological surgery, and minimally invasive surgery. He is currently accepting patients from Turkey as well as from countries such as Germany and France at his private clinic located in Istanbul.