Liraglutide for Weight Loss: Evidence, Eligibility, Coverage

Liraglutide is FDA approved for weight loss as Saxenda. In SCALE Obesity and Prediabetes, people on Saxenda lost 7.4% of body weight on average, vs 3% on placebo.

Brands: Victoza and Saxenda
Best result (SCALE Obesity and Prediabetes): 7.4% weight loss

Saxenda in brief

How long it remains in your body

Its half-life is about 13 hours: by 13 h, half is gone, and about 3% remains once five half-lives have passed (2.7 d).

Main trial: how much weight was lost

For SCALE Obesity and Prediabetes, 56 weeks, the reported body-weight figure was 7.4%, compared with 3% on placebo.

Reference: FDA DailyMed label.

Who qualifies for it?

Liraglutide: who qualifies
Who sets the rule	Who qualifies for it?
Victoza	For people 10 and older with type 2 diabetes, it lowers blood sugar when used with diet and exercise.
Victoza	For adults with heart disease and type 2 diabetes, the risk of heart-related death, heart attack or stroke becomes lower.
Saxenda	For adults and children 12 and up (over 60 kg) who have obesity, or adults who have overweight plus a weight-related condition, this medicine is for weight loss and keeping weight off long term when used with diet and activity.
Typical commercial plan (Aetna policy)	BMI 30 or higher
Typical commercial plan (Aetna policy)	BMI 27 or higher with a weight-related condition
Typical commercial plan (Aetna policy)	a diet and activity program that lasts 6 months comes first

Source: FDA DailyMed label 1 2, and aetna.com.

Results from weight-loss trials

Liraglutide weight-loss trials
Trial	Medicine	Who took part	Length	People	Main result	Comparison
SCALE Obesity and Prediabetes	Saxenda	Adults with obesity or overweight but without type 2 diabetes	56 weeks	3,731	7.4% weight loss	3% on placebo

Trial source: SCALE Obesity and Prediabetes (FDA label (DailyMed)).

How is it different for weight loss?

Liraglutide: what the label says about weight loss
What changes	What the label says	Labels
Acute Pancreatitis	Can cause inflammation of the pancreas. Get care and stop taking it if the severe pain in your stomach does not go away.	All of them
Acute Gallbladder Disease	Gallstones and gallbladder inflammation can happen. Mention fever, yellow skin or eyes, or upper right belly pain.	All of them

From the labels: FDA DailyMed label.

From the warnings: FDA DailyMed label.

Coverage for weight loss

A GLP-1 used only for weight loss is not covered by Medicare Part D.

When Medicaid covers weight-loss GLP-1s, prior authorization is the standard.

Sources: humana.com, KFF.

Other weight-loss choices

GLP-1 medicines and weight loss
Medicine	For weight loss	How it is taken	Trial result
Saxenda	FDA approved	daily injection	7.4% weight loss
Wegovy	FDA approved	weekly injection or daily tablet	14.9% weight loss
Zepbound	FDA approved	weekly injection	20.9% weight loss
Foundayo	FDA approved	daily tablet	11.1% weight loss
Victoza	Not an approved use	daily injection	Not listed
Ozempic	Not an approved use	weekly injection	Not listed
Rybelsus	Not an approved use	daily tablet	Not listed
Mounjaro	Not an approved use	weekly injection	Not listed
Trulicity	Not an approved use	weekly injection	Not listed
Byetta	Not an approved use	twice-daily injection	Not listed