If you have recently started taking Saxenda® (liraglutide), a once-daily prescription weight—loss medication, you may be looking for a Saxenda diet plan. Generally, using a diet plan can help make sure that you stay on track while using your new weight loss tool.
If you have recently started taking Saxenda® (liraglutide), a once-daily injectable prescription medication for weight loss, you may be looking for some tips for a reduced-calorie diet to help you meet your weight loss goals. The truth is there is no “best” diet for weight loss. In fact, if you are like most Americans, you know how to lose weight, but the trick is how to keep it off. That is what is so exciting about Saxenda and other GLP-1 Receptor Agonist medications. We will go into how to approach a reduced-calorie diet plan and the best way to incorporate physical activity while you are taking Saxenda
What is Saxenda?
Your body naturally produces an appetite hormone known as glucagon-like peptide-1 (GLP-1) that helps to regulate your hunger. In December 2014, the FDA granted approval for Saxenda for the treatment of chronic weight management, combined with a reduced-calorie diet and physical activity.
Saxenda and Obesity
Obesity is a complex condition. Effective management often requires several therapies, like:
- Dietary changes.
- Exercise.
- Anti-Obesity Medications (including GLP-1 Agonists like Saxenda).
- Behavior modification programs.
- Bariatric (weight loss) surgery.
Saxenda (liraglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist. It’s similar to GLP-1, which is a hormone that your body makes to control appetite. Saxenda (liraglutide) works by acting like GLP-1 in your body. It helps with weight loss by slowing gastric emptying, thus causing you to feel less hungry. It’s similar to GLP-1, which is a hormone that your body makes to control appetite.
How does Saxenda work?
Saxenda® works like GLP-1 by regulating your appetite, which can lead to eating fewer calories and losing weight.
Disclaimer: This should not be taken as medical advice. This is my opinion as a registered dietitian nutritionist.
What are the potential benefits of GLP-1 agonists?
Other than lowering blood sugar levels and reducing weight, studies show that GLP-1 agonists may have other potential benefits, like:
- Lowering blood pressure.
- Improving lipid disorders.
- Improving fatty liver disease.
- Reducing your risk of heart disease and kidney disease.
- Delaying the progression of diabetes-related nephropathy.
What are the side effects of GLP-1 agonists and how to avoid?
The most common side effects of GLP-1 agonists include:
- Loss of appetite.
- Nausea.
- Vomiting.
- Diarrhea.
These side effects are more likely to happen when you start the medication or if you’re taking an increased dose.
Other side effects can include:
- Dizziness.
- Mild tachycardia (increased heart rate).
- Infections.
- Headaches.
- Indigestion (upset stomach).
You may also have temporary mild itchiness and/or redness on your skin at the site of the injections.
Severe — but rare — side effects can include:
- Pancreatitis.
- Medullary thyroid cancer.
- Acute (sudden) kidney injury.
- Worsening diabetes-related retinopathy.
Nausea/vomiting
In aggregate, gastrointestinal (GI) side effects are by far the most common adverse effects of Saxenda. Approximately 68% of users reported some type of gastrointestinal side effect, compared to 39% of placebo users in clinical trials, according to the product information. The most prevalent GI side effect was nausea, affecting 39% of Saxenda users. The drug delays gastric (stomach) emptying. Nausea progressed to vomiting in 15% of those taking Saxenda. When fatigue or a lack of strength are experienced, it is usually in connection with gastrointestinal symptoms like nausea.
While strikingly common, these GI problems only led 6% of individuals to discontinue Saxenda, and these adverse effects tend to improve with extended GLP-1 agonist use and can be avoided by gradually increasing the dose. The dose of Saxenda can be increased by 0.6 mg every week, starting with 0.6 mg and ending at 3 mg once daily. The dose escalation can be even slower if needed.
Hypoglycemia
Victoza is another brand name of liraglutide manufactured by Novo Nordisk, used at lower doses than Saxenda and for Type 2 diabetes mellitus. Saxenda has a dual purpose in those with Type 2 diabetes and obesity, by assisting with blood glucose (sugar) control and weight loss. In this setting, the incidence rate of hypoglycemia was 23% in a clinical study, but the risk depends largely on what other diabetic medications are being taken concurrently. When diabetes was not present, less than 2% of Saxenda users reported hypoglycemia.
Serious side effects of Saxenda
- Thyroid C-cell cancer in animal studies
- Medullary thyroid carcinoma (MTC) risk or papillary thyroid carcinoma
- Colorectal neoplasm (tumor)
- Hypersensitivity reactions or anaphylaxis (a serious allergic reaction that can be life-threatening)
- Angioedema (sudden swelling of the face or body)
- Acute renal failure (sudden kidney failure) or chronic renal failure exacerbation (worsening of kidney function in one who has pre-existing kidney impairment)
- Acute pancreatitis (inflammation of the pancreas)
- Gallbladder disease including cholecystitis or cholelithiasis
- Suicidal ideation
Thyroid cancer
Liraglutide was associated with higher rates of thyroid C-cell tumors in studies of rodents. The applicability of this finding to humans is unknown as it has not been demonstrated in humans. Compared to rodents, humans also have fewer C-cells and a low level of GLP-1 on C-cells. Despite these mitigating facts, more research is needed, and until then, the FDA has a black box warning on Saxenda regarding this concern. The warning states that anyone with a personal or family history of thyroid cancer or a history of Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not use GLP-1 agonists. These historical circumstances are mentioned because of their association with thyroid tumors.
Pancreatitis
Non-severe abdominal or stomach pain is listed as one of Saxenda’s common side effects, approaching a 5% incidence rate among users. Pain in the abdomen should be brought to medical attention to determine a cause, as it may be a symptom of pancreatitis. Less commonly, severe causes, such as acute pancreatitis, could be present. Since GLP-1 agonists have been in use, sporadic cases of pancreatitis have been noted during treatment, although a causal effect has not been defined.
Suicidal ideation
Uncommonly, in less than 1% of users, suicidal thoughts have occurred during Saxenda therapy. Confusing the matter is the fact that some placebo (inactive pill for comparison) users in the studies also experienced suicidal ideation. Consequently, no causal association between Saxenda and suicidal thoughts has been confirmed.
How long do side effects last?
Adverse events with Saxenda range widely. Nausea may improve despite continued use or could resolve with lowering the dose. Otherwise, mild, common side effects usually resolve with the discontinuation of the drug. Serious side effects, such as allergic reactions, renal failure, and pancreas or gallbladder problems, may require emergent treatment and drug stoppage.
When should I call my healthcare provider?
You should have regular appointments with your healthcare provider when taking a GLP-1 agonist to assess how well it’s working.
Otherwise, talk to your provider in the following situations:
- If you develop bothersome side effects.
- If you don’t think it’s working to manage your condition.
- If you’re thinking of stopping the medication.
- If you become pregnant or are thinking of becoming pregnant.
Goals while on Saxenda
By taking this medication exactly as your healthcare provider has prescribed, you will likely lose weight. So, in addition to the number on the scale, other goals you may want to consider include:
1. Eating a reduced calorie diet with adequate (but not excessive) protein intake;
2. Increased physical activity (particularly resistance-type exercise), should be promoted to maintain muscle mass and improve muscle strength and physical function in persons with obesity
Weight Loss
Losing weight can improve self-perception and mood, but typically, the goal of treating obesity is not about achieving a certain size or weight—it’s about health.
What is a good weight loss goal?
The easiest way to determine a good weight loss goal would be to look at the BMI Chart and find the weight that puts you in a normal range.
For example, looking at this BMI chart, if you are 5’6, a target weight might be 148 lbs. Of course, if you have a lot of weight to lose, that goal may take a long time to achieve, and in that case, it may be best to break the goal into smaller parts. Healthcare providers often look at losing 5-10% of your starting weight as a success.
Benefits of losing 5-10% of body weight
Losing 5-10 percent of body weight has been shown to decrease triglycerides by an average of 40 mg/dl, which is a significant drop. This level can further improve with exercise, a diet low in concentrated sugars, refined carbohydrates, and unhealthy fats, as well as with reduction of excessive alcohol intake.
What is the best Saxenda diet plan?
The “best” diet plan is one you can follow. Indeed, considerable research shows that diets don’t work. But, sticking with a reduced-calorie meal plan can be easier when you have a tool like Saxenda in your toolbox. The key is to use the tool to help create new healthful habits that lead to long-lasting lifestyle changes.
You may not feel like eating while taking this medication, but it is incredibly important that you eat regular small meals and snacks and stay hydrated. To do that, it is recommended that you plan to eat 5-6 small meals per day like shown in the sample 1-day meal plan below.
How many calories do I need?
Caloric needs can be analyzed using a machine called an indirect calorimeter machine. Presently, access to a machine like this is limited due to cost and time so registered dietitians often use equations like the Harris-Benedict Equation or Mifflin St. Jeor equation to estimate your caloric needs based on height, weight, age, and activity level.
What should I eat on Saxenda?
Protein First
While on Saxenda, your appetite will be lower, YAY! However, because of your decreased appetite, the quality of food that you eat is that much more important. I suggest eating protein first because the body cannot store amino acids, you need to replenish them regularly. After protein, adding whole foods like non-starchy vegetables will help round out your meals.
Proteins are made up of a combination of molecules called amino acids — your body needs 20 different amino acids to function correctly. It can produce 11 of them, but it must get the final nine — called essential amino acids — from the protein you eat.
How much protein do I need on a Saxenda diet plan?
The amount of protein to eat at each meal isn’t the same for everyone. In general, a good general rule of thumb is to aim for about 25 to 30 grams per meal and at least 8-10 grams per snack. Here is a list of high-protein snacks for some ideas and here is a list of vegetarian high-protein snacks. Visit a registered dietitian to determine your individual protein needs.
How can I eat more protein?
A healthy and balanced diet typically provides all the amino acids your body needs, that is to say, eating protein with every meal and snack will likely allow you to meet protein goals. Complete proteins — which contain all nine essential amino acids in equal amounts — provide the most bang for your buck.
Complete proteins contain all nine essential amino acids.
To summarize, the following foods contain complete proteins:
- Beef
- Turkey
- Chicken
- Fish
- Eggs
- Dairy
- Soy
- Buckwheat
- Hempseed
- Quinoa
If you’re a vegetarian or vegan, or if you limit the amount of animal products you consume, you can combine incomplete, plant-based proteins to meet your body’s needs. Combinations include:
- Nuts or seeds with whole grains (peanut butter on whole wheat toast)
- Whole grains with beans (beans and rice; hummus and pita bread; bean-based chili and crackers; refried beans and tortillas)
- Beans with nuts or seeds (salad with chickpeas and sunflower seeds)
Look for easy ways to add or substitute complete proteins into what you already eat. Switch rice for quinoa, include edamame in salads, or add hempseed or Greek yogurt to smoothies.
Fiber
A good target for fiber is 20-25 grams/day. See this article for more information on fiber, or join our 31-day fiber challenge.
Sample 1-Day Diet Plan
Breakfast
Scrambled Eggs, Black Beans, Corn, Cheese and Corn Tortilla
Avocado
Tangerine
Snack
Cheerios with Milk
Banana
Lunch
Chicken, Mushrooms and Pita
Snack
Apple and Peanut Butter
Dinner
Salmon with Lemon
Couscous
Asparagus
Roasted Brussel Sprouts
Physical Activity Guidelines for Americans
Progressive muscle-strengthening activities preserve or increase muscle mass, strength, and power. Greater amounts (through higher frequency, heavier weights, or more resistance) improve muscle function to a greater degree. Improvements occur in children and adolescents as well as in younger and older adults.
Though aerobic activity does not increase muscle mass in the same way that muscle strengthening activities do, it may also help slow the loss of muscle with aging. Preserving bone, joint, and muscle health is essential with increasing age. Studies show that the frequent decline in bone density that happens during aging can be slowed with regular physical activity. These effects are seen in people who participate in aerobic, muscle-strengthening, and bone-strengthening physical activity programs of moderate or vigorous intensity. The range of total physical activity for these benefits varies widely. Important changes seem to begin at 90 minutes a week.
Building strong, healthy bones is also important for children and adolescents. Along with having a healthy diet that includes adequate calcium and vitamin D, physical activity is critical for bone development in youth. Children and adolescents ages 3 through 17 years who are physically active (such as by running, jumping, and doing other bone-strengthening activities) have higher bone mass, improved bone structure, and greater bone strength. Regular physical activity also helps people with osteoarthritis or other rheumatic conditions affecting the joints. Participation in 150 minutes a week of moderate-intensity aerobic physical activity plus muscle-strengthening activity improves pain management, function, and quality of life.
Long-term
The goal of taking Saxenda long-term is to lose weight and keep the weight off. If you are looking for additional support and answers to your questions and would like access to a registered dietitian, join our private Facebook page at Wegovy / Ozempic Meal Plans and Recipes.
Notes
If you’re a vegetarian or vegan, or if you limit the amount of animal products you consume, you can combine incomplete, plant-based proteins to meet your body’s needs. Combinations include:
- Nuts or seeds with whole grains (peanut butter on whole wheat toast)
- Whole grains with beans (beans and rice; hummus and pita bread; bean-based chili and crackers; refried beans and tortillas)
- Beans with nuts or seeds (salad with chickpeas and sunflower seeds)
Look for easy ways to add or substitute complete proteins into what you already eat. Switch rice for quinoa, include edamame in salads, or add hempseed or Greek yogurt to smoothies.
