Liraglutide
In a 56-week trial, daily liraglutide 3.0 mg cut weight by 8.4 kg against 2.8 kg on placebo. Over 3 years it delayed type 2 diabetes in people with prediabetes. In people with type 2 diabetes it lowered heart events by 13%. Nausea, gallbladder disease and a faster heart rate were more common than on placebo.
- Status
- Prescription drug in the US. FDA-approved as Saxenda (daily injection) for chronic weight management in adults and in adolescents aged 12 and older with obesity, and as Victoza (daily injection) for type 2 diabetes.
- Also called
- Saxenda, Victoza, GLP-1, GLP-1 receptor agonist, lira
- Taken for
- weight loss, fat loss, appetite, keeping weight off, diabetes prevention, heart health
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Shown to help6
- StrongShown to cut about 5.6 kg more weight than placebo over a year in adults with obesity, alongside diet and activity counseling. Adolescents also lost more.Very common
- ModerateShown to keep off about 6.8 kg more than placebo for a year after a diet. Only liraglutide plus exercise also improved blood sugar and fitness.Very common
- ModerateShown to cut fat mass and visceral fat more than placebo in people with overweight or obesity, with visceral fat down 12 to 23%. Lean mass results varied.
- LimitedOne trial found fewer diabetes diagnoses on liraglutide than placebo over 3 years in adults with prediabetes and obesity, 2% against 6%.
- LimitedOne trial found fewer major cardiovascular events, 13.0% against 14.9% on placebo, in adults with type 2 diabetes at high cardiovascular risk.
- LimitedOne open-label trial found fewer repeat strokes within 90 days, 7.9% against 13.8%, in adults with type 2 diabetes after a minor stroke.
Reported risks9
- StrongShown to raise nausea and diarrhea, with about 3 times the odds of stopping for side effects as on placebo.Very common
- ModerateShown to raise resting heart rate about 2 to 3 bpm over placebo. Rises over 10 bpm occurred in 34% against 19% on placebo.Very common
- ModerateShown to raise low blood pressure reactions, including fainting on standing, to 1.1% against 0.5% on placebo in adult trials.Common
- LimitedLimited evidence: pancreatitis was 0.3% on Saxenda against 0.1% on placebo, while a diabetes trial found it slightly lower on liraglutide.Uncommon
- ModerateAcross GLP-1 drug trials, shown to raise gallbladder and bile duct disease about 37%, and more in weight loss trials, at higher doses and with longer use.How often is not known
- LimitedThe label warns of thyroid C-cell tumors in rats and mice, and states it is unknown whether liraglutide causes them in humans.How often is not known
- LimitedLimited evidence: injection-site redness, itching and bleeding were reported with GLP-1 drugs, rising with dose. Liraglutide-specific rates were not given.How often is not known
- LimitedThe label reports cases of acute kidney injury, some needing dialysis, mostly in people dehydrated by nausea, vomiting or diarrhea.How often is not known
- LimitedThe label warns adults with type 2 diabetes on insulin or a sulfonylurea may have a higher risk of low blood sugar, including severe episodes.How often is not known
What people take it for, and what was found
Shown to help6
Weight loss
Shown to cut about 5.6 kg more weight than placebo over a year in adults with obesity, alongside diet and activity counseling. Adolescents also lost more.
The numbers and sources
- How common
- Very common: more than 1 in 10 people.
- Effect
- At 56 weeks, people on liraglutide lost a mean 8.4 kg and people on placebo 2.8 kg, a difference of -5.6 kg (95% CI -6.0 to -5.1). A loss of at least 5% occurred in 63.2% on liraglutide and 27.1% on placebo, and a loss of more than 10% in 33.1% and 10.6% [1]. Across trials of 1 year or more, liraglutide produced 5.3 kg (95% CrI 4.52 to 6.06) more weight loss than placebo [2]. A second network meta-analysis found GLP-1 receptor agonists as a class lowered body weight by 5.79 percentage points (95% CI 5.25 to 6.34) more than lifestyle change alone [3]. In adolescents, body weight fell 5.01 percentage points more than on placebo at 56 weeks [4].
- Population
- 3,731 adults without diabetes, mean BMI 38.3, 78.5% women [1]; 28 RCTs with 29,018 adults [2]; 132 RCTs with 48,209 adults [3]; 251 adolescents aged 12 to 17 with obesity [4].
- Sources
- [1], [2], [3], [4]
- Caveats
- All trials paired the drug with diet and activity counseling. [1] and [4] were funded by Novo Nordisk, the maker. Attrition in the pooled trials ran 30 to 45% [2]. [3] pools all GLP-1 receptor agonists, including semaglutide.
Keeping weight off after a diet
Shown to keep off about 6.8 kg more than placebo for a year after a diet. Only liraglutide plus exercise also improved blood sugar and fitness.
The numbers and sources
- How common
- Very common: more than 1 in 10 people.
- Effect
- After a low-calorie diet run-in that cut 6.0% of weight, people on liraglutide lost a further 6.2% over 56 weeks and people on placebo 0.2%, a difference of -6.1% (95% CI -7.5 to -4.6). The run-in loss was held by 81.4% on liraglutide and 48.9% on placebo [5]. After an 8-week diet that cut a mean 13.1 kg, a year of liraglutide held 6.8 kg (95% CI 3.1 to 10.4) more off than placebo. Exercise alone held 4.1 kg more, and exercise plus liraglutide 9.5 kg more. Only the combination group improved HbA1c, insulin sensitivity and cardiorespiratory fitness. Body fat percentage fell 3.9 points with the combination, about twice as much as with either alone [6].
- Population
- 422 adults with overweight or obesity who lost at least 5% on the run-in [5]; 195 adults with BMI 32 to 43 without diabetes [6].
- Sources
- [5], [6]
- Caveats
- [5] was funded by Novo Nordisk. [6] was funded by the Novo Nordisk Foundation and others. The combination did not differ from liraglutide alone on weight (-2.7 kg, 95% CI -6.3 to 0.8) [6].
Body fat and visceral fat
Shown to cut fat mass and visceral fat more than placebo in people with overweight or obesity, with visceral fat down 12 to 23%. Lean mass results varied.
The numbers and sources
- Effect
- Across 15 placebo-controlled RCTs, liraglutide reduced total weight, fat mass and visceral fat more than placebo. Visceral fat fell 12.49% to 23% across studies. Lean mass results varied, with some studies reporting it held or rose and others reporting losses [7].
- Population
- 15 RCTs with 960 people with obesity or overweight [7].
- Sources
- [7]
- Caveats
- The review did not pool the results, and the authors could not calculate the share of weight lost as fat or lean mass [7].
Type 2 diabetes onset in prediabetes
One trial found fewer diabetes diagnoses on liraglutide than placebo over 3 years in adults with prediabetes and obesity, 2% against 6%.
The numbers and sources
- Effect
- By week 160, diabetes was diagnosed on treatment in 2% on liraglutide and 6% on placebo, a hazard ratio of 0.21 (95% CI 0.13 to 0.34). Weight changed by -6.1% on liraglutide and -1.9% on placebo at 3 years [8].
- Population
- 2,254 adults with prediabetes and a BMI of 30 or more, or 27 or more with a comorbidity [8].
- Sources
- [8]
- Caveats
- One trial. Half of participants finished the 160 weeks, and people who withdrew were not followed after stopping. Funded by Novo Nordisk [8].
- Why limited
- This rests on one trial, of 2,254 people. Strength counts independent studies that agree, so one trial is limited at any size.
Heart attack, stroke and cardiovascular death in type 2 diabetes
One trial found fewer major cardiovascular events, 13.0% against 14.9% on placebo, in adults with type 2 diabetes at high cardiovascular risk.
The numbers and sources
- Effect
- A first major cardiovascular event occurred in 13.0% on liraglutide and 14.9% on placebo (HR 0.87, 95% CI 0.78 to 0.97). Cardiovascular death was 4.7% against 6.0% (HR 0.78), and death from any cause 8.2% against 9.6% (HR 0.85). Nonfatal heart attack, nonfatal stroke and heart failure hospitalization were lower but not significantly [9].
- Population
- 9,340 adults with type 2 diabetes at high cardiovascular risk, median follow-up 3.8 years [9].
- Sources
- [9]
- Caveats
- One trial, in people with type 2 diabetes. It does not describe people without diabetes. Funded by Novo Nordisk and the National Institutes of Health [9]. A re-analysis estimating the effect of staying on treatment found a 3.5-year risk difference of 1.1% (95% CI -0.4 to 2.6), against 1.5% (95% CI 0.1 to 2.9) by intention to treat [10].
- Why limited
- This rests on one trial, of 9,340 people. Strength counts independent studies that agree, so one trial is limited at any size.
Repeat stroke after a minor stroke in type 2 diabetes
One open-label trial found fewer repeat strokes within 90 days, 7.9% against 13.8%, in adults with type 2 diabetes after a minor stroke.
The numbers and sources
- Effect
- Within 90 days, stroke recurred in 7.9% on liraglutide added to standard care and 13.8% on standard care alone (HR 0.56, 95% CI 0.34 to 0.91). An excellent functional outcome was reached by 87.3% against 77.8% (OR 1.95). Symptomatic brain bleeding and death were low and similar between groups [11].
- Population
- 636 adults with type 2 diabetes randomized within 24 hours of a minor ischemic stroke or high-risk transient ischemic attack, at 27 hospitals in China [11].
- Sources
- [11]
- Caveats
- One open-label trial over 90 days, which the authors describe as underpowered [11].
Doses studied
The weight trials in adults and adolescents used 3.0 mg by subcutaneous injection once daily [1][4][5][6][8]. The stroke trial used 0.6 mg rising to 1.8 mg daily for 90 days [11].
Risks
Reported risks8
Gastrointestinal effects and stopping treatment
Shown to raise nausea and diarrhea, with about 3 times the odds of stopping for side effects as on placebo.
The numbers and sources
- How common
- Very common: more than 1 in 10 people.
- Effect
- Mild or moderate nausea and diarrhea were the most frequent adverse events. Serious events occurred in 6.2% on liraglutide and 5.0% on placebo [1]. In adolescents, gastrointestinal events occurred in 64.8% on liraglutide and 36.5% on placebo, and events leading to discontinuation in 10.4% and 0% [4]. Across trials, liraglutide had odds of stopping for adverse events 2.95 times (95% CrI 2.11 to 4.23) those of placebo [2].
- Population
- Trial participants in [1], [2] and [4].
- Sources
- [1], [2], [4]
- Caveats
- In LEADER, gastrointestinal events were the most common reason for stopping [9].
Faster resting heart rate
Shown to raise resting heart rate about 2 to 3 bpm over placebo. Rises over 10 bpm occurred in 34% against 19% on placebo.
The numbers and sources
- How common
- Very common: more than 1 in 10 people.
- Effect
- The FDA label reports mean resting heart rate increases of 2 to 3 bpm against placebo, and 4 to 9 bpm higher in 24-hour monitoring. Rises of more than 10 bpm at two consecutive visits occurred in 34% on Saxenda and 19% on placebo [13]. A higher heart rate was observed more often with liraglutide alone than with liraglutide plus exercise [6].
- Population
- Adult participants in the Saxenda clinical trials [13]; 195 adults [6].
- Sources
- [13], [6]
- Caveats
- The label figures pool the manufacturer's trials and are not broken out by trial.
Low blood pressure (label)
Shown to raise low blood pressure reactions, including fainting on standing, to 1.1% against 0.5% on placebo in adult trials.
The numbers and sources
- How common
- Common: between 1 in 100 and 1 in 10 people.
- Effect
- Reactions related to low blood pressure, including fainting on standing and circulatory collapse, were reported in 1.1% on Saxenda and 0.5% on placebo in adult trials. Systolic pressure fell below 80 mmHg in 4 people on Saxenda (0.1%) and none on placebo [13].
- Population
- Adults in the Saxenda trials, as reported in the label [13].
- Sources
- [13]
- Caveats
- Pooled figures from the manufacturer's trials, not broken out by trial.
Gallbladder and bile duct disease
Across GLP-1 drug trials, shown to raise gallbladder and bile duct disease about 37%, and more in weight loss trials, at higher doses and with longer use.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- Across GLP-1 receptor agonist trials, the relative risk of gallbladder or biliary disease was 1.37 (95% CI 1.23 to 1.52), and 2.29 (95% CI 1.64 to 3.18) in weight loss trials. Risk was higher at higher doses and with longer use [12]. Gallstones were observed more often with liraglutide alone than with liraglutide plus exercise [6].
- Population
- 76 RCTs with 103,371 patients [12]; 195 adults [6].
- Sources
- [12], [6]
- Caveats
- [12] pools all GLP-1 receptor agonists, not only liraglutide.
Thyroid C-cell tumors (boxed warning)
The label warns of thyroid C-cell tumors in rats and mice, and states it is unknown whether liraglutide causes them in humans.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- The label carries a boxed warning. Liraglutide caused dose- and duration-dependent thyroid C-cell tumors in rats and mice. The label states it is unknown whether it causes them in humans, and that postmarketing reports of medullary thyroid carcinoma are insufficient to establish or exclude a causal link. It is contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2 [13].
- Population
- Animal (rats and mice), plus postmarketing case reports [13].
- Sources
- [13]
- Caveats
- The tumor finding is from animals. No human trial measured it as an outcome.
Skin reactions
Limited evidence: injection-site redness, itching and bleeding were reported with GLP-1 drugs, rising with dose. Liraglutide-specific rates were not given.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- A systematic review of 101 studies found injection-site reactions, including redness, itching and bleeding, most often with tirzepatide (2 to 7%), then liraglutide, then semaglutide, rising with dose. Uncommon reactions reported across these drugs included angioedema, hypersensitivity reactions, autoimmune blistering diseases, drug eruptions and vasculitis [14].
- Population
- 32 RCTs, 6 cohort or cross-sectional studies, 20 pharmacovigilance studies and 43 case reports or series of semaglutide, liraglutide and tirzepatide [14].
- Sources
- [14]
- Caveats
- The abstract does not give liraglutide-specific rates. Case reports cannot give a rate.
Acute kidney injury from dehydration (label warning)
The label reports cases of acute kidney injury, some needing dialysis, mostly in people dehydrated by nausea, vomiting or diarrhea.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- The label reports postmarketing cases of acute kidney injury, some requiring hemodialysis, in people treated with liraglutide. Most occurred in people whose nausea, vomiting or diarrhea led to dehydration. The label tells prescribers to monitor kidney function in people reporting those reactions, especially when starting and raising the dose [13].
- Population
- Postmarketing reports summarized in the label [13].
- Sources
- [13]
- Caveats
- These are reports, not rates from a controlled comparison.
Low blood sugar with insulin or sulfonylureas (label)
The label warns adults with type 2 diabetes on insulin or a sulfonylurea may have a higher risk of low blood sugar, including severe episodes.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- The label states that adults with type 2 diabetes on an insulin secretagogue, such as a sulfonylurea, or on insulin may have a higher risk of hypoglycemia on Saxenda, including severe hypoglycemia [13].
- Population
- As reported in the label [13].
- Sources
- [13]
- Caveats
- A label warning, without a rate given here.
Mixed results1
Pancreatitis
Limited evidence: pancreatitis was 0.3% on Saxenda against 0.1% on placebo, while a diabetes trial found it slightly lower on liraglutide.
The numbers and sources
- How common
- Uncommon: between 1 in 1,000 and 1 in 100 people.
- Effect
- Acute pancreatitis was confirmed by adjudication in 0.3% (9 of 3,291) on Saxenda and 0.1% (2 of 1,843) on placebo in adult trials [13]. In LEADER, pancreatitis was nonsignificantly lower on liraglutide than placebo [9].
- Population
- Saxenda trial participants [13]; 9,340 adults with type 2 diabetes [9].
- Sources
- [13], [9]
- Caveats
- Few events. The two sources point in different directions.
Claims tested and not found
- That the weight stays off after stopping. In adolescents, BMI standard-deviation score rose more after liraglutide was stopped than after placebo was stopped (difference 0.15, 95% CI 0.07 to 0.23) over 26 weeks of follow-up [4].
Sources
- Pi-Sunyer X, Astrup A, Fujioka K, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. New England Journal of Medicine. 2015. https://doi.org/10.1056/NEJMoa1411892
- Khera R, Murad MH, Chandar AK, et al. Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events. JAMA. 2016. https://doi.org/10.1001/jama.2016.7602
- Shi Q, Wang Y, Hao Q, et al. Pharmacotherapy for adults with overweight and obesity: a systematic review and network meta-analysis of randomised controlled trials. The Lancet. 2024. https://doi.org/10.1016/S0140-6736(24)00351-9
- Kelly AS, Auerbach P, Barrientos-Perez M, et al. A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity. New England Journal of Medicine. 2020. https://doi.org/10.1056/NEJMoa1916038
- Wadden TA, Hollander P, Klein S, et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: The SCALE Maintenance randomized study. International Journal of Obesity. 2013. https://doi.org/10.1038/ijo.2013.120
- Lundgren JR, Janus C, Jensen SBK, et al. Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined. New England Journal of Medicine. 2021. https://doi.org/10.1056/NEJMoa2028198
- Schmidt PHS, Pasqualotto E, Dos Santos HV, et al. Effects of liraglutide on body composition in people living with obesity or overweight: A systematic review. Obesity Research & Clinical Practice. 2025. https://doi.org/10.1016/j.orcp.2025.01.009
- le Roux CW, Astrup A, Fujioka K, et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. The Lancet. 2017. https://doi.org/10.1016/S0140-6736(17)30069-7
- Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. New England Journal of Medicine. 2016. https://doi.org/10.1056/NEJMoa1603827
- Sørensen KK, Ohlendorff JS, Munch A, et al. Accounting for non-adherence: A re-analysis of the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results trial. Clinical Trials. 2026. https://doi.org/10.1177/17407745261449668
- Zhu H, Yang B, Lu L, et al. Liraglutide in Acute Minor Ischemic Stroke or High-Risk Transient Ischemic Attack With Type 2 Diabetes: The LAMP Randomized Clinical Trial. JAMA Internal Medicine. 2026. https://doi.org/10.1001/jamainternmed.2025.5684
- He L, Wang J, Ping F, et al. Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Internal Medicine. 2022. https://doi.org/10.1001/jamainternmed.2022.0338
- U.S. Food and Drug Administration. SAXENDA (liraglutide) injection, prescribing information. Revised 2026. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3946d389-0926-4f77-a708-0acb8153b143
- Gupta AK, Teasell EM, Magalhães RF, et al. Cutaneous Adverse Events Associated with Semaglutide, Liraglutide and Tirzepatide: A Systematic Review. Medical Sciences. 2026. https://doi.org/10.3390/medsci14060652