Week by week — from your first dose through the first year
Last reviewed: September 2026·Based on 1 clinical trial
Your dose schedule
1
0.6 mgWeeks 1–4
Starting dose. The dose is escalated in steps across the first four weeks so your body can adjust.
2
3.0 mgWeeks 5+
The dose used in the SCALE trials.
Maintenance
Key insight
The first four weeks are an escalation period rather than a treatment period. Trial data puts the first visible effects at 4 to 8 weeks, once you are on the full 3.0 mg dose.
Starting Saxenda — what to expect
Every day, at a time that suits you
Saxenda is a once-daily injection. It can be taken at any time of day, with or without food — the important thing is picking a time that is easy to remember.
Rotate where you inject
The abdomen, upper thigh and upper arm are all used. Changing the spot each day rather than injecting in the same place repeatedly is standard practice.
The dose goes up in steps
You start at 0.6 mg and escalate to 3.0 mg over four weeks. The early doses exist to let your gut adjust, not to drive weight loss.
Expect the gut to complain early
Nausea was reported by about 4 in 10 trial participants, diarrhoea by 21% and constipation by 19%. Smaller, slower meals are the usual first response.
What most people experience
The starting dose is deliberately low. Most people will not see much on the scale in the first four weeks, and that is what the trial pattern predicts rather than a sign the drug is not working.
Your journey — what typically happens month by month
Based on SCALE Obesity and Prediabetes trial data (56 weeks) and patient-reported outcomes. Average weight loss was 8.0% at 56 weeks. Individual experiences vary significantly.
Weeks 1–4
Dose escalation
The dose steps up from 0.6 mg to 3.0 mg. Gut side effects are most likely to be noticeable in this window — nausea was the most commonly reported side effect across the trials.
What to watch: Whether you can eat and drink normally. Smaller meals eaten slowly are the standard suggestion. Tell your prescriber if vomiting or diarrhoea is stopping you keeping fluids down.
Weeks 4–8
Effects become visible
Trial data puts the first visible effects at 4 to 8 weeks. By this point you are usually on the full 3.0 mg daily dose, and appetite reduction is the mechanism doing the work.
What to watch: Portion sizes. Feeling satisfied sooner is the change most people notice before the scale moves much.
Months 3–13
Toward maximum benefit
The SCALE trials ran for 56 weeks, and maximum benefit was typically reached by then. Average weight loss at that point was 8.0% of starting body weight, against 2.6% on placebo.
What to watch: The trend across four-week windows rather than the weekly number. Flat weeks are part of the pattern.
Beyond 56 weeks
Staying on treatment
Obesity is treated as a long-term condition, and the effect lasts while treatment continues. Weight regain after stopping is expected, as with other GLP-1 drugs.
What to watch: Protein intake and resistance training, which matter more as total weight loss accumulates. Any decision to stop is one to plan with your prescriber.
Key insight
The most useful thing to know about the first month on Saxenda is that it is an escalation period. The trials put the first visible effects at 4 to 8 weeks, so judging the drug at week two is judging it before it has started.
Tips for starting — what actually helps
Some tips apply to everyone on weight loss medication. Others are specific to Saxenda. Both matter most in the first 8 weeks.
Saxenda-specific
Same time every day
Saxenda is daily rather than weekly, so the habit matters more. Link it to something you already do at the same time each day.
General
Smaller meals, eaten slowly
The drug slows how quickly your stomach empties. Eating past the point of fullness is what turns mild nausea into a bad evening.
Important
Keep fluids up
The label lists dehydration from vomiting or diarrhoea as a cause of acute kidney injury. Sipping through the day beats drinking a lot at once.
General
Protein at every meal
When you are eating less, what you do eat has to work harder. Protein protects muscle during weight loss and keeps you fuller for longer.
Important
Tell anyone who sedates you
The label warns about food entering the lungs during general anaesthesia or deep sedation. Mention Saxenda before any procedure, including dental sedation.
Saxenda-specific
Rotate injection sites
With a daily injection this matters more than with a weekly one. Change the spot each day rather than using the same place repeatedly.
General
Start resistance training early
Two sessions a week from the start helps preserve muscle while you lose fat. The earlier you begin, the less you have to make up later.
General
Weigh weekly, not daily
Day-to-day weight moves by several pounds on water and food alone. Weekly weigh-ins at the same time give a far more honest picture.
What people actually say about starting
Personal experiences from public online communities — not medical advice.
“Many people find the daily injection less disruptive than expected after the first couple of weeks — the needle is very small.”
r/Saxenda
“Saxenda is often the first GLP-1 that insurers approve before allowing semaglutide or tirzepatide — some members step through it for insurance purposes.”
r/WeightLossAdvice
Bottom line
→Weeks 1–4: the dose escalates from 0.6 mg to 3.0 mg. Gut side effects are most likely here.
→Weeks 4–8: trial data puts the first visible effects in this window, on the full daily dose.
→Months 3–13: maximum benefit was typically reached by 56 weeks — an average of 8.0% in the SCALE trial.
→After that: the effect lasts while treatment continues. Weight regain after stopping is expected.
→The biggest lever you control: what you eat and whether you do resistance training — regardless of which drug.
Common questions
Trial data puts the first visible effects at 4 to 8 weeks, with maximum benefit typically reached by 56 weeks. The first four weeks are taken up escalating the dose from 0.6 mg to 3.0 mg, so early weeks are about tolerance rather than results.
You are on the 0.6 mg starting dose, which exists so your body can adjust rather than to drive weight loss. Nausea is the side effect most commonly reported across the trials, at about 4 in 10 participants, and it tends to be most noticeable while the dose is going up.
Liraglutide has a half-life of roughly 13 hours, which is why it is dosed every day. The newer GLP-1 injections last far longer in the body, which is what allows weekly dosing.
In the SCALE Obesity and Prediabetes trial, 3,731 adults taking 3.0 mg lost an average of 8.0% of their starting body weight over 56 weeks, against 2.6% on placebo. About 63% lost at least 5% of their weight, compared with 27% on placebo.
Tell your surgeon, anaesthetist or dentist that you take Saxenda. The FDA label carries a warning about food entering the lungs during general anaesthesia or deep sedation, because the drug slows stomach emptying.
Weight regain after stopping is expected, as with other GLP-1 drugs. No large randomised withdrawal study has been published for the obesity indication, so there is no trial figure for how much comes back. Plan any stop with your prescriber.
Written and maintained by one person · Built with agentic AI tools · Every number checked against the cited trial · Not medical advice
Built with agentic AI tools and not a substitute for medical advice
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Medical disclaimer: This website is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any treatment. Prices shown are United States self-pay or list prices and vary by insurance and country.