What is Liraglutide?
Liraglutide is a GLP-1 receptor agonist with 97% homology to native human GLP-1. It was the first GLP-1 agonist approved for weight management (Saxenda, 3mg daily) and is also approved for type 2 diabetes (Victoza, 1.8mg daily). While largely superseded by semaglutide, it remains widely used with extensive long-term safety data.
What Liraglutide Is Investigated For
Liraglutide is FDA-approved for type 2 diabetes (Victoza, 2010) and chronic weight management (Saxenda, 2014), with the LEADER trial (Marso et al., NEJM 2016, n=9,340) additionally establishing a 13% reduction in major adverse cardiovascular events (HR 0.87, 95% CI 0.78–0.97) — the first cardiovascular mortality benefit demonstrated for the GLP-1 class. That result belongs to a specific population: adults with type 2 diabetes and high cardiovascular risk. It does not transfer automatically to obesity without diabetes, where the 2025 Cochrane review of 24 trials found liraglutide likely makes little to no clinically meaningful difference to MACE (RR 0.86, 95% CI 0.66–1.10, 6 studies, 5,762 participants, moderate-certainty evidence). The two findings are not in conflict — they are different populations and different baseline risk — but the cardiovascular case for liraglutide rests on the diabetes evidence, not the obesity evidence. The strongest evidence is across all three indications: the LEAD program for T2D, the SCALE program for obesity (~8% mean weight loss at 56 weeks on 3.0 mg), and LEADER for CV outcomes all involved thousands of patients with over 15 years of post-marketing safety data. Liraglutide has been clinically superseded by semaglutide and tirzepatide on weight-loss magnitude (STEP-8 showed semaglutide produced roughly twice the weight loss) and convenience (weekly vs daily), but it retains meaningful niches: the longest real-world safety record in the class, genuine pediatric approvals (now including children 6 to under 12), and generic availability. Like all GLP-1 agonists, weight is largely regained within 1–2 years of discontinuation, and the thyroid C-cell tumor boxed warning and pancreatitis signals apply class-wide.
History & Discovery
Liraglutide was developed by Novo Nordisk as the second long-acting GLP-1 receptor agonist to reach market (after exenatide twice-daily) and represented a structural breakthrough — a GLP-1 analog with 97% homology to the native human peptide, modified by addition of a C-16 palmitic acid side chain that enabled reversible albumin binding and extended the half-life from 2 minutes (native GLP-1) to approximately 13 hours. The FDA approved Victoza for type 2 diabetes in January 2010 following the LEAD (Liraglutide Effect and Action in Diabetes) program of six Phase III trials. The higher-dose Saxenda formulation (3.0 mg daily) gained FDA approval for chronic weight management in December 2014, the first GLP-1 agonist indicated specifically for obesity. The landmark LEADER cardiovascular outcomes trial (Marso et al., NEJM 2016, PMID 27295427), which randomized 9,340 adults with type 2 diabetes and high cardiovascular risk, demonstrated a 13% relative reduction in major adverse cardiovascular events over a median 3.8 years (13.0% vs 14.9%; HR 0.87, 95% CI 0.78–0.97), establishing the first cardiovascular mortality benefit for the GLP-1 class and setting the template for subsequent CVOT trials in the class. The population matters for how that result is read: the 2025 Cochrane review of liraglutide in obesity (PMID 41161684) found little to no clinically meaningful MACE difference in trials of people without the LEADER cohort's diabetes and cardiovascular risk burden. Liraglutide has largely been clinically superseded by once-weekly semaglutide and tirzepatide on efficacy and convenience grounds, but it retains one of the longest real-world safety records in the class and is expected to enter generic availability as key patents expire during 2024–2026. By September 2026 the class-ranking picture is well-mapped in peer-reviewed meta-analyses — a BMJ July 2026 network meta-analysis (PMID 42419792) is the current definitive head-to-head ranking, and an updated Ann Intern Med 2026 systematic review of GLP-1 RAs and co-agonists in adults without diabetes (PMID 42673585) reinforces the class hierarchy — while the generic-market transition has begun producing its own peer-reviewed analytical work, including a 2026 Pharm Res orthogonal-comparability framework for chemically synthesized liraglutide versus rDNA-origin reference product (PMID 42687068) that directly addresses the higher-order-structure + in-vitro-function evidence generic filings need to meet.
How It Works
Like semaglutide, liraglutide mimics the GLP-1 hormone to reduce appetite, slow digestion, and improve blood sugar control. It requires daily injection because it has a shorter duration of action.
Liraglutide activates GLP-1R with a C-16 fatty acid (palmitic acid) modification enabling albumin binding and extending half-life to ~13 hours (vs 2 minutes for native GLP-1). Same downstream signaling as semaglutide but with lower receptor occupancy due to daily dosing and shorter half-life. The LEADER cardiovascular outcomes trial demonstrated a 13% reduction in MACE (HR 0.87, 95% CI 0.78–0.97) in adults with type 2 diabetes and high cardiovascular risk; the equivalent benefit has not been shown in obesity without diabetes, where the 2025 Cochrane review found little to no clinically meaningful MACE difference (RR 0.86, 95% CI 0.66–1.10).
Evidence Snapshot
Human Clinical Evidence
Extensive. LEAD, SCALE, and LEADER trial programs. 10+ years of post-marketing data.
Animal / Preclinical
Comprehensive.
Mechanistic Rationale
Very strong. Same GLP-1R mechanism as semaglutide.
Research Gaps & Open Questions
What the current literature has not yet settled about Liraglutide:
- 01Long-term pediatric data in young populations — new approvals for children 6 to under 12 (the SCALE Kids trial, NCT04775082) are recent, and long-term metabolic and developmental outcomes are still accruing. A 2026 Pediatrics real-world prescribing-trends analysis in children 8–11 (PMID 42692477) documents rapid uptake in the newly-approved population, but multi-year outcomes data lags the prescribing curve. A 2026 Pediatr Obes RCT (PMID 42538646) extended the adolescent evidence base into the post-vertical-sleeve-gastrectomy population, an increasingly relevant clinical intersection with pediatric bariatric surgery.
- 02Generic-to-branded equivalence in real-world practice — as liraglutide generics enter the market, real-world comparative effectiveness and switching data are not yet mature; a 2026 Pharm Res orthogonal-comparability framework paper (PMID 42687068) demonstrates the higher-order-structure and in-vitro functional bar for chemically synthesized liraglutide vs. the rDNA reference product, but real-world clinical switching outcomes are still absent.
- 03Comparative effectiveness of daily vs once-weekly GLP-1 agonists in specific populations — whether any patients benefit from daily dosing over once-weekly (for tolerability or pharmacodynamic reasons) remains underexplored.
- 04Liraglutide in neuropsychiatric indications — the ELAD Phase 2b trial (Nature Medicine, January 2026) reported a negative primary endpoint (cerebral glucose metabolic rate by FDG-PET, P=0.14) but a positive secondary executive-function signal (ADAS-Exec, P=0.01) in mild-to-moderate Alzheimer's disease, leaving the question of clinically meaningful AD benefit open rather than settled. Whether liraglutide's shorter half-life and pharmacokinetic profile matter for AD or other neuropsychiatric indications (Parkinson's, bipolar, depression) versus the once-weekly molecules remains an active research question, and semaglutide's EVOKE and EVOKE+ Phase 3 trials were negative in early symptomatic Alzheimer's disease (Lancet, May 2026).
- 05Post-discontinuation metabolic rebound — well-documented for weight but less quantified for glycemic, CV, and renal outcomes.
- 06Liraglutide in T1D with residual C-peptide — a 2026 Diabetes Obes Metab blinded RCT (PMID 42595732) in young adults with long-standing T1D tested liraglutide's effect on β-cell function; whether GLP-1 agonism can meaningfully preserve or extend the residual insulin-secreting capacity in this population is an emerging question outside the current type-2-diabetes and obesity indications.
Forms & Administration
Daily SC injection. Victoza: 0.6-1.8mg/day for T2D. Saxenda: 0.6-3.0mg/day for weight management. Dose titration over 4-5 weeks. All injectable peptides should only be administered under the guidance of a qualified healthcare provider. Never self-administer without clinician oversight.
Dosing & Protocols
The ranges below reflect protocols commonly discussed in the literature and by clinicians — not a prescription. Actual dosing for any individual should be determined by a qualified healthcare provider who knows the patient.
Typical Range
For Victoza (type 2 diabetes), the FDA-labeled schedule begins at 0.6 mg once daily for at least 1 week (a non-therapeutic initiation dose for tolerability), increases to 1.2 mg once daily, and may be further titrated to 1.8 mg once daily if glycemic targets are not met. For Saxenda (chronic weight management), titration is slower: 0.6 mg daily for 1 week, then 1.2, 1.8, 2.4, and finally 3.0 mg daily as the maintenance dose, with each step lasting 1 week, reaching maintenance by week 5. The full Saxenda dose is 3.0 mg daily.
Frequency
Once daily by subcutaneous injection, at any time of day (morning, evening, or meal-associated) as long as the same approximate time is maintained day-to-day. Unlike once-weekly semaglutide or tirzepatide, a missed daily dose cannot be meaningfully 'made up' — if more than 12 hours have elapsed, patients are instructed to skip and resume at the next scheduled dose.
Timing Considerations
Time of day
Once daily at approximately the same time each day. Morning is common; evening is equally valid. The ~13-hour half-life is short enough that consistent clock time matters more than with weekly GLP-1 analogs.
Relative to meals
With or without food. GLP-1-class nausea may feel more manageable when the injection is not paired with a large meal.
Relative to exercise
Unrelated to training.
Cycle Length
Liraglutide is intended for indefinite chronic use in both the Victoza and Saxenda indications. Weight regain after discontinuation is well-documented in SCALE extension data and mirrors the broader GLP-1 class pattern: the majority of lost weight returns within 1–2 years in the absence of other interventions. The underlying diabetes or obesity is chronic, and the pharmacological effect ends shortly after the drug clears.
Protocol Notes
Liraglutide is supplied as a pre-filled multi-dose pen injector — no reconstitution is required. The Saxenda pen includes 0.6, 1.2, 1.8, 2.4, and 3.0 mg dose settings on a single pen, allowing titration without changing pen strength. Injection sites are abdomen, thigh, or upper arm, with rotation to minimize injection-site reactions. The 5-week titration for Saxenda is driven primarily by GI tolerability; nausea and vomiting concentrate at each upward step and typically attenuate within several days. Compared to once-weekly agents, liraglutide's daily dosing creates more consistent but less convenient pharmacokinetic exposure, which some patients prefer for tolerability reasons. As generic versions enter the US market during 2024–2026 under AB-rated approvals, formulation and pen-device details may vary across manufacturers.
These doses reflect FDA-labeled protocols for specific indications. Individual dosing, titration pacing, and continuation decisions require clinician supervision and individualized evaluation.
Timeline of Effects
Onset
Appetite suppression is reported within the first few days of initiation, though at the non-therapeutic 0.6 mg starting dose the effect is typically modest. HbA1c improvement appears within 2–4 weeks. Measurable weight loss on Saxenda generally begins during the titration phase and accelerates once the 3.0 mg maintenance dose is reached at week 5.
Peak Effect
In the SCALE Obesity and Prediabetes trial (n=3,731), mean weight loss at 56 weeks with Saxenda 3.0 mg was 8.0%, compared to 2.6% with placebo; 33.1% of participants lost more than 10% of body weight, versus 10.6% on placebo. The LEAD program for Victoza established HbA1c reductions of 1.0–1.5 percentage points at the 1.8 mg dose. Weight-loss curves with Saxenda generally plateau around month 9–12, which is modest compared to semaglutide or tirzepatide but meaningful for many patients. The STEP-8 head-to-head trial directly compared weekly semaglutide 2.4 mg to daily liraglutide 3.0 mg and showed semaglutide produced approximately twice the weight loss (15.8% vs 6.4%).
After Discontinuation
SCALE extension and real-world data show a pattern broadly consistent with the rest of the GLP-1 class: majority of lost weight is regained within 12–24 months of stopping, with reversion of HbA1c, blood pressure, and lipid markers toward baseline. Liraglutide's shorter half-life means pharmacokinetic clearance is complete within roughly 3 days of the last injection; the behavioral and metabolic effects unwind over the following weeks to months as appetite and satiety signaling return to baseline.
Monitoring & Measurement
Bloodwork & Labs
- •HbA1c — primary glycemic endpoint at 3-month intervals
- •Fasting glucose and fasting insulin (HOMA-IR)
- •Lipid panel (total, LDL, HDL, triglycerides)
- •ALT and AST
- •Lipase and amylase at baseline
Functional & Performance Tests
- •Body weight (same scale, weekly)
- •Waist circumference
- •Home blood pressure cuff
When to Test
Baseline, 12 weeks, 24 weeks; weight weekly.
Interpretation & Notes
The SCALE trial anchors expectations: about 8% weight loss at week 56 on 3.0 mg. Liraglutide's response is meaningfully smaller than semaglutide or tirzepatide — if you're not a responder by week 16 (less than 4% loss), switching to a longer-acting analog is often more productive than dose escalation. Daily injection makes adherence the biggest practical differentiator. Same pancreatitis and gallbladder cautions as the rest of the class. Standard metabolic and lipid panels via LabCorp/Quest direct-to-consumer. Body composition is worth tracking, not just total weight: the Batsis 2026 systematic review of 36 RCTs found that roughly 35% of incretin-driven weight loss came from lean body mass — comparable to lifestyle-based weight loss in proportion but consequential in absolute terms for older adults, athletes, and anyone with baseline sarcopenia. DXA or BIA at baseline and 6–12 months, plus resistance training and adequate protein intake, are reasonable for users who want to preserve muscle.
Common Questions
How does liraglutide compare to semaglutide?
Semaglutide produces greater weight loss (~15-17% vs ~5-8%) and is dosed weekly vs daily. Liraglutide has longer real-world safety data. Some patients who don't tolerate semaglutide do well on liraglutide.
Are Victoza and Saxenda the same drug?
Yes — both are liraglutide. Victoza is the FDA-approved formulation for type 2 diabetes (max dose 1.8 mg daily, approved January 2010), and Saxenda is the same molecule labeled for chronic weight management (max dose 3.0 mg daily, approved December 2014). The active ingredient is identical; the label determines the indication, titration schedule, and insurance coverage.
What happens if I stop taking liraglutide?
Pharmacokinetic clearance is complete within roughly 3 days of the last injection (half-life ~13 hours). Behavioral and metabolic effects unwind over weeks to months. SCALE extension and real-world data show the majority of lost weight is regained within 12–24 months of stopping, with HbA1c, blood pressure, and lipid markers reverting toward baseline — a pattern consistent across the GLP-1 class.
Who Liraglutide Is NOT For
- •Personal or family history of medullary thyroid carcinoma (MTC) — a contraindication stated in the FDA boxed warning on both liraglutide labels (Saxenda, Novo Nordisk, label effective 25 February 2026; Victoza, Novo Nordisk, 14 October 2025). The warning rests on dose-dependent and treatment-duration-dependent thyroid C-cell tumors seen in rats and mice at clinically relevant exposures; the labels are explicit that it is unknown whether liraglutide causes thyroid C-cell tumors, including MTC, in humans, because the human relevance of the rodent finding has not been determined.
- •Multiple Endocrine Neoplasia syndrome type 2 (MEN2) — the same boxed warning names MEN 2 as a contraindication, since the syndrome carries a genetic predisposition to medullary thyroid carcinoma. The labels also note that routine monitoring of serum calcitonin or thyroid ultrasound is of uncertain value for early MTC detection in patients on liraglutide.
- •Prior serious hypersensitivity reaction (anaphylaxis, angioedema) to liraglutide or any component of the formulation.
- •Active pancreatitis or history of recurrent pancreatitis — post-marketing signals for acute pancreatitis have been reported, and the class warning applies.
- •Pregnancy — animal reproductive toxicity data exists; the labeling advises discontinuation once pregnancy is recognized.
- •Breastfeeding — transfer into human milk is not adequately characterized; weigh risk-benefit with the prescribing clinician.
- •Severe gastroparesis or significant gastrointestinal motility disorders — delayed gastric emptying can worsen symptoms and rarely precipitate obstruction.
- •Pediatric use below approved age cutoffs — Victoza is approved for type 2 diabetes in patients 10 and older; Saxenda is approved for chronic weight management in adolescents 12 and older; younger pediatric use is not approved outside of specific investigational settings.
- •Concurrent use with other GLP-1 receptor agonists — redundant mechanism, amplified GI and hypoglycemia risk, no incremental benefit.
Drug & Supplement Interactions
The two principal clinical interaction domains are hypoglycemia risk and altered oral drug absorption. Combined with insulin or insulin secretagogues (sulfonylureas, meglitinides), liraglutide materially raises hypoglycemia risk; downward adjustment of those agents at liraglutide initiation and each titration step is typically required. Delayed gastric emptying can alter the rate and sometimes the extent of absorption of orally administered drugs — most clinically relevant for warfarin (INR monitoring after dose changes), levothyroxine (TSH monitoring), and orally administered antibiotics and antiepileptics. Liraglutide has been specifically studied for oral contraceptive pharmacokinetics and appears to have less pronounced interaction than tirzepatide, though modest reductions in drug exposure have been reported. Concurrent use with SGLT2 inhibitors, metformin, and DPP-4 inhibitors is generally well-tolerated and does not require dose adjustment of liraglutide itself. Patients on any chronic oral regimen should review timing and monitoring with their prescribing clinician; liraglutide's 15+ years of post-marketing pharmacovigilance provides the most mature interaction dataset in the class.
Safety Profile
Common Side Effects
Cautions
- • Thyroid C-cell tumor boxed warning (FDA label)
- • Pancreatitis risk
- • Gallbladder disease
- • Renal impairment monitoring
What We Don't Know
Well-characterized safety profile with 10+ years of post-marketing data.
Legal Status
United States
Liraglutide is FDA-approved as Victoza (January 2010) for adults and pediatric patients 10 years and older with type 2 diabetes, and as Saxenda (December 2014) for chronic weight management in adults and adolescents 12 and older with obesity. Key patents protecting liraglutide's exclusivity have begun to expire, and generic liraglutide entered the US market in 2024 under AB-rated approvals, making it the first GLP-1 agonist to go generic. Unlike semaglutide and tirzepatide, liraglutide injection is still on FDA's drug shortage list: it was first posted in July 2023 and was still listed as in shortage in October 2026, with some Victoza and Saxenda presentations in limited supply. Novo Nordisk has told FDA it is discontinuing Saxenda, which will be available until January 2027. On April 30, 2026, FDA proposed excluding liraglutide, along with semaglutide and tirzepatide, from the 503B bulks list, finding no clinical need for outsourcing facilities to compound it from bulk drug substance; no final decision had been published at the time of this update.
International
Liraglutide is authorized by the EMA (Victoza 2009, Saxenda 2015), UK MHRA, Health Canada, Australia's TGA, and numerous other regulators for parallel indications. NICE has reimbursement criteria for Saxenda that have historically been restrictive in England but have loosened as obesity pharmacotherapy has expanded. Generic availability is emerging in parallel jurisdictions on timelines roughly aligned with the US.
Sports & Competition
Liraglutide is not named on the WADA Prohibited List (the 2026 list, or the 2027 list that takes effect January 1, 2027), and neither is any GLP-1 receptor agonist. Because liraglutide is an approved medicine, WADA's S0 'non-approved substances' category does not apply, so no Therapeutic Use Exemption is needed. Athletes in weight-category or endurance sports should still check their own federation's rules before use.
Regulatory status changes over time. Verify current local rules with a qualified professional.
Myths & Misconceptions
Myth
Liraglutide is obsolete now that semaglutide and tirzepatide exist.
Reality
Liraglutide is less potent than the newer molecules on weight-loss outcomes, but it retains clinical niches: the longest real-world safety record in the class, genuine pediatric and adolescent approvals (including the recent SCALE Kids trial in children 6 to under 12), established cardiovascular outcomes data from LEADER in high-cardiovascular-risk type 2 diabetes, and generic availability. For some patients — those who prefer daily dosing or want a molecule with a longer post-marketing history — liraglutide remains the better choice.
Myth
Victoza and Saxenda are different drugs.
Reality
Victoza and Saxenda are the same molecule — liraglutide — at different maximum doses (1.8 mg vs 3.0 mg) and with different FDA-approved indications (T2D vs chronic weight management). The clinical label determines indication, dosing schedule, and insurance coverage, but the active pharmaceutical ingredient is identical.
Myth
Because liraglutide has to be injected daily, it must cause more side effects than weekly agents.
Reality
Daily dosing creates more consistent pharmacokinetic exposure with less peak-to-trough variation than once-weekly agents, which for some patients translates to fewer GI side effects rather than more. Direct head-to-head data (STEP 8, liraglutide vs semaglutide in obesity) showed comparable gastrointestinal adverse event rates between the two dosing frequencies — 82.7% on liraglutide versus 84.1% on semaglutide. But the same trial cuts against a clean "convenience, not tolerability" reading: discontinuation for any reason ran roughly twice as high on daily liraglutide (27.6%) as on weekly semaglutide (13.5%). Whatever drove those withdrawals, more people stopped taking the daily drug.
Myth
Liraglutide is safer for children because it's been around longer.
Reality
'Around longer' in adults does not automatically extend to pediatric safety. Liraglutide's pediatric approvals (T2D for 10+, obesity for 12+, and more recently for children 6 to under 12 on the strength of the SCALE Kids trial) are backed by specific pediatric studies — but those studies are comparatively small and short-duration relative to the adult dataset. Pediatric use requires pediatric-specific evidence, which has accrued gradually rather than transferring automatically from adult safety data.
Published Research
46 studiesTrends in GLP-1 Receptor Agonist Prescriptions for Children Ages 8 to 11 With Obesity: 2019-2026.
An Orthogonal Framework for Higher-Order Structural and In Vitro Functional Comparability of Chemically Synthesized Liraglutide Relative to an rDNA-Origin Reference Product.
Pharm Res September 2026 analytical-comparability framework for chemically synthesized liraglutide versus rDNA-origin reference product — directly relevant to the ongoing generic-market transition. The kind of higher-order-structure + in-vitro-function evidence that regulators use to accept generic liraglutide filings; unusually well-matched to the file's legalStatus/history discussion of generic availability.
Efficacy and Safety of Glucagon-like Peptide-1 Receptor Agonists and Co-agonists for Weight Loss Among Adults Without Diabetes: An Updated Systematic Review.
Liraglutide and Βeta-Cell Function in Young Adults With Long-Standing Type 1 Diabetes and Residual C-Peptide: A Blinded, Randomized Controlled Trial.
Effects of Liraglutide on Energy Intake in Adolescents With Persistent Obesity After Vertical Sleeve Gastrectomy.
Comparative effects of drugs for adults with overweight or obesity: systematic review and network meta-analysis.
BMJ July 2026 systematic review and network meta-analysis of drugs for adults with overweight or obesity — the highest-impact 2026 head-to-head ranking, updating the STEP-8 direct-comparison finding that liraglutide 3.0 mg produces roughly half the weight loss of once-weekly semaglutide 2.4 mg. The current definitive class-ranking reference.
Effect of Incretin-Based and Nonpharmacologic Weight Loss on Body Composition: A Systematic Review
Batsis et al., Annals of Internal Medicine (April 2026): systematic review of 36 RCTs across incretin therapies (liraglutide, semaglutide, tirzepatide) versus non-pharmacologic weight loss interventions. Incretins produced substantial total weight loss but approximately 34.9% of that loss came from lean body mass — broadly similar to non-pharmacologic interventions but quantitatively important for older adults, athletes, and patients with baseline sarcopenia. Reshapes the body-composition framing of GLP-1 weight loss.
Liraglutide in mild to moderate Alzheimer's disease: a phase 2b clinical trial
ELAD Phase 2b (Nature Medicine, January 2026): n=204, 52 weeks, liraglutide 1.8 mg daily vs placebo in mild-to-moderate Alzheimer's disease. The primary outcome — cerebral glucose metabolic rate by FDG-PET — was negative (P=0.14). The secondary executive function endpoint (ADAS-Exec) favored liraglutide (P=0.01) and the drug was generally well tolerated. The first Phase 2b readout for any GLP-1 agonist in Alzheimer's disease; mixed result that resolves the long-standing open question about whether liraglutide affects cerebral metabolism in AD.
Liraglutide for adults living with obesity
The Cochrane review (2025), WHO-funded and independent of Novo Nordisk: 24 RCTs, 9,937 participants. Liraglutide roughly doubled the proportion reaching at least 5% weight loss (RR 2.10, 95% CI 1.80–2.45, moderate certainty), but the percentage-weight-change estimate (MD −4.72%) was graded very-low-certainty and MACE showed little to no clinically meaningful difference (RR 0.86, 95% CI 0.66–1.10) in this obesity population. The most skeptical appraisal of the obesity evidence base, and it flags that 22 of the 24 trials were manufacturer-funded.
Genetic and physiological insights into satiation variability predict responses to obesity treatment
A randomized, double-blind, placebo-controlled trial of weight loss using liraglutide 3.0 mg for weight recurrence after Roux-en-Y gastric bypass
Liraglutide for Children 6 to <12 Years of Age with Obesity - A Randomized Trial
SCALE Kids (NEJM, 2025) — the Phase 3a registration trial behind the extension of liraglutide to children 6 to under 12, the first drug approved for nonmonogenic, nonsyndromic obesity in that age band. 82 children randomized 2:1 to liraglutide 3.0 mg (or maximum tolerated dose) or placebo for 56 weeks plus lifestyle intervention: mean BMI change was −5.8% versus +1.6% (difference −7.4 percentage points, P<0.001), and 46% versus 9% achieved a BMI reduction of at least 5%. Gastrointestinal adverse events were markedly more common on drug (80% vs 54%), and with only 56 treated children the safety dataset is small next to the adult record.
Safety and efficacy of glucagon-like peptide-1 (GLP-1) receptor agonists in patients with weight regain or insufficient weight loss after metabolic bariatric surgery: A systematic review and meta-analysis
Liraglutide Improves Myocardial Perfusion and Energetics and Exercise Tolerance in Patients With Type 2 Diabetes
Bone Health After Exercise Alone, GLP-1 Receptor Agonist Treatment, or Combination Treatment: A Secondary Analysis of a Randomized Clinical Trial
Effect of liraglutide on thigh muscle fat and muscle composition in adults with overweight or obesity: Results from a randomized clinical trial
Effects of Liraglutide, Empagliflozin and Their Combination on Left Atrial Strain and Arterial Function
Liraglutide for Lower Limb Perfusion in People With Type 2 Diabetes and Peripheral Artery Disease: The STARDUST Randomized Clinical Trial
Liraglutide in Obese or Overweight Individuals With Stable Bipolar Disorder
Cotadutide promotes glycogenolysis in people with overweight or obesity diagnosed with type 2 diabetes
Glycemia and Gluconeogenesis With Metformin and Liraglutide: A Randomized Trial in Youth-onset Type 2 Diabetes
Weight Loss-Independent Effect of Liraglutide on Insulin Sensitivity in Individuals With Obesity and Prediabetes
Liraglutide restores impaired associative learning in individuals with obesity
Safety and Efficacy of Liraglutide, 3.0 mg, Once Daily vs Placebo in Patients With Poor Weight Loss Following Metabolic Surgery: The BARI-OPTIMISE Randomized Clinical Trial
BARI-OPTIMISE (JAMA Surgery, 2023): 70 patients at least a year past Roux-en-Y bypass or sleeve gastrectomy who had lost 20% or less of body weight and had a documented blunted nutrient-stimulated GLP-1 response, randomized to liraglutide 3.0 mg or placebo for 24 weeks. Weight change was −8.8% versus −0.5% (difference −8.03 percentage points, 95% CI −10.39 to −5.66, P<.001). The trial that gave a mechanistic rationale — replacing a deficient endogenous GLP-1 signal — for adding liraglutide after metabolic surgery rather than simply stacking a second weight drug.
Evaluating potential predictors of weight loss response to liraglutide in adolescents with obesity: A post hoc analysis of the randomized, placebo-controlled SCALE Teens trial
Post hoc analysis of SCALE Teens (n=251 pubertal adolescents randomized to liraglutide 3.0 mg or placebo for 56 weeks), the trial behind the Saxenda indication for ages 12 and older. No baseline characteristic — sex, race, ethnicity, age, Tanner stage, glycemic status, obesity class, depression score or weight variability — predicted who reached a BMI reduction of at least 5% or 10%; only early response (at least 4% BMI reduction by week 16) tracked with the week-56 result. The evidence behind judging adolescent response at roughly 16 weeks rather than by baseline phenotype.
Effect of the glucagon-like peptide-1 receptor agonist liraglutide, compared to caloric restriction, on appetite, dietary intake, body fat distribution and cardiometabolic biomarkers: A randomized trial in adults with obesity and prediabetes
Combination of exercise and GLP-1 receptor agonist treatment reduces severity of metabolic syndrome, abdominal obesity, and inflammation: a randomized controlled trial
Efficacy of the Glucagon-Like Peptide-1 Receptor Agonists Liraglutide and Semaglutide for the Treatment of Weight Regain After Bariatric surgery: a Retrospective Observational Study
Improvement of glycaemic control and treatment satisfaction by switching from liraglutide or dulaglutide to subcutaneous semaglutide in patients with type 2 diabetes: A multicentre, prospective, randomized, open-label, parallel-group comparison study (SWITCH-SEMA 1 study)
Liraglutide for Weight Management in Children and Adolescents With Prader-Willi Syndrome and Obesity
Efficacy and safety of liraglutide for obesity and people who are overweight: a systematic review and meta-analysis of randomized controlled trials
Glycemia Reduction in Type 2 Diabetes - Microvascular and Cardiovascular Outcomes
Glycemia Reduction in Type 2 Diabetes - Glycemic Outcomes
GRADE (NEJM, 2022) — the NIH-funded comparative-effectiveness trial that randomized liraglutide against insulin glargine, glimepiride and sitagliptin as add-ons to metformin in 5,047 adults with type 2 diabetes, followed a mean of 5.0 years. Liraglutide and glargine were the two most effective at holding HbA1c below 7% (26.1 and 26.5 events per 100 participant-years versus 30.4 for glimepiride and 38.1 for sitagliptin), with low severe hypoglycemia on liraglutide (1.0%) and the largest weight loss of the four arms. The largest independent, non-manufacturer trial in which liraglutide is a randomized arm.
Exploratory analysis of eating- and physical activity-related outcomes from a randomized controlled trial for weight loss maintenance with exercise and liraglutide single or combination treatment
Effects of liraglutide on gastrointestinal functions and weight in obesity: A randomized clinical and pharmacogenomic trial
Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial
STEP 8 (JAMA, 2022) — the only head-to-head Phase 3b trial of the two molecules, and the source of the 15.8% vs 6.4% figure cited on this page: 338 adults with overweight or obesity and without diabetes randomized to once-weekly semaglutide 2.4 mg or once-daily liraglutide 3.0 mg for 68 weeks. Weight change was −15.8% versus −6.4% (difference −9.4 percentage points, P<.001) and 70.9% versus 25.6% lost at least 10%. Gastrointestinal adverse events were near-identical (84.1% vs 82.7%), so the gap is potency rather than tolerability — though discontinuation for any reason ran twice as high on liraglutide (27.6% vs 13.5%).
The efficacy and safety of liraglutide in the obese, non-diabetic individuals: a systematic review and meta-analysis
Liraglutide for weight management: a critical review of the evidence
Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes
LEADER (Marso et al., NEJM 2016; NCT01179048) — the cardiovascular outcomes trial behind the 13% MACE figure cited throughout this page, and the source of the first cardiovascular benefit demonstrated for the GLP-1 class. 9,340 adults with type 2 diabetes and high cardiovascular risk were randomized to liraglutide or placebo and followed a median of 3.8 years. The primary composite of cardiovascular death, nonfatal myocardial infarction or nonfatal stroke occurred in 13.0% on liraglutide versus 14.9% on placebo (hazard ratio 0.87, 95% CI 0.78–0.97, P=0.01 for superiority), with cardiovascular death at 4.7% versus 6.0% (HR 0.78, 95% CI 0.66–0.93) and all-cause death at 8.2% versus 9.6% (HR 0.85, 95% CI 0.74–0.97). Note the population: high-cardiovascular-risk type 2 diabetes, not obesity without diabetes. Funded by Novo Nordisk and the NIH.
A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management
SCALE Obesity and Prediabetes (NEJM, 2015) — the registration trial for Saxenda and the source of the ~8% figure quoted throughout this page: 3,731 adults without diabetes, randomized 2:1 to liraglutide 3.0 mg or placebo for 56 weeks. Mean weight loss was 8.4 kg versus 2.8 kg (difference −5.6 kg, 95% CI −6.0 to −5.1), with 63.2% versus 27.1% losing at least 5% of body weight and 33.1% versus 10.6% losing more than 10%. Every later comparison of liraglutide against semaglutide or tirzepatide is measured against this result.
Cost effectiveness of liraglutide in type II diabetes: a systematic review
Achieving a clinically relevant composite outcome of an HbA1c of <7% without weight gain or hypoglycaemia in type 2 diabetes: a meta-analysis of the liraglutide clinical trial programme
The composite-endpoint readout of the LEAD Phase 3 programme that supported the 2010 Victoza approval: a prespecified patient-level meta-analysis of seven 26-week trials (N=4,625) against glimepiride, rosiglitazone, glargine, exenatide, sitagliptin and placebo. 40% of patients on liraglutide 1.8 mg reached HbA1c <7% with no weight gain and no hypoglycaemia, versus 6–25% across the comparators (odds ratios 2.0- to 10.5-fold in liraglutide's favour). The clearest single quantification of what separated liraglutide from the older type 2 diabetes agents.
Saxenda (liraglutide) injection — FDA prescribing information, boxed warning: Risk of Thyroid C-Cell Tumors (Novo Nordisk, label effective February 25, 2026)
Victoza (liraglutide) injection — FDA prescribing information, boxed warning: Risk of Thyroid C-Cell Tumors (Novo Nordisk, label effective October 14, 2025)
FDA Drug Shortages database: Liraglutide Injection (currently in shortage; first posted July 18, 2023)
FDA proposes to exclude semaglutide, tirzepatide, and liraglutide on 503B bulks list (April 30, 2026)
Quick Facts
- Class
- GLP-1 Receptor Agonist
- Tier
- A
- Evidence
- Strong
- Safety
- Well-Studied
- Updated
- Nov 2026
- Citations
- 46PubMed
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View Clinical TrialsLinks to ClinicalTrials.gov for reference. Listing does not imply endorsement.