Victoza (liraglutide) is a GLP-1 receptor agonist licensed in the UK for managing type 2 diabetes in adults and adolescents aged 10 and above. Whilst its primary purpose is to improve blood glucose control, many patients experience modest weight loss as a secondary benefit. Clinical trials show that people taking Victoza 1.8 mg typically lose between 2 to 3 kg over 26 to 52 weeks. However, individual results vary considerably, and weight reduction should be viewed as an additional benefit rather than the main treatment goal. Understanding what to expect can help patients and healthcare professionals set realistic objectives for diabetes management.

What Is Victoza and How Does It Work?

Victoza (liraglutide) is a prescription medicine licensed in the UK for the treatment of type 2 diabetes mellitus in adults and adolescents aged 10 years and above. It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of a naturally occurring hormone in the body.

The mechanism of action involves several complementary effects:

• Stimulating insulin secretion when blood glucose levels are elevated, helping to lower blood sugar after meals

• Suppressing glucagon release, which reduces glucose production by the liver

• Slowing gastric emptying, meaning food moves more slowly from the stomach into the small intestine

• Acting on appetite centres in the brain, which can reduce feelings of hunger and increase satiety

Victoza is administered as a once-daily subcutaneous injection using a pre-filled pen device. The dose is typically started at 0.6 mg daily and gradually increased to the maintenance dose of 1.2 mg or 1.8 mg, depending on individual response and tolerability. This gradual titration helps minimise gastrointestinal side effects.

Whilst Victoza's primary indication is glycaemic control in type 2 diabetes, many patients do experience weight loss as a secondary benefit. This occurs largely through the appetite-suppressing and gastric-slowing effects of the medication. It is important to note that in the UK, liraglutide is also available at a higher dose (3.0 mg) under the brand name Saxenda, which is specifically licensed for weight management in adults with a BMI ≥30 kg/m², or ≥27 kg/m² with weight-related comorbidities, and in adolescents with specific criteria. However, Victoza at diabetes doses (up to 1.8 mg) is not formally licensed as a weight-loss treatment, though weight reduction is a recognised clinical effect.

How Much Weight Can You Lose on Victoza?

Clinical trial data suggests that modest weight loss is a common outcome for people taking Victoza for type 2 diabetes. However, the amount varies considerably between individuals, and it is important to maintain realistic expectations.

Clinical trial findings from the LEAD (Liraglutide Effect and Action in Diabetes) programme showed that patients taking Victoza 1.8 mg typically lost between 2 to 3 kg (approximately 4 to 7 pounds) over 26 to 52 weeks, compared to those on placebo or other diabetes medications. Some individuals experienced greater weight loss, whilst others saw minimal change or even slight weight gain.

Key points about weight loss on Victoza:

• Weight loss tends to be gradual and modest rather than dramatic

• Most weight loss occurs within the first 6 to 12 months of treatment

• The effect appears to plateau after this initial period

• Weight loss may be maintained while treatment continues, but can vary between individuals

• Results are typically better when combined with lifestyle modifications including dietary changes and increased physical activity

It is crucial to understand that Victoza is not primarily a weight-loss medication at the doses used for diabetes management. The weight reduction observed is considered a beneficial side effect rather than the main therapeutic goal. Patients prescribed Victoza should focus primarily on its intended purpose: improving blood glucose control in type 2 diabetes. Any weight loss should be viewed as an additional benefit that may help improve overall metabolic health and diabetes management.

Factors That Affect Weight Loss with Victoza

The degree of weight loss experienced on Victoza varies significantly between individuals due to multiple interacting factors. Understanding these variables can help set appropriate expectations and optimise outcomes.

Baseline characteristics play an important role:

• Starting weight: People with higher initial body weight may experience greater absolute weight loss

• Dose: Higher doses (1.8 mg vs 1.2 mg) are generally associated with slightly greater weight reduction

• Duration of diabetes: Longer-standing diabetes may be associated with different metabolic responses

• Concurrent medications: Some diabetes medications (such as insulin or sulphonylureas) can promote weight gain, potentially offsetting Victoza's weight-reducing effects and increasing hypoglycaemia risk

Lifestyle factors are equally critical:

• Dietary habits: Victoza works synergistically with calorie reduction and healthier food choices

• Physical activity levels: Regular exercise enhances weight loss and improves insulin sensitivity

• Sleep quality and stress: Both can influence appetite hormones and weight regulation

• Adherence to treatment: Consistent daily dosing is essential for optimal effect

Individual response variation also matters. People respond differently to the appetite-suppressing effects of Victoza, with some experiencing significant reduction in hunger or increased feelings of fullness, while others notice minimal impact on appetite.

Tolerability and side effects can indirectly affect weight outcomes. Gastrointestinal symptoms such as nausea, which are common especially during dose escalation, may temporarily reduce appetite and food intake. However, these effects typically diminish over time as the body adjusts to the medication.

Managing Expectations: Weight Loss vs Blood Sugar Control

When starting Victoza, it is essential to maintain a balanced perspective on treatment goals. Whilst weight loss can be a welcome benefit, the primary objective remains optimising glycaemic control and reducing long-term diabetes complications.

The primary purpose of Victoza in type 2 diabetes management is to:

• Lower HbA1c (a measure of average blood glucose over 2-3 months)

• Reduce fasting and post-meal blood glucose levels

Additionally, clinical evidence from the LEADER trial has shown that liraglutide can reduce the risk of major cardiovascular events in people with type 2 diabetes who have established cardiovascular disease.

According to NICE guidance (NG28), GLP-1 receptor agonists like Victoza are typically considered for adults with type 2 diabetes when:

• Metformin and other oral medications have not achieved adequate glycaemic control

• The person has a BMI of 35 kg/m² or higher (or lower with specific circumstances)

• Weight loss would benefit other significant obesity-related comorbidities

Importantly, NICE recommends continuing GLP-1 receptor agonist treatment only if there is a beneficial metabolic response (a reduction in HbA1c of at least 11 mmol/mol [1%] and weight loss of at least 3% of initial body weight in 6 months).

Setting realistic expectations is crucial for treatment satisfaction and adherence. Patients should understand that:

• Weight loss, if it occurs, will likely be modest (typically 2-5% of body weight)

• The medication is not a substitute for lifestyle modifications

• Blood sugar improvements may occur independently of weight changes

• Some people may not lose weight at all, yet still achieve excellent diabetes control

• Discontinuing the medication typically results in weight regain and worsening glycaemic control

Healthcare professionals should emphasise that successful diabetes management encompasses multiple outcomes beyond the number on the scales, including improved energy levels, better blood glucose stability, reduced medication burden, and decreased risk of long-term complications.

When to Speak to Your GP About Weight Changes on Victoza

Regular communication with your healthcare team is essential when taking Victoza, particularly regarding weight changes and overall treatment response. Certain situations warrant prompt medical review.

Contact your GP or diabetes specialist nurse if you experience:

• Unexpected or rapid weight loss (more than 1-2 kg per week) that seems excessive or is accompanied by other symptoms

• No improvement in blood glucose control after 3-6 months of treatment at the maximum tolerated dose

• Persistent gastrointestinal side effects (nausea, vomiting, diarrhoea) that interfere with eating, hydration, or quality of life

• Signs of dehydration including dark urine, dizziness, or reduced urination, particularly if experiencing vomiting or diarrhoea

Seek urgent medical advice (call NHS 111, urgent care or emergency services) and stop taking Victoza if you experience:

• Severe, persistent abdominal pain, especially if radiating to the back, which could indicate pancreatitis (a rare but serious side effect)

• Right-sided upper abdominal pain, fever or yellowing of the skin/eyes, which could indicate gallbladder problems

Contact your healthcare team promptly if you experience:

• Symptoms of hypoglycaemia (low blood sugar) such as trembling, sweating, confusion, or palpitations, particularly if taking Victoza alongside insulin or sulphonylureas

Routine monitoring is also important. Your healthcare team will typically:

• Review your HbA1c levels every 3-6 months to assess diabetes control

• Monitor weight and BMI at regular appointments

• Assess kidney function periodically (no dose adjustment is required in renal impairment, though caution is advised in severe renal impairment)

• Discuss any changes in other medications that might affect weight or blood glucose

If weight loss is insufficient or you have concerns about your diabetes management, your GP may consider:

• Reviewing your overall diabetes treatment plan

• Referring you to a dietitian for specialist nutritional advice

• Discussing whether alternative or additional medications might be appropriate

• Assessing whether referral to specialist weight management services is suitable

Remember that diabetes management is individualised, and what works well for one person may differ for another. Open, ongoing dialogue with your healthcare team ensures your treatment remains optimally tailored to your needs.

If you suspect you've experienced a side effect from Victoza, you can report it through the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk.

Frequently Asked Questions