Saxenda (liraglutide) is a once-daily subcutaneous injection for weight management, approved in the UK for adults with a BMI of 30 kg/m² or above, or 27 kg/m² with weight-related comorbidities. As a GLP-1 receptor agonist, it helps regulate appetite and food intake. Patients often ask whether to inject Saxenda in the thigh or stomach. Both sites are equally effective when proper technique is followed. The abdomen typically offers a larger surface area for rotation, whilst the thigh provides an accessible alternative, particularly when seated. This guide explains injection site selection, technique, and best practices to support safe, effective treatment.

Understanding Saxenda Injection Sites: Thigh or Stomach

Saxenda (liraglutide) is a once-daily subcutaneous injection licensed in the UK for weight management in adults with a body mass index (BMI) of 30 kg/m² or greater, or 27 kg/m² or greater in the presence of weight-related comorbidities. It is also licensed for adolescents aged 12 to <18 years weighing ≥60 kg as an adjunct to diet and physical activity. As a glucagon-like peptide-1 (GLP-1) receptor agonist, Saxenda works by mimicking the action of the naturally occurring hormone GLP-1, which regulates appetite and food intake.

Treatment begins with a weekly dose titration, starting at 0.6 mg daily and increasing gradually to a maintenance dose of 3.0 mg daily as tolerated. The medication must be administered subcutaneously—into the fatty tissue layer beneath the skin—rather than into muscle or directly into a vein.

The three approved injection sites for Saxenda are the abdomen (stomach area), the front of the thighs, and the upper arms. Each of these areas contains sufficient subcutaneous fat to allow proper absorption of the medication. The choice between thigh and stomach is largely a matter of personal preference, accessibility, and comfort, as clinical studies have demonstrated comparable efficacy and safety profiles across all approved sites when proper injection technique is followed.

Understanding the anatomy of these injection sites is important for optimal drug delivery. The subcutaneous layer varies in thickness between individuals and across different body areas. The abdomen typically offers a larger surface area with consistent fat distribution, making it a popular choice for many patients. The thighs provide an alternative that some find easier to access, particularly when seated. Both sites are equally effective when injections are administered correctly, and patients are encouraged to rotate between sites to minimise the risk of lipohypertrophy (fatty lumps) or lipoatrophy (loss of fat tissue) at injection points. Your prescriber or diabetes specialist nurse will provide personalised guidance on injection technique during your initial consultation.

How to Inject Saxenda in the Stomach (Abdomen)

The abdominal area is often the preferred injection site for Saxenda due to its accessibility and the relatively consistent absorption rate in this region. When injecting into the stomach area, it is essential to select the correct zone: choose an area at least 5 cm (approximately two inches) away from your navel (belly button), avoiding the area directly around it. The recommended injection zone extends across the lower abdomen and to the sides, providing ample space for site rotation.

Step-by-step injection technique for the abdomen:

• Prepare your injection: Ensure your Saxenda pen is at room temperature, check the medication is clear and colourless, and attach a new needle for each injection. For a new pen, perform a flow check (priming) before first use as described in the Patient Information Leaflet.

• Clean the site: Wash your hands thoroughly with soap and water. Clean the chosen injection site with an alcohol wipe if recommended by your healthcare provider, and allow the skin to dry completely.

• Pinch the skin: Gently pinch a fold of skin between your thumb and forefinger to lift the subcutaneous tissue away from the underlying muscle. This technique helps ensure the medication is delivered into the fatty layer rather than muscle tissue. If you have adequate subcutaneous fat, a skin pinch may not be necessary when using a short needle at a 90-degree angle.

• Insert the needle: Hold the pen at a 90-degree angle to your skin and insert the needle fully with a quick, dart-like motion. Release the skin pinch if desired, then press and hold the dose button until the dose counter returns to 0. Keep the needle in place for at least 6 seconds to ensure complete delivery of the dose.

• Withdraw and dispose: Remove the needle straight out, dispose of it safely in a sharps container, and apply gentle pressure to the site if needed. Do not rub the injection site, as this may affect absorption.

Patients should avoid injecting into areas with scars, bruises, or skin abnormalities, and should never inject through clothing. Never share your pen or needles with anyone else, even if the needle has been changed, as this risks transmission of infection. Use a prescription sharps bin for needle disposal and return it according to local arrangements when full.

Comparing Injection Sites: Which Is Better for You?

When deciding between the thigh and stomach for Saxenda injections, several practical and physiological factors merit consideration. From a pharmacokinetic perspective, there is no clinically significant difference in the absorption, efficacy, or safety profile of liraglutide when administered correctly into either the abdomen or thigh. Both sites provide adequate subcutaneous tissue for proper drug delivery and achieve comparable blood concentration levels of the active ingredient.

The abdomen offers certain practical advantages: it typically provides a larger surface area for injection site rotation, which is particularly beneficial for long-term treatment. Many patients find the stomach area easier to access and visualise, allowing for better control during self-injection. The abdominal subcutaneous tissue tends to be relatively consistent in thickness across the injection zone, potentially offering more predictable absorption. However, some individuals may feel more self-conscious about abdominal injections or find this area less comfortable, particularly if they have less subcutaneous fat in this region.

The thigh presents an accessible alternative, especially for patients who prefer to inject whilst seated or who have concerns about abdominal injection. The front and outer aspects of the thigh contain sufficient subcutaneous tissue in most adults. Some patients report that thigh injections cause less discomfort, though this is highly individual. The thigh may be preferable for those with abdominal scarring, recent surgery, or skin conditions affecting the stomach area.

The upper arm is also an approved site, but may require assistance for correct technique as it can be difficult to self-administer in this location.

Factors influencing your choice include:

• Body composition: Areas with adequate subcutaneous fat (typically at least 1–2 cm when pinched) are most suitable.

• Comfort and convenience: Choose the site you can access easily and inject confidently.

• Skin condition: Avoid areas with active skin conditions, inflammation, or scarring.

• Personal preference: Psychological comfort with the injection site affects adherence to treatment.

Discuss your individual circumstances with your prescriber or practice nurse, who can assess your injection sites and provide tailored recommendations. The most important consideration is consistent, correct technique rather than the specific site chosen.

Rotating Injection Sites and Best Practices

Systematic rotation of injection sites is essential for maintaining skin health and ensuring optimal drug absorption throughout your Saxenda treatment. Repeatedly injecting into the same spot can lead to lipohypertrophy (thickened, lumpy areas of fat tissue) or, less commonly, lipoatrophy (loss of subcutaneous fat). These changes not only affect the cosmetic appearance of the skin but can also reduce or vary the absorption of subcutaneous medicines. Avoid injecting into affected areas.

A structured rotation strategy involves dividing each injection area into multiple sites and following a systematic pattern. For the abdomen, imagine dividing the area into quadrants (upper right, upper left, lower right, lower left), avoiding the area immediately around the navel. For the thighs, alternate between the right and left leg, using different spots on the front and outer aspects of each thigh. Some patients find it helpful to keep a simple diary or use a body map to track injection sites, ensuring they don't return to the same spot for at least one week.

Best practices for injection site management include:

• Maintain spacing: Keep injections at least 2–3 cm apart from the previous injection site.

• Inspect regularly: Check your injection sites weekly for signs of lumps, hardness, redness, or skin changes. Report any persistent abnormalities to your GP or prescriber.

• Avoid problematic areas: Do not inject into areas with lipohypertrophy, as absorption will be impaired. Allow affected areas to recover fully before using them again.

• Use fresh needles: Always use a new needle for each injection. Reusing needles increases pain, risk of infection, and can damage the pen mechanism.

• Proper technique: Ensure you're injecting into subcutaneous tissue, not muscle. If you're very lean or injecting into an area with less fat, your healthcare provider may recommend a 45-degree angle or a shorter needle.

If you notice persistent bruising, bleeding, or discomfort at injection sites, consult your healthcare provider for a technique review.

Common Questions About Saxenda Injection Technique

Can I inject Saxenda in my arm? Yes, the upper arm is an approved injection site for Saxenda, specifically the outer back area of the upper arm where there is adequate subcutaneous tissue. However, this site can be more challenging to reach for self-injection, and many patients find it difficult to pinch the skin properly in this area. If you choose to use your arm, you may need assistance from a family member or carer to ensure correct technique. The abdomen and thighs generally remain the most practical options for self-administration.

What should I do if I see blood after injecting? A small amount of bleeding or bruising at the injection site is not uncommon and is generally not a cause for concern. This occurs when the needle passes through a small blood vessel in the skin. Apply gentle pressure with a clean tissue or cotton wool for a minute or two. Do not rub the area, as this may affect medication absorption. If you experience frequent or excessive bleeding, or if you're taking anticoagulant medication, discuss this with your prescriber, as you may benefit from a technique review.

Does it matter what time of day I inject? Saxenda can be administered at any time of day, with or without food. However, consistency is important—try to inject at approximately the same time each day to maintain steady medication levels and establish a routine that supports adherence. Many patients find that injecting at the same time as another daily activity (such as before breakfast or before bed) helps them remember their dose.

What if I forget to inject or miss a dose? If you miss a dose and it has been less than 12 hours since you would normally inject, administer your dose as soon as you remember. If more than 12 hours have passed, skip the missed dose and resume your normal schedule the following day. Never inject a double dose to make up for a missed one, as this increases the risk of adverse effects, particularly nausea and vomiting. If you miss doses for three or more consecutive days, you should restart at 0.6 mg and follow the dose escalation schedule again. Contact your prescriber for advice before resuming treatment.

Can injection site affect side effects? The injection site does not significantly influence the likelihood or severity of Saxenda's common side effects, which are primarily gastrointestinal (nausea, diarrhoea, constipation, vomiting). These effects are related to the medication's mechanism of action rather than where it is injected. However, local site reactions—such as redness, itching, or discomfort—can occur and may vary between individuals and injection sites. If you experience persistent or severe local reactions, try rotating to a different area and consult your healthcare provider if symptoms continue.

What should I do if I experience concerning symptoms? Seek urgent medical help if you develop symptoms of a severe allergic reaction (such as difficulty breathing, swelling of the face or throat, or severe rash) or if you experience severe, persistent abdominal pain which could indicate pancreatitis. Report any suspected side effects to your healthcare provider and to the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk or via the Yellow Card app).

Frequently Asked Questions