SCALE Diabetes

SCALE Diabetes tested liraglutide as a weight-management drug in people who also had type 2 diabetes, comparing the 3.0 mg weight dose against the 1.8 mg diabetes dose and against placebo. Davies and colleagues published the 56-week results in JAMA in 2015, and they became the basis for prescribing Saxenda in this population.

Participants began at a mean weight of about 106 kg. Weight loss was 6.0% (6.4 kg) on liraglutide 3.0 mg, 4.7% (5.0 kg) on 1.8 mg, and 2.0% (2.2 kg) on placebo. At least 5% of body weight was lost by 54.3% of the 3.0 mg group, 40.4% of the 1.8 mg group and 21.4% on placebo. More than 10% was lost by 25.2%, 15.9% and 6.7% respectively.

Those numbers look small next to what semaglutide and tirzepatide report a decade later, and that comparison is fair as far as it goes. But two things soften it: this was a diabetes population, where weight loss is consistently harder, and the dose-response pattern between 1.8 mg and 3.0 mg is a clean demonstration that the same molecule does more for weight at a higher dose — the same logic that separates Ozempic from Wegovy.

The common confusion is treating Saxenda and Victoza as interchangeable because both are liraglutide. They are different products with different maximum doses, different indications and different insurance handling. Victoza’s label tops out at 1.8 mg daily for glycemic control; Saxenda’s recommended dose is 3 mg daily for weight management.

Worth asking your clinician: whether a daily injection is something you will realistically keep up compared with a weekly one, whether a newer weekly agent is available and covered for you, and how your other diabetes medications interact with a weight-loss goal. Our SCALE Diabetes deep dive and Saxenda dosage chart cover the ladder.