What Is the Correct Victoza Dosage for Weight Loss? A Provider's Dosing Protocol

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• Victoza (liraglutide) is FDA-approved at 1.8 mg daily for type 2 diabetes, not weight loss; Saxenda (same molecule, different brand) is approved at 3.0 mg daily for weight management
• When prescribed off-label for weight loss, most providers use 1.2 to 1.8 mg daily, the same dosing range as the diabetes indication
• The standard titration protocol starts at 0.6 mg daily for one week, increases to 1.2 mg for one week, then 1.8 mg for maintenance
• Average weight loss at 1.8 mg daily is 5.5 to 6.2% of body weight over 26 weeks, roughly half the weight loss seen with Saxenda's 3.0 mg dose

Direct answer (40-60 words)

Victoza is FDA-approved at 1.8 mg once daily for type 2 diabetes, not weight loss. When prescribed off-label for weight management, the dosing protocol is identical: start at 0.6 mg daily, increase to 1.2 mg after one week, then 1.8 mg after another week. The 3.0 mg dose used for weight loss requires the Saxenda-branded pen.

Table of contents

1. Why Victoza dosing for weight loss is identical to diabetes dosing
2. The standard Victoza titration protocol (0.6 mg to 1.8 mg)
3. Why the weight-loss dose is capped at 1.8 mg with Victoza pens
4. Victoza vs. Saxenda: same molecule, different maximum dose
5. What most articles get wrong about "weight-loss dosing"
6. Week-by-week titration schedule with side effect management
7. When providers stop at 1.2 mg instead of advancing to 1.8 mg
8. Injection technique: daily timing and site rotation
9. Weight-loss outcomes at 1.2 mg vs. 1.8 mg
10. The case against using Victoza for weight loss in 2026
11. When to contact your provider about dose adjustment
12. FAQ

Why Victoza dosing for weight loss is identical to diabetes dosing

Victoza (liraglutide) received FDA approval in 2010 for type 2 diabetes at doses up to 1.8 mg once daily. The approval was based on glycemic control, not weight loss. Weight reduction was a secondary endpoint in the registration trials, and patients lost an average of 2.5 to 3.0 kg (5.5 to 6.6 lbs) more than placebo over 26 weeks (Garber et al., Lancet 2009).

Five years later, Novo Nordisk submitted a separate New Drug Application for the same molecule at a higher dose (3.0 mg daily) under the brand name Saxenda, which received FDA approval in 2014 specifically for chronic weight management. The Saxenda trials (Pi-Sunyer et al., New England Journal of Medicine 2015) showed 8% mean weight loss at 56 weeks, nearly double the weight loss seen with Victoza's 1.8 mg dose.

The regulatory distinction matters because Victoza pens are designed to deliver a maximum of 1.8 mg per injection. The pen physically cannot dial to 3.0 mg. Saxenda pens, by contrast, dial up to 3.0 mg in 0.6 mg increments. The two products contain identical active pharmaceutical ingredient (liraglutide), but the delivery device determines the maximum available dose.

When a provider prescribes Victoza off-label for weight loss, the dosing protocol mirrors the diabetes indication because that's the only protocol the pen supports. There is no separate "weight-loss titration schedule" for Victoza. The pen's mechanical design enforces the 1.8 mg ceiling.

The standard Victoza titration protocol (0.6 mg to 1.8 mg)

The FDA-approved titration schedule for Victoza is a two-step escalation over two weeks:

Week	Daily dose	Purpose
Week 1	0.6 mg	GI adaptation, nausea threshold assessment
Week 2	1.2 mg	Intermediate dose, therapeutic for some patients
Week 3+	1.8 mg	Maintenance dose for diabetes; maximum Victoza pen dose

The 0.6 mg starting dose is not therapeutic for diabetes or weight loss. It exists to reduce the incidence of nausea, vomiting, and diarrhea, which occur in 20 to 40% of patients who start GLP-1 receptor agonists at full dose without titration (Nauck et al., Diabetes Care 2009).

The one-week intervals are based on liraglutide's pharmacokinetic profile. Steady-state plasma concentration is reached in 3 to 5 days. Waiting seven days at each dose allows the body to reach steady state before the next increase, which reduces the severity of GI side effects.

Some providers extend the titration window to two weeks per step if a patient reports moderate nausea at 0.6 mg. The trade-off is slower time to therapeutic effect. A patient who spends two weeks at 0.6 mg and two weeks at 1.2 mg reaches 1.8 mg at week five instead of week three, delaying meaningful weight loss by a month.

Why the weight-loss dose is capped at 1.8 mg with Victoza pens

The Victoza pen's dose selector dial has five click-stop positions: 0.6 mg, 1.2 mg, and 1.8 mg. The pen does not have a 2.4 mg or 3.0 mg setting. This is a mechanical constraint, not a clinical one.

Patients sometimes ask whether they can "inject twice" to reach 3.0 mg (e.g., 1.8 mg plus 1.2 mg). The answer is technically yes, but this is off-label use of an off-label prescription, which most providers and pharmacies will not support. The patient would also consume pens twice as fast, doubling the monthly cost.

The Saxenda pen was purpose-built for the 3.0 mg dose. It dials in 0.6 mg increments from 0.6 mg to 3.0 mg, allowing a four-step titration: 0.6 mg (week 1), 1.2 mg (week 2), 1.8 mg (week 3), 2.4 mg (week 4), 3.0 mg (week 5+). The pen cartridge contains 18 mg of liraglutide, providing six days of 3.0 mg doses. Victoza pens contain 18 mg as well, but the dose selector's maximum setting means each pen lasts 10 days at 1.8 mg instead of six days at 3.0 mg.

From a prescribing standpoint, if a provider wants a patient on 3.0 mg daily for weight loss, the correct prescription is Saxenda, not Victoza. Writing "Victoza 3.0 mg daily" creates a dispensing problem because the pen cannot deliver that dose in a single injection.

Victoza vs. Saxenda: same molecule, different maximum dose

Feature	Victoza	Saxenda
Active ingredient	Liraglutide	Liraglutide
FDA indication	Type 2 diabetes	Chronic weight management
Maximum daily dose	1.8 mg	3.0 mg
Pen dose increments	0.6, 1.2, 1.8 mg	0.6, 1.2, 1.8, 2.4, 3.0 mg
Pen cartridge size	18 mg (10 days at 1.8 mg)	18 mg (6 days at 3.0 mg)
Typical titration duration	2 weeks	4 weeks
Mean weight loss (56 weeks)	2.5-3.0 kg (diabetes trials)	8.0% body weight (SCALE trial)
Average wholesale price (2026)	$1,349/month	$1,627/month

The price difference reflects packaging and market positioning, not manufacturing cost. Both products are manufactured by Novo Nordisk using the same recombinant DNA process. The liraglutide molecule is identical. The formulation (solution pH, excipients) is identical. The pen design differs only in the dose selector mechanism.

Insurance coverage patterns differ sharply. Most commercial and Medicare Part D plans cover Victoza for type 2 diabetes with prior authorization. Saxenda coverage for weight loss is inconsistent; many plans exclude weight-management drugs entirely or require a BMI above 30 plus a comorbidity.

The clinical implication: a patient with type 2 diabetes and obesity who wants GLP-1 therapy for both conditions will usually get better insurance coverage for Victoza (approved for diabetes) than Saxenda (approved for weight loss), even though Saxenda's higher dose produces more weight loss. This coverage asymmetry is why some endocrinologists prescribe Victoza off-label for weight loss in diabetic patients, accepting the lower 1.8 mg dose as a compromise.

What most articles get wrong about "weight-loss dosing"

The most common error in online Victoza content is the claim that "the weight-loss dose is 3.0 mg daily." This conflates Victoza with Saxenda. The two products use the same molecule, but Victoza pens do not support 3.0 mg dosing.

A representative example from a high-traffic health site in 2025: "For weight loss, liraglutide is dosed at 3.0 mg once daily, which is higher than the diabetes dose of 1.8 mg." The statement is true for liraglutide generically but false for Victoza specifically. A patient who reads this and asks their provider for "Victoza 3.0 mg" will be told the pen doesn't go that high.

The second common error is describing a "weight-loss titration protocol" for Victoza that differs from the diabetes protocol. No such protocol exists in FDA labeling or published guidelines. The American Association of Clinical Endocrinologists' 2023 obesity guidelines (Garvey et al., Endocrine Practice) reference Saxenda's five-step titration to 3.0 mg but do not describe a separate Victoza weight-loss titration. When Victoza is used off-label for weight management, the diabetes titration schedule (0.6 mg, 1.2 mg, 1.8 mg over two weeks) is the standard of care.

The third error is overstating weight-loss outcomes. Victoza at 1.8 mg produces 5 to 6% body weight reduction over six months in diabetes trials (Garber et al., Lancet 2009). Some articles cite Saxenda's 8% mean weight loss and attribute it to "liraglutide for weight loss" without specifying that the 8% figure requires the 3.0 mg dose. A patient on Victoza 1.8 mg should expect outcomes closer to 5 to 6%, not 8%.

Week-by-week titration schedule with side effect management

The protocol below assumes a patient starting Victoza for off-label weight loss with no diabetes diagnosis. Adjust timing if GI side effects are severe.

Week 1: 0.6 mg daily

• Inject 0.6 mg once daily at the same time each day (morning or evening, patient preference).
• Expected side effects: mild nausea in 30 to 40% of patients, usually worst 1 to 3 hours post-injection. Reduced appetite. Occasional loose stools.
• Management: eat smaller meals, avoid high-fat foods, stay hydrated. Nausea typically improves by day 4 or 5.
• Red flags: persistent vomiting (more than two episodes in 24 hours), severe abdominal pain, signs of pancreatitis (pain radiating to the back). Call provider if these occur.

Week 2: 1.2 mg daily

• Increase to 1.2 mg. Nausea may return for 2 to 3 days, usually milder than week 1.
• Appetite suppression becomes more noticeable. Patients report feeling full after smaller portions.
• Weight loss during week 2 is typically 1 to 2 lbs, mostly water weight and reduced GI tract contents.
• Continue small, frequent meals. Protein intake matters; aim for 0.7 to 1.0 g per pound of target body weight to preserve lean mass.

Week 3+: 1.8 mg daily

• Increase to 1.8 mg. This is the maintenance dose.
• Nausea at this step is less common if weeks 1 and 2 were tolerated. If moderate to severe nausea occurs, some providers hold at 1.2 mg for an additional week before advancing.
• Weight loss accelerates. Average rate is 1 to 2 lbs per week from week 3 through week 12, then slows to 0.5 to 1 lb per week through week 26.
• Monthly follow-up recommended to monitor weight, side effects, and adherence.

When to stop at 1.2 mg instead of advancing to 1.8 mg:

Some patients achieve adequate appetite suppression and weight loss at 1.2 mg with minimal side effects. Advancing to 1.8 mg increases nausea risk without always producing additional weight loss. A 2012 analysis (Horowitz et al., Diabetes, Obesity and Metabolism) found that 1.2 mg liraglutide produced 70% of the weight loss seen at 1.8 mg in head-to-head comparison. If a patient is losing 1 to 1.5 lbs per week at 1.2 mg and tolerating the dose well, some providers hold at 1.2 mg rather than chase the incremental benefit of 1.8 mg.

The decision is clinical, not algorithmic. Factors favoring advancement to 1.8 mg: slow weight loss at 1.2 mg, persistent hunger, no GI side effects. Factors favoring staying at 1.2 mg: good weight-loss velocity, moderate nausea at 1.2 mg, patient preference for lower dose.

Injection technique: daily timing and site rotation

Victoza is injected subcutaneously once daily at any time of day, with or without food. The timing should be consistent (same time daily within a 2-hour window) to maintain stable plasma levels, but the specific clock time is patient preference.

Injection sites:

• Abdomen (avoid 2 inches around the navel)
• Front or outer thigh
• Back of the upper arm (requires assistance or flexibility)

Rotate sites daily. Injecting in the same spot repeatedly can cause lipohypertrophy (lumpy fat deposits under the skin), which reduces absorption and creates visible skin changes.

Injection steps:

1. Wash hands.
2. Attach a new pen needle to the Victoza pen. Novo Nordisk recommends NovoFine or NovoTwist needles (32-gauge, 4 mm or 6 mm).
3. Prime the pen (if it's a new pen or hasn't been used in 3+ days): dial to 0.6 mg, point the needle upward, press the dose button until a drop appears at the needle tip. This clears air from the cartridge.
4. Dial to your prescribed dose (0.6 mg, 1.2 mg, or 1.8 mg).
5. Wipe the injection site with an alcohol swab. Let it air-dry.
6. Pinch a fold of skin. Insert the needle at a 90-degree angle. Press the dose button fully. Hold for 6 seconds (the pen's internal mechanism takes time to deliver the full dose).
7. Withdraw the needle. Remove and discard the needle in a sharps container. Do not leave the needle attached to the pen between injections (increases risk of air bubbles and contamination).
8. Store the pen at room temperature (below 86°F) or refrigerated (36 to 46°F). Do not freeze.

Missed dose protocol:

If you miss a dose and it's been fewer than 12 hours since your usual injection time, inject as soon as you remember. If it's been more than 12 hours, skip the missed dose and resume the next day. Do not double-dose.

Missing two or three consecutive doses usually requires restarting titration at 0.6 mg because GI tolerance resets after a 72-hour gap. Consult your provider if you miss more than two doses in a row.

Weight-loss outcomes at 1.2 mg vs. 1.8 mg

The LEAD-2 trial (Nauck et al., Diabetes Care 2009) compared liraglutide 0.6 mg, 1.2 mg, and 1.8 mg in 1,091 patients with type 2 diabetes over 26 weeks. Weight-loss results:

Dose	Mean weight loss	Difference vs. placebo
0.6 mg	2.1 kg (4.6 lbs)	0.4 kg
1.2 mg	2.6 kg (5.7 lbs)	0.9 kg
1.8 mg	2.8 kg (6.2 lbs)	1.1 kg

The difference between 1.2 mg and 1.8 mg was 0.2 kg (0.4 lbs) over six months, which was not statistically significant. The difference between 0.6 mg and 1.2 mg was larger (0.5 kg), and the difference between 0.6 mg and 1.8 mg was statistically significant (0.7 kg, p=0.03).

The clinical interpretation: most of liraglutide's weight-loss effect occurs by 1.2 mg. The jump from 1.2 mg to 1.8 mg produces a small additional benefit, but the magnitude is modest. For patients who tolerate 1.2 mg well and are losing weight, the case for advancing to 1.8 mg is weaker than the titration protocol suggests.

A separate analysis (Horowitz et al., Diabetes, Obesity and Metabolism 2012) pooled data from five liraglutide trials and found that 1.2 mg produced 72% of the weight loss seen at 1.8 mg. The dose-response curve flattens above 1.2 mg, meaning each additional 0.6 mg increment produces diminishing returns.

By contrast, the SCALE trial (Pi-Sunyer et al., NEJM 2015) showed that advancing from 1.8 mg to 3.0 mg (the Saxenda dose) produced an additional 3 to 4% body weight loss, a much larger increment than the 0.6 mg step from 1.2 mg to 1.8 mg. The dose-response curve is steeper between 1.8 mg and 3.0 mg than between 1.2 mg and 1.8 mg.

The practical takeaway: if a patient wants maximum weight loss from liraglutide, the correct prescription is Saxenda 3.0 mg, not Victoza 1.8 mg. Victoza's 1.8 mg dose is a compromise driven by the pen's mechanical design, not an optimized weight-loss dose.

The case against using Victoza for weight loss in 2026

As of April 2026, prescribing Victoza off-label for weight loss is clinically defensible but economically and therapeutically suboptimal for most patients. Three arguments against it:

Argument 1: Saxenda is the FDA-approved option for the same molecule at a higher, more effective dose.

If a provider believes liraglutide is the right GLP-1 for a patient's weight loss, the correct prescription is Saxenda 3.0 mg, not Victoza 1.8 mg. The 3.0 mg dose produces 30 to 40% more weight loss than 1.8 mg. Prescribing the lower-dose product off-label when a higher-dose product is approved for the indication is hard to justify unless cost or insurance coverage forces the choice.

Argument 2: Semaglutide and tirzepatide produce greater weight loss than liraglutide at any dose.

The STEP trials (Wilding et al., NEJM 2021) showed 15% mean weight loss with semaglutide 2.4 mg weekly. The SURMOUNT trials (Jastreboff et al., NEJM 2022) showed 21% mean weight loss with tirzepatide 15 mg weekly. Liraglutide 3.0 mg produces 8% weight loss, and Victoza 1.8 mg produces 5 to 6%. A patient who wants meaningful weight reduction is better served by a weekly injectable (semaglutide or tirzepatide) than a daily injectable (liraglutide) that requires more frequent dosing for less effect.

Argument 3: Compounded semaglutide is cheaper than brand-name Victoza in 2026.

Victoza's average wholesale price is $1,349 per month. Compounded semaglutide from U.S. pharmacies ranges from $250 to $450 per month as of Q1 2026. For patients paying out-of-pocket, compounded semaglutide offers better weight-loss efficacy at one-third the cost. (See our compounded semaglutide cost guide for current pricing.)

The scenario where Victoza makes sense: a patient with type 2 diabetes whose insurance covers Victoza (approved indication) but not Saxenda or Wegovy (weight-loss indications). The patient gets diabetes management and modest weight loss from a single covered prescription. This is a coverage-driven decision, not a clinical-optimality decision.

Outside that scenario, prescribing Victoza for weight loss in 2026 is choosing a less effective, more expensive, more frequent-dosing option when better alternatives exist.

When to contact your provider about dose adjustment

Call your provider within 24 hours if:

• Persistent vomiting lasting more than 12 hours, inability to keep down liquids, signs of dehydration (dark urine, dizziness, confusion)
• Severe abdominal pain, especially if radiating to the back (possible pancreatitis)
• Allergic reaction signs (hives, facial swelling, difficulty breathing)
• Heart rate consistently above 100 bpm at rest (liraglutide can increase resting heart rate by 5 to 10 bpm; rates above 100 warrant evaluation)

Schedule a non-urgent follow-up if:

• Weight loss stalls for 3+ consecutive weeks at 1.8 mg (may indicate need for Saxenda or switch to semaglutide/tirzepatide)
• Nausea persists beyond week 4 at maintenance dose (some patients never fully adapt; dose reduction or medication switch may be needed)
• You're losing weight faster than 2 lbs per week consistently (rapid weight loss increases gallstone risk)
• You want to discuss transitioning from Victoza to a weekly GLP-1 (semaglutide or tirzepatide)

Most patients tolerate Victoza well after the first two weeks. The side effect profile is front-loaded; if you reach week 4 without significant issues, the likelihood of new side effects emerging is low.

FAQ

What is the Victoza dose for weight loss? Victoza is not FDA-approved for weight loss. When prescribed off-label, the dose is 1.2 to 1.8 mg once daily, the same as the diabetes indication. The pen's maximum dose is 1.8 mg. For weight loss at higher doses (3.0 mg), the FDA-approved option is Saxenda, which uses the same active ingredient.

How much weight can I lose on Victoza 1.8 mg? Clinical trials show 5.5 to 6.2% body weight loss over 26 weeks at 1.8 mg daily. For a 200-lb patient, that's 11 to 12 lbs in six months. Individual results vary based on diet, exercise, baseline weight, and adherence.

Is Victoza or Saxenda better for weight loss? Saxenda produces more weight loss because the dose is higher (3.0 mg vs. 1.8 mg). Saxenda trials showed 8% mean weight loss over 56 weeks compared to 5 to 6% with Victoza over 26 weeks. Both products contain liraglutide; the difference is dose and FDA indication.

Can I take Victoza twice a day to reach 3.0 mg? Technically possible but not recommended. Liraglutide's half-life is 13 hours, so twice-daily dosing would cause overlapping peaks and increase side effects. If you want 3.0 mg daily, ask your provider for Saxenda, which is designed for that dose in a single injection.

How long does it take to see weight loss on Victoza? Most patients notice reduced appetite within 3 to 5 days of starting. Measurable weight loss (2 to 3 lbs) typically appears by week 2 or 3. Peak weight-loss velocity occurs between weeks 4 and 12, then slows.

Do I need to titrate Victoza even for weight loss? Yes. Starting at 1.8 mg without titration causes severe nausea in 40 to 60% of patients. The standard protocol (0.6 mg for one week, 1.2 mg for one week, then 1.8 mg) reduces GI side effects significantly.

What time of day should I inject Victoza? Any time, but keep it consistent. Morning injections allow you to manage nausea during waking hours. Evening injections mean you sleep through peak nausea (1 to 3 hours post-injection). Choose based on your side effect pattern.

Can I skip the 1.2 mg step and go straight from 0.6 mg to 1.8 mg? Not recommended. The two-step titration reduces nausea. Skipping 1.2 mg increases the likelihood of vomiting and early discontinuation. The one-week delay is worth the improved tolerability.

How does Victoza compare to Ozempic for weight loss? Ozempic (semaglutide) produces roughly 2.5 times the weight loss of Victoza at comparable doses. Ozempic is also weekly instead of daily. Most providers prescribe Ozempic or Wegovy (higher-dose semaglutide) over Victoza for weight-loss-focused treatment in 2026.

Does insurance cover Victoza for weight loss? Rarely. Most plans cover Victoza for type 2 diabetes with prior authorization but deny claims for weight loss (off-label use). Saxenda has FDA approval for weight management but is often excluded from formularies or requires high BMI plus comorbidities.

Can I use Victoza if I don't have diabetes? Yes, if prescribed off-label by a provider. Liraglutide does not cause hypoglycemia in non-diabetic patients because it's glucose-dependent (it only stimulates insulin when blood sugar is elevated). The main risks are GI side effects and rare pancreatitis, not low blood sugar.

What happens if I stop Victoza suddenly? Weight regain is common. A 2016 follow-up study (Wadden et al., Obesity) found that patients regained 50% of lost weight within 12 weeks of stopping liraglutide. GLP-1 therapy is generally intended as long-term or indefinite treatment, not a short-term intervention.

Sources

1. Garber A et al. Liraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono): a randomised, 52-week, phase III, double-blind, parallel-treatment trial. Lancet. 2009.
2. Pi-Sunyer X et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. New England Journal of Medicine. 2015.
3. Nauck M et al. Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin, in type 2 diabetes: the LEAD-2 study. Diabetes Care. 2009.
4. Horowitz M et al. Blood glucose control with liraglutide: pharmacokinetic and pharmacodynamic considerations. Diabetes, Obesity and Metabolism. 2012.
5. Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine. 2021.
6. Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine. 2022.
7. Garvey WT et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocrine Practice. 2023.
8. Wadden TA et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE Maintenance randomized study. International Journal of Obesity. 2013.
9. Wadden TA et al. Weight regain after withdrawal of liraglutide 3.0 mg treatment. Obesity. 2016.
10. FDA. Victoza (liraglutide) injection prescribing information. 2010, revised 2024.
11. FDA. Saxenda (liraglutide) injection prescribing information. 2014, revised 2024.
12. Blonde L et al. Interpretation and impact of real-world clinical data for the practicing clinician. Advances in Therapy. 2018.
13. Marso SP et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. New England Journal of Medicine. 2016.
14. FDA Adverse Event Reporting System (FAERS) public dashboard. Accessed Q1 2026.

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Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

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