Saxenda side effects and rebound weight: what the data says

What did @themidlandsmum actually say?

She stopped Saxenda (liraglutide) after a few months due to headaches and cost, lost about a stone and a half while on it, and then experienced what she describes as appetite far worse than before she ever started. "My appetite has absolutely skyrocketed," she says, and connects this directly to the drug's effect on hunger hormones. She's now struggling to calorie count, getting shakes from hunger, and is reconsidering her timeline for bariatric surgery. Her core warning: only start Saxenda if you can afford to stay on it until goal weight.

She isn't claiming the drug doesn't work. She's claiming the off-ramp is brutal, and that she wishes someone had told her that before she started. That's a meaningfully different argument, and it's worth taking seriously.

Does the science back this up?

Largely yes, and the evidence here is stronger than most TikTok health claims deserve. GLP-1 receptor agonists like liraglutide suppress appetite partly by acting on GLP-1 receptors in the hypothalamus and gut, reducing ghrelin signalling and slowing gastric emptying. When you stop, those effects reverse.

The SCALE trial (Davies et al., 2015, The Lancet) showed that participants who stopped liraglutide regained a significant portion of lost weight within a year. A 2022 analysis by Rubino et al. in Diabetes, Obesity and Metabolism found that after stopping semaglutide, participants regained roughly two-thirds of their lost weight within a year, alongside a return of cardiometabolic risk factors. While that study used semaglutide rather than liraglutide, both work through the same receptor class and the rebound pattern is consistent across the drug family.

Whether rebound appetite exceeds pre-treatment baseline, which is her specific claim, is harder to pin down in the literature. Some researchers have proposed that disrupting endogenous GLP-1 signalling patterns could temporarily dysregulate appetite beyond baseline, but this is not yet well-established in controlled trials. The subjective experience she describes, hunger worse than before, is plausible but not definitively proven.

What did they get wrong (or right)?

She got the core mechanism right. Saxenda does work substantially through hunger hormone suppression, and stopping it does reverse those effects. Credit where it's due: this is a real clinical issue that gets under-discussed in the influencer space, where the focus is almost always on results during treatment.

Where she oversimplifies is in saying the rebound "will happen... most likely" to everyone. That's too confident. Individual variation in GLP-1 sensitivity, dietary habits built during treatment, and duration of use all affect what happens after stopping. Some people maintain weight loss. The SCALE maintenance data showed a range of outcomes, not a uniform cliff-edge.

Her theory that hunger came back "100 times over" compared to pre-treatment baseline is the most scientifically uncertain part of her video. It's her genuine experience and it shouldn't be dismissed, but presenting it as an expected pharmacological outcome for all users goes beyond what the current evidence supports. It may reflect her specific circumstances, including stopping abruptly, returning to previous eating patterns, and the psychological contrast effect of having had appetite suppression removed.

What should you actually know?

GLP-1 medications like Saxenda are not designed as short courses. Clinical guidelines from NICE and the prescribing information for liraglutide both state that discontinuation typically results in weight regain. This isn't a secret buried in small print. It's a fundamental characteristic of how these drugs work, and any prescriber initiating treatment should be having that conversation upfront.

The issue she raises about cost is also clinically significant. Saxenda runs to several hundred pounds per month in the UK without NHS coverage. Patients starting on private prescriptions without a clear plan for long-term continuation are in a structurally difficult position, and that's a healthcare access problem, not just a personal finance one.

• If you're considering a GLP-1 medication, ask your prescriber explicitly what the stopping plan looks like before you start.
• Abrupt discontinuation versus a structured taper may affect how pronounced the rebound feels, though evidence on tapering protocols is still limited.
• Behavioural support during treatment, structured eating habits, psychological work around hunger cues, may buffer some of the rebound effect, though it won't eliminate it.
• Her situation, stopping after a few months before reaching goal weight, is the scenario most associated with full weight regain in the clinical literature.

She's not wrong to flag this publicly. But the nuance matters: the rebound is real and documented, the claim that it's universally worse than baseline is not.