Does Farxiga cause weight loss?

In this article:

• Does Farxiga cause weight loss?
• How does Farxiga work for weight loss?
• How fast does Farxiga cause weight loss?
• Who should not take Farxiga?
• The bottom line: Farxiga can cause weight loss

In this article

• Does Farxiga cause weight loss?
• How does Farxiga work for weight loss?
• How fast does Farxiga cause weight loss?
• Who should not take Farxiga?
• The bottom line: Farxiga can cause weight loss

Nearly half of U.S. adults want to lose weight, and many are looking for solutions that can aid them in their journey. Some are turning to Farxiga (dapagliflozin), a Type 2 diabetes drug that can cause weight loss as a side effect. This medication improves blood glucose levels by removing excess sugar from the body. Farxiga also can reduce the risk of hospitalization from heart failure and slow down kidney disease progression in patients with chronic renal disease. 

However, experts say taking Farxiga off-label for weight loss isn’t for everyone. Here’s what you need to know about how the medication works, how much weight you may lose, and whether it’s the right option for you.

Does Farxiga cause weight loss?

One possible side effect of Farxiga (dapagliflozin) is weight loss. However, the U.S. Food and Drug Administration (FDA) has not approved Farxiga as a weight-loss medication.

Rather, Farxiga is an FDA-approved treatment for Type 2 diabetes mellitus. This drug helps to control blood sugar levels and reduce the risk of heart failure. The medication is also used to help slow down the progression of chronic kidney disease.

Because Farxiga can cause weight loss as a side effect, the drug has been used off-label for weight management. Clinical studies show that people who took Farxiga for 24 weeks lost up to seven pounds (just over three kilograms). Another study of patients with Type 2 diabetes and heart disease found that Farxiga led to an average of six pounds lost within one year of starting the medication.

Experts believe that Farxiga sends extra glucose, or sugar, from blood to the urine. Calories from the glucose then leave the body in the urine. “The studies show that glucose output from medications like Farxiga is equal to about 300 calories per day,” says Briee Kulesa, Pharm.D., a clinical pharmacist with Franciscan Health. “This reduction in calories as well as fluid volume reduction from urine contributes to weight loss.”

While lifestyle factors like a healthy diet, exercise, other medications, and genetics can contribute to weight loss, Dr. Kulesa says the average person can expect to lose three to ten pounds while taking Farxiga.

How does Farxiga work for weight loss?

Farxiga belongs to a family of medications called SGLT2 inhibitors, or sodium-glucose co-transporter 2 inhibitors. Healthcare providers use these medications to treat conditions like Type 2 diabetes mellitus, heart failure, and chronic kidney disease.

The active ingredient in Farxiga, dapagliflozin, blocks the SGLT2 protein in the kidneys from doing its job—reabsorbing glucose into the bloodstream, says Danielle Kelvas, MD, a primary care provider with the HCG Institute, a telemedicine weight loss company.

By blocking this process, dapagliflozin causes excess sugar to leave the body through the urine, aiding in weight loss and improved blood pressure. “While not officially sanctioned for weight loss, its mechanism contributes to weight reduction, marking it as a noteworthy off-label option for this purpose,” Dr. Kelvas explains.

How fast does Farxiga cause weight loss?

When patients first begin taking Farxiga, they may initially lose weight thanks to the need to urinate more frequently, Dr. Kulesa says.

A healthcare study published in Cardiovascular Diabetology found that participants noticed a drop in body weight within just three days. Any weight lost in the first month when on drugs like Farxiga is often from fluid loss, commonly known as water weight, says Shannon Fitzgerald, Pharm.D., a medical expert with Drugwatch. “A reduction in body weight is usually noticed in the first two to four weeks, typically water loss, with a fat reduction noticed by six weeks,” Dr. Fitzgerald said.

When people lose weight in general, they may lose fat, muscle, water, or other body elements. “The body holds on to fat and water in different ways,” Dr. Kulesa explains. “Fat loss often occurs more slowly and gradually, whereas water loss often occurs more rapidly and fluctuates more. Both can be affected by diet and medications, among other factors.”

Who should not take Farxiga?

While Farxiga offers some benefits, such as weight loss, blood sugar level control, and heart failure prevention, it’s not suitable for everyone. People with a history of certain medical conditions should not take Farxiga, such as:

• Type 1 diabetes
• Genital yeast infections
• Urinary tract infections (UTIs)
• Chronic kidney disease (CKD) that requires dialysis
• History of bariatric surgery, including gastric bypass and sleeve gastrectomy surgery

Diabetic ketoacidosis is a medical condition where the body can’t produce enough insulin and can increase ketones in the blood or urine. Farxiga can cause ketoacidosis to occur, which can be a serious side effect that is life-threatening.

This medication should be used with caution if a patient is also taking:

• Diuretics, like hydrochlorothiazide
• Other glucose-lowering medications like sulfonylureas
• Lithium

In addition to weight loss and ketoacidosis, common side effects include:

• Dehydration
• Urinary tract infections
• Hypoglycemia (low blood sugar)
• Bacterial infections
• Yeast infections
• Constipation
• Nausea
• Back pain

Using Farxiga for long-term weight management isn’t recommended. “Our kidneys work hard to keep our fluid in balance, and this includes electrolytes,” Dr. Kelvas says. “Urinating sugar long-term can really negatively impact the kidneys. That’s why when we prescribe these drugs, it’s always with the goal of eventually coming off of them and getting on more ideal long-term drugs like metformin.” Other Farxiga alternatives for weight loss are glucagon-like peptide-1 (GLP-1) agonists, such as Wegovy (semaglutide) or Saxenda (liraglutide).

The bottom line: Farxiga can cause weight loss

Patients who take Farxiga may experience weight loss within the first few weeks of starting the drug. Yet studies show patients may only experience a weight loss of about seven pounds over the course of six months.

While losing weight is a common side effect of Farxiga,  Dr. Kelvas says she does not recommend this drug for long-term weight management. It’s also important to seek medical advice from a healthcare professional to create an individualized weight management plan. Make sure the healthcare provider is aware of any current prescription drugs, over-the-counter drugs, and dietary supplements you take to help avoid serious side effects.

“I tell patients that there is no single magic bullet medication that you can take to make fat melt away,” Dr. Kelvas says. “It has to be combined with overall lifestyle changes, like improving your diet and exercise.”