If you are questioning why you are not losing weight on semaglutide, you are not alone.

Reaching a weight loss plateau is common during active weight loss. In fact, you may have heard people talk about an Ozempic plateau or a GLP-1 plateau. Because of the resounding success of GLP-1 medications, there may now be the expectation that weight loss will continue, uninterrupted; however, that may not always be the case.

GLP-1 medications like Ozempic and Wegovy with the active ingredient semaglutide have reported weight loss in the 15-22 percent range, and even more for some patients.  If you are questioning why you are not losing weight on semaglutide, you are not alone.

Your Metabolism May Have Changed

One reason you may not be losing weight on semaglutide is that your body has adjusted to its new weight set point. Your metabolism needs time to adjust to a new weight, so weight loss plateau is normal. Additionally, as you lose weight, your body size is decreasing and its metabolic needs are decreased. This process is called metabolic adaptation, a process wherein the decrease in energy expenditure is above what would be expected as one’s body mass changes. In other words, your metabolism has changed.

• Strategy: To mitigate the Ozempic plateau, be sure to meet your recommended daily allowance for lean protein. Lean protein not only makes you feel full, but it also promotes the growth and maintenance of lean muscle mass. Lean muscle mass requires more energy, so even while at rest, your metabolism will be burning calories.

Healthy Eating & Physical Activity

Weight loss medications are optimized when paired with a healthy eating plan and physical activity.  Another reason you may not be losing weight on semaglutide is that you may not be getting enough exercise. You might also “calorie creep,” which is a gradual, often unnoticed increase in caloric intake over time. Calorie creep can happen to all of us. Despite our best intentions to eat healthy and stay within a specific energy-intake range, we are all susceptible to one more bite of or one more small helping or even giving in to the temptation to eat something unhealthy.

• Strategy: Assess your level of physical activity. If you have no physical limitations or restrictions, are you getting the recommended 150 minutes of moderate exercise each week? Including brisk walking, yoga, hiking, cycling, swimming, strength training, or resistance training to your weekly routine can help jump start your metabolism and build lean mass.
• Strategy: Follow a weekly meal plan. As you create your weekly grocery list, be sure to include lean proteins, complex carbohydrates, fiber, fruits and vegetables, and healthy fats. Eating healthy does not have to be boring. The Dietary Guidelines for Americans provides a range of options and ideas for healthy foods, and it is a good source for information on how many macro- and micronutrients to consume.

You May be a “Nonresponder”

According to an article in The Associated Press, “In clinical trials, most participants taking Wegovy or Mounjaro to treat obesity lost an average of 15 percent to 22 percent of their body weight — up to 50 pounds or more in many cases. But roughly 10 percent to 15 percent of patients in those trials were ‘nonresponders’ who lost less than five percent of their body weight. Now that millions of people have used the drugs, several obesity experts told The Associated Press that perhaps 20 percent of patients — as many as one in five — may not respond well to the medications. It’s a little-known consequence of the obesity drug boom, according to doctors who caution eager patients not to expect one-size-fits-all results.”

Other Reasons You May Not be Losing Weight on Semaglutide

In addition to the reasons mentioned above, you may not be losing weight on semaglutide — or you may have hit the Ozempic plateau— because you may no longer be tolerating your GLP-1 medication — or there may be an underlying condition that is impeding weight loss. For example, stress or poor sleep can disrupt weight loss. Take note of how you are feeling and sleeping and consult with your healthcare provider. Some lifestyle changes related to stress management and sleep may get you back on track.

Another Option to Consider as You Manage the Ozempic Plateau

Pairing lean protein, fiber, complex carbohydrates, healthy fats, and fruits and vegetables with exercise should be the foundation of a healthy lifestyle. To supplement your GLP-1 diet, consider adding Biocare — a dietary beverage that is scientifically formulated to counteract nutritional deficiencies associated with weight loss medications. It contains probiotics and prebiotic fiber to promote gut health and contains specialized ingredients to help manage GLP-1 side effects. Even better, Biocare contains high-quality whey protein to help maintain lean muscle mass, and two servings provide 100 percent of the recommended daily intake of 26 vitamins and minerals.

Prior to starting any weight loss program, whether it includes GLP-1 weight loss medication or not, be sure to consult with your healthcare provider to make sure your desired weight loss strategy is right for you.  

About the Author: Dr. Dawn M. Sweet has over 20 years of experience in the field of communication. Dr. Sweet has given several invited talks to and workshops for academic and private sector audiences on the role of nonverbal and verbal communication in achieving positive outcomes and mitigating bias. Her research has been published in several top ranked peer-review journals, and it has been featured on NPR’s River to River / All Things Considered, Buzzfeed, and Science Daily. Her research has also been used to inform expert testimony.