It’s been all over the internet and the news, and you may even personally know some people who have tried it. If you’re looking to lose weight, the word to know is “semaglutide.” Sold under the brand name Wegovy when used for weight loss and Ozempic when used to treat type 2 diabetes, semaglutide is all the rage in the world of weight loss, and it’s easy to see why. Obese patients in clinical trials lost up to 20% of their body weight, which is a pretty incredible result. So why are you not losing weight on semaglutide?
Why Am I Not Losing Weight on Semaglutide?
Here’s the catch. The results of many semaglutide studies were nothing short of amazing for the 86% of patients who lost weight on the drug. Some basic math and a slight change in perspective, however, tells us that if 86% of the patients lost weight, then 14% did not. When we talk about the efficacy of semaglutide, we don’t tend to talk about the 14% for whom it didn’t seem to work. If you’re finding yourself to be one of them, there are several reasons why you may be struggling. The good news is that some of these issues have simple solutions. Others may prove more complex, however.
It’s Too Soon
Semaglutide takes time to work. Yes, a lot of people lost a lot of weight in clinical trials. But most of these trials lasted for 68 weeks. That’s more than a year. Although there are no hard and fast rules, most endocrinologists and other prescribers don’t declare semaglutide for weight loss a failure until a patient fails to lose 3% of their body weight over a period of 3 months. This means it could take up to 3 months for you to start to see any significant results, so make sure you’re giving yourself enough time.
Your Dosage is Too Low
To minimize common side effects like nausea and vomiting, patients receive a fairly low dose of semaglutide at first. As you get used to the drug, your doctor can slowly ramp up your dosage. A normal semaglutide dosing schedule begins with 0.25 milligrams per week. The dosage then jumps up once a month, increasing to 0.5, 1.0, 1.7, and then 2.4 milligrams per week. If you’ve just started semaglutide or are getting it as a skinny shot at a clinic mixed with other ingredients, the shot may not contain enough semaglutide for you. If this is a concern, talk to your doctor or provider about increasing your dose.
You Missed a Dose
While taking semaglutide, you will give yourself one injection a week. While convenient, this dosing schedule means that forgetting a dose can have a big impact. If you forget to take your medication, it can mean going an entire week without it. This is significantly longer than if you forget a pill that you take several times a day.
To make it easier to remember, try to take your semaglutide on the same day every week. You may want to pair it with a weekly event that is already a part of your routine. You could, for example, take your semaglutide on trash day or laundry day. If you forget to take your semaglutide, go ahead and take it if your next scheduled dose is more than 2 days away. If your next dose is less than 2 days away, just skip the forgotten dose altogether and resume your normal dosing schedule on the next normal day.
You May Need to Eat Differently
Semaglutide can give you a massive boost on your weight loss journey, but it can’t do all the work for you. You will still likely need to change your eating habits in order to be successful. A weekly semaglutide injection can’t completely counter poor daily food choices. Foods high in fat and sugar are still going to try their hardest to add weight to your frame, even while the semaglutide tries to take it off. If you haven’t changed a poor diet at all or enough, you may struggle to lose weight even while taking this medication.
You’re Too Sedentary
Just as it needs a balanced diet to work, semaglutide also needs you to do some exercising as well. You don’t necessarily have to hit the gym three times a week, but you do need to get up and moving. If you lived a very sedentary lifestyle before taking semaglutide, walking a few days a week may be enough to help with your weight loss. If you were fairly active before taking semaglutide, however, you may need to further increase your exercise and movement. Even with the help of a weight loss medication, you still need to burn more calories than you consume if you want to lose weight.
You’ve Hit the Plateau
If you’ve embarked on an attempt to lose weight before, you already know the dreaded P-word: “plateau.” You may want to lose a significant amount of weight and do it as quickly as possible, but your body is programmed to see weight loss as a potentially negative thing. Fearing famine and starvation, your body will naturally try to put on the brakes after you’ve lost a certain amount of weight. While it may be a frustration in your mind, your body does this out of a self-preservation instinct. If you stick to your diet, exercise, and medication regimen, your body will ultimately speed your metabolism back up and get with the program. This process can take a couple of weeks, however, and there is no speeding it up. You simply have to cross the plateau and make it to the other side.
You Have Other Uncontrolled Health Issues
Sometimes semaglutide’s effects are slowed or blunted by other health conditions. Obesity is sometimes the cause of problems like insulin resistance, but it can also be exacerbated by them. If you have undiagnosed or uncontrolled diabetes, for example, it can slow your weight loss even with semaglutide. Kidney problems, liver issues, and some psychological issues, for example, can all reduce the medication’s effectiveness. It’s very common for patients with complicated metabolic profiles to lose less weight with semaglutide than those who have minimal health issues. If you’re really struggling, talk to your doctor to see if there may be an underlying health reason.
You probably weren’t expecting to see constipation on a list of things that can slow weight loss, but here it is. In order to lose weight, you have to keep your metabolism working. This means keeping your digestion moving. Semaglutide can slow your digestion and back things up, which can also slow your weight loss. If things are moving more slowly than usual for you, drink lots of water and make sure you’re getting at least 26 grams of fiber per day. Physical activity can also help get your bowels moving.
You’re Stressed Out
Seriously. Who isn’t stressed out, right? But chronic stress can lead to weight gain in a number of different ways. For starters, you may not have time to make healthy meals or eat right if you’ve got too much on your plate. Your responsibilities can also cut into your exercise time. Stress can also make you crave sugary and fatty foods that don’t coincide well with your weight loss goals. At a more fundamental level, however, stress messes with your hormones, causing your body to have all kinds of interesting reactions, including packing on the pounds.
You’re Not Sleeping Well
Good sleep is vital to good health. If you’re getting less than 8 hours or more than 10 each night, your sleep schedule is likely out of whack. Like stress, poor sleep can cause hormonal changes in your body and lead to all sorts of issues and changes. One is potential weight gain. Even if the semaglutide can counter the gain and prevent you from getting bigger, it may not be able to overcome the weight gain well enough to keep you losing weight. If semaglutide doesn’t seem to be working for you, take a look at how you’re sleeping and make some adjustments if necessary.