Why Am I Not Losing Weight on Semaglutide?

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?


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.


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 see any significant results, so make sure you’re giving yourself enough time. Give semaglutide 3 months to work. If you’re still not seeing results, check in with your doctor.


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.


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.


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 need to reduce your calorie intake for it to work. Semaglutide mimics hormones that tell your brain you’re full to make it easier for you to decrease your daily calories, but the basic rules of weight loss still apply: you need to eat less to lose weight.

A weekly semaglutide injection also 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.

Make sure you avoid empty calories like candy and soda and try to skip processed foods. Opt for fresh lean meats, vegetables, and fruits instead. Increase your fiber and protein intake, both of which will help you to feel fuller longer. Try and eat nutrient-rich foods so you can get a lot of nutrition from smaller portions. Foods packed with a lot of nutrients include berries, broccoli, salmon, beans, eggs, avocados, and whole grains.


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.


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.


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.


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.


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.


The best way to get the most from your semaglutide is to remember that it is a tool but not a substitute. The medication will be far more effective if you eat a healthy diet and increase your exercise level. If you’ve been living a sedentary lifestyle, you don’t have to suddenly start spending your life in the gym. Even small changes like parking farther away from stores and taking the stairs rather than the elevator can help.

A little support goes a long way when you’re trying to lose weight, as well. Try losing weight with a friend who can encourage you and exercise with you. You can also join a local or online support group. Surrounding yourself with successful people can help you succeed. So can your doctor. Don’t be afraid to ask your healthcare provider for help or express your frustrations to them. They can help you tailor a plan specifically designed for you.

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