Why Am I Not Losing Weight on Semaglutide? 10 Reasons

Feb 7, 2024 | Weight Loss

Starting a weight loss journey with medications like semaglutide can be a promising step toward achieving your health goals.

This innovative medication has become famous for weight loss due to its appetite-suppressing and digestion-slowing properties. However, some people on semaglutide may lose less weight than desired. What could be the reason?

Several factors could be at play. This post will explore 10 reasons you’re not losing weight on semaglutide and how to optimize the effectiveness of this medication for your wellness journey.


What Is Semaglutide?

Semaglutide is an injectable medication designed to treat type 2 diabetes and obesity; it has gained popularity as a weight-loss medication. Semaglutide helps reduce blood sugar levels to normal. It also slows down food digestion and decreases hunger, leading to weight loss.

Semaglutide is an active ingredient in three FDA-approved drugs, which include:

  • Wegovy injection: Wegovy is approved to help adults and children 12 years of age and older with obesity, or some adults who are overweight and have weight-related medical conditions lose weight and keep it off.
  • Ozempic injection and Rybelsus tablets are approved to reduce blood sugar levels in people with type 2 diabetes mellitus. Ozempic is also authorized to lower the risk of stroke, heart attack, or death in people with known heart disease and type 2 diabetes mellitus. As demands for semaglutide for weight loss keep rising, medical experts are developing strategies to control the market. Many prescribe Rybelsus and Ozempic off-label (using a drug that is FDA-approved for a different purpose).

All three medications are combined with increased physical activity and diet adjustments and are only available with a prescription.


How Does Semaglutide Work for Weight Loss?

Semaglutide belongs to a group of drugs called glucagon-like peptide-1 receptor agonists (GLP-1RA). It mimics the GLP-1 hormone produced in the gut after eating. GLP-1 stimulates the body to produce more insulin, which lowers blood sugar (glucose). Higher doses of GLP-1 also affect the brain regions that control hunger and make you feel full.

When combined with diet and exercise, semaglutide can result in significant weight loss, as well as a decreased risk of diabetes, heart disease, and cancer in people with obesity or overweight.


Why Am I Not Losing Weight on Semaglutide? 10 Reasons From an Expert

Semaglutide is effective for most people, but if it isn’t delivering the weight loss results you hoped for, here are the 10 common pitfalls that might be holding you back.


1. You’ve just started on the medication

Everyone responds differently to semaglutide. While some people lose weight quickly, others may require a few weeks to notice changes.

In an Ozempic trial, which lasted 1 year and 4 months, some people took longer to lose weight, but most people began losing weight within the first four weeks. In another study, people taking 1.0 mg of semaglutide lost 13 pounds on average in 56 weeks.

As with any new treatment plan, starting semaglutide requires patience.


2. Your dosage may be too low

Health professionals begin semaglutide at a low dosage of 0.25 mg once a week for the first 4 weeks to minimize side effects. After 4 weeks, you will increase the dosage to 0.5 mg per week for 4 weeks.

Your doctor may increase your dosage every four weeks until you reach the maximum maintenance dosage of 2.4 mg for Wegovy and 1 mg for Ozempic, depending on how your body responds to semaglutide. The whole process of scaling up might take up to three months.

Studies have indicated that with a low dose of semaglutide, 25% of people may gain weight, while people on higher doses of semaglutide see greater weight loss.


3. You’re skipping doses

If you skip a weekly Ozempic or Wegovy injection, it may greatly impede your progress. And predicting how your body will react if you take your prescription inconsistently can be challenging.

To ensure you don’t forget, try to take your dose on the same day each week. Consistency in medication administration, eating habits, and exercise are essential for the best weight loss results.


4. You’ve not changed your diet

While semaglutide can help promote weight loss, it works most effectively with a healthy lifestyle. Maintaining a balanced and calorie-conscious diet is crucial for weight loss. Medications alone may not compensate for an unhealthy diet.

Even in clinical trials, semaglutide was effective in weight loss when combined with lifestyle changes. Participants in this trial were encouraged to implement these healthy diet changes.

Weight loss fundamentally depends on burning more calories than you consume. If you’re not losing weight, it could be that your caloric intake is still surpassing your energy expenditure.

Besides your calorie intake, various dietary practices may hinder your efforts to lose weight. For instance, red meat, refined carbohydrates, starches, and beverages with added sugar are all linked to weight gain. Drinking alcohol can also hamper your weight loss attempts.


5. You’re not physically active

As mentioned above, semaglutide effectiveness in promoting weight loss is enhanced when coupled with regular physical activity and diet. Exercise helps burn calories and improves overall metabolic health, complementing the effects of the medication.

Aim for 75 minutes of intense aerobic activity like running or at least 150 minutes of moderate aerobic activity, such as walking or swimming, each week. Perform strength training exercises for all major muscle groups at least twice weekly.

Exercise can also boost metabolism, helping your body burn calories more efficiently. This can enhance the weight-loss effects of semaglutide.


6. You’ve reached a plateau

You’ve followed a healthy, low-calorie diet, improved your exercise habits, and haven’t missed a dose of semaglutide. You have watched your weight reduce and are excited. But, suddenly, the scale has stopped budging–You’ve hit a weight-loss plateau.

Don’t be scared. A plateau in weight loss is a common experience. Plateaus occur when your body adapts to changes in diet, exercise, or medication, and progress slows down.

When it happens like this, it’s essential to reevaluate your diet and ensure you are still maintaining a calorie deficit by choosing nutrient-dense foods and controlling portion sizes.

Consider also changing your workout routine. If you’ve been doing the same exercises for a while, your body may have adapted. Try adding a variety of routines, like increasing intensity or resistance training.


7. You have a pre-existing medical condition

Several underlying medical issues may impede weight loss efforts. For instance, hypothyroidism may cause a slower metabolism. PCOS (Polycystic Ovarian Syndrome), a medical condition that results in hormonal imbalances, frequently leads to weight gain.

People with type 2 diabetes, which semaglutide treats, may lose weight more slowly than those without.

Semaglutide trials have shown that people with diabetes have higher chances of losing weight than those with diabetes.

People without type 2 diabetes lost an average of 6.3% of their body weight after taking semaglutide for three months, whereas those with diabetes lost 3.9%. Those without type 2 diabetes lost 11.8% after six months, while those with diabetes lost 7.2%.

Inform your healthcare provider about your pre-existing medical condition and express your concerns about the lack of significant weight loss. They can assess how the condition may affect your response to semaglutide and adjust your treatment plan accordingly.


8. You’re stressed

Stress can lead to weight gain. Research suggests that there is a connection between obesity and chronic stress. Stress triggers the release of hormones such as cortisol, often called the “stress hormone.” Elevated cortisol levels can stimulate appetite and lead to cravings for high-calorie and sugary foods.

Even if you’re not consuming high-fat and sugary foods, cortisol may also slow your metabolism, making it challenging to lose weight.

Some people also respond to stress by seeking solace in food, leading to emotional or stress eating. This can result in consuming more calories than the body needs for energy.

You may also exercise less, lack the time and motivation to make healthier meals, and tend to eat anything you find, which is not often the healthiest choice.

For some people, weight gain can cause more stress.


9. You’re not getting enough sleep

Sleep deprivation impacts how many calories you burn and consume during the day.

Lack of sleep can disrupt the balance of hunger-regulating hormones, increasing ghrelin (the hunger hormone) and reducing leptin ( the satiety hormone). This hormonal imbalance can lead to increased appetite and cravings for calorie-dense foods.

Fatigue and lack of motivation from inadequate sleep can also lead to decreased physical activity and exercise, reducing overall calorie expenditure.


10. You’re constipated

Constipation is one of the side effects of using semaglutide. And if your body is holding onto waste longer, you may not lose weight as quickly as you had hoped.

Regular bowel movements are necessary for the proper functioning of your digestive system. Increase your regularity by drinking lots of water, exercising, and eating a lot of fiber—from whole grains, fruits, vegetables, nuts, seeds, and legumes.


How to Maximize Weight Loss on Semaglutide

Here are some general tips that may help maximize weight loss while using semaglutide:


1. Adopt a Healthy Diet

Adopting a new eating pattern that encourages weight loss must include reducing your overall calorie consumption. Reducing roughly 500 calories each day is a good place to start, striving for fewer than 1,500 calories total per day. But don’t do this alone. Follow a doctor’s instructions while on this diet.

One way to reduce your calorie intake is by increasing your consumption of plant-based foods. Prioritize eating a well-balanced and nutrient-rich diet, including plenty of fruits, vegetables, whole grains, lean meats, and healthy fats. Aim for variety to help you reach your goals without sacrificing flavor or nutrition.

Limit the intake of processed foods, sugary beverages, and high-calorie snacks, and pay attention to portion sizes to avoid overeating.


2. Exercise regularly

Semaglutide is prescribed in combination with exercise. Reducing calories and engaging in regular physical activity can help you lose weight more effectively. Exercise can help burn the extra calories you can’t cut through medication alone.

Exercise also provides many health benefits, including improving your mood, strengthening your heart, and lowering blood pressure. Exercise can also help you maintain weight. Long-term weight loss maintenance is linked to regular physical activity.

Still trying to figure out where to begin? Start with a walk. Set reasonable goals, such as 15 minutes daily, and gradually increase it to 30 minutes. Don’t strive to walk 10,000 steps a day if you’re walking 2,000. Increase to 4,000 daily and increase every week.

Next, add strength training and aerobic activities such as biking, swimming, or running. Strength training builds muscles, which helps you burn calories even when sleeping.

A healthy balance is walking every day, strength training twice or thrice a week, and cardio or high-intensity interval training (HIIT) once or three times a week.


3. Make lifestyle changes

Making positive lifestyle changes is crucial for overall well-being and weight management. Ensure you stay hydrated by drinking enough water daily. Studies suggest that drinking a lot of water can prevent you from overeating, leading to weight loss.

Prioritize adequate sleep, aiming for 7-8 hours each night, as it impacts metabolism and prevents hormonal changes that can impede weight loss.

Manage stress through stress-reducing activities, like walking, reading, journaling, meditation, or deep breathing, to promote a healthier mind-body balance.

These lifestyle changes, combined with a balanced diet and regular exercise, contribute to a holistic approach to better health and sustainable weight management.


3. Monitor Your Progress

Self-monitoring is a simple and efficient technique to track your progress, especially if you’re using weight loss medications like semaglutide.

It can be as easy as writing down what you eat daily or using a calorie calculator to calculate your calories or as extensive as using a smartphone or web app to track your daily caloric intake, weight, exercise levels, and other variables.

Weekly check-ins with your doctor can also be helpful to monitor any changes in your weight loss journey and if you’re experiencing any side effects with the medication.


5. Cut out alcohol

For many people, cutting back on alcohol is a simple method to reduce their calorie intake. Since alcohol has no nutritional value, drinking it will result in empty calories—up to 500 for mixed cocktails that contain fruit juices, ice cream, or heavy cream, as well as syrupy sweeteners. If you order drinks, choose a 5-ounce (145 mL) glass of wine, which has 120 calories, or a 12-ounce (355 mL) light beer with 103 calories.


6. Be patient with yourself

Losing weight with semaglutide may take weeks to start seeing results. Sticking to a healthier diet is not a one-day thing either.

It could take weeks to start noticing benefits while using semaglutide for weight loss. Sticking to a healthier diet also takes time.

Your body may also take weeks to adjust to the medication, and it takes trial and error to learn the best diet for yourself. Try not to get discouraged if it takes longer than you’d like for your new habits to stick because some days will be easier than others.

If you set reasonable goals for yourself, stay committed, and continually monitor your progress, you’re likely to achieve your goals.


How long Does It Take to Lose Weight on Semaglutide?

You may start losing weight on semaglutide in the first four weeks of treatment, but it might take several months to get the full effects. While this may vary from person to person, other factors, such as food and activity, might influence the rate of weight loss.

According to clinical trials, people on a weekly semaglutide dosage can expect to lose an average of 5–10% of their body weight. Patients who were overweight lost 5.9% of their body weight after three months of weekly semaglutide injections. The average weight loss was 10.9% after 6 months of weekly injections.



Can semaglutide cause weight gain?

No, semaglutide is associated with weight loss rather than weight gain. However, some people may feel bloated during the first few weeks of the medication.

Why is semaglutide not working?

Semaglutide may not be working due to several reasons, such as inconsistent medication adherence, lower dosage, diet adjustment, reduced physical activity, and lifestyle changes.

How much does semaglutide cost?

Semaglutide may cost anywhere between $1,000 and $1,200 per month. Compounding semaglutide may be much cheaper, usually $300–$500 per month.


Can I lose Weight on Semaglutide In the US?

If you’ve tried the above strategies without success on your weight loss journey, know you’re not alone. At NP2GO Weight Loss Clinic, we specialize in helping people successfully lose weight on semaglutide.

Our team of healthcare professionals, registered dietitians, and behavior change specialists is here to provide science-based recommendations and the accountability needed for success.

Remember, you don’t have to navigate this journey alone – let us be your dedicated support team.

Our care team supports you when things are going well and, most importantly, helps you solve problems when they aren’t. It’s essential to have a team that you connect with, who listens to you when you need help and will put in the effort to get you back on track.

Losing weight is a collaborative effort, and our trained professionals can guide you through personalized meal plans, habit changes, and emotional well-being. We offer objective support and expertise.

If you’re facing challenges with semaglutide, we can also explore alternative strategies tailored to your unique needs, such as trying weight loss medications like Zepbound or Mounjaro, known for their effectiveness in weight loss.

Our weight loss services are across 28 states, including Alaska, Oklahoma, Colorado, Delaware, Idaho, and more.

Book your consultation with us today to get the best semaglutide support in the US! You can also call 405-696-7003.