I’m on Wegovy, So Why Am I Not Losing Weight? - GoodRx (2024)

With all the excitement about Wegovy and similar weight-loss medications, it’s easy to forget that not everyone will lose weight while taking them.

Wegovy (semaglutide) is a glucagon-like peptide 1 (GLP-1) medication that’s used for weight loss. GLP-1 medications are more effective than previous generations of weight-loss medications. But this doesn’t mean they are the best solution for everyone. They cost a lot of money and have possible side effects. So it’s helpful to know how likely you are to lose weight on Wegovy, and what to do if it’s not working.

How fast do you lose weight on Wegovy?

Wegovy and other GLP-1 weight-loss medications can help you lose weight quickly. Most people can expect to lose more than 5% of their current body weight within 3 months. So if you weigh 200 pounds, you could expect to lose 10 pounds or more within 3 months. And here’s how much you might lose in the long term:

• People without diabetes: On average, 15% of your body weight after 16 months

• People with diabetes: On average, 10% of your body weight after 16 months

Keep in mind that these numbers are averages across groups of people. Some people lose a lot more weight, and some people lose less.

If you have been on Wegovy for more than 3 months and haven’t lost at least 5% of your body weight, you may be considered a “nonresponder” to the medication. This just means Wegovy isn’t working for your body as well as expected. This doesn’t mean you’re doing anything wrong. Each body is different. This just means that it’s a good time to talk with your healthcare professional about whether you should consider a different medication or approach.

Is it normal not to lose weight on Wegovy?

Although most people lose weight while taking Wegovy, some people (10% to 15%) do not. But this doesn’t mean the medication hasn’t been helping. Even if you don’t lose weight on Wegovy, you may still get other health benefits. These include:

• Improved cholesterol numbers

• Improved blood sugar

• Lower blood pressure

• Better heart health

And in clinical trials, people who were classified as “nonresponders” but continued to take Wegovy still lost about 5% of their body weight after 16 months. They just didn’t lose as much weight as other people did.

Keep in mind that losing a lot of weight quickly isn’t necessarily better than more gradual weight loss. Unless you’re pairing Wegovy with strength training and a high-protein diet, you’ll probably lose muscle as well as fat. And having enough lean muscle is important to stay healthy as you age.

So if you’re losing weight steadily, even if slower than expected, you don’t necessarily need to change strategies. But if you would like to lose weight more quickly, there are a few things you could consider.

What are the possible reasons you are not losing weight on Wegovy?

Experts don’t know for sure why some people lose weight on Wegovy, and other people don’t. According to Dr. Richa Mittal, a board-certified internist and diplomate of the Boards of Obesity Medicine and Lifestyle Medicine, there’s no way to predict with perfect accuracy who will or will not lose weight. However, weight-loss medicine specialists have noticed patterns in who tends to have better results, and possible reasons some may not be seeing those results.

1. Your other medical conditions are making it harder

People who have diabetes generally lose less weight on Wegovy than people who don’t have diabetes. And people with multiple medical conditions may lose even less. Weight-loss medicine specialists have noticed that the more active medical problems someone has, the less likely they are to lose a lot of weight on Wegovy.

2. Other medications are slowing down weight loss

Certain medications contribute to weight gain and make it harder to lose weight, even when you take Wegovy. Examples of these medications include some types of:

• Antipsychotics

• Antidepressants

• Anti-seizure medications

• Steroids

• Diabetes medications, including insulin

• Blood pressure medications

If you have questions about whether your regular medications are affecting your weight goals, talk with your primary care provider about whether you could safely switch to an alternative.

3. You’re not sleeping enough

Quality sleep is one of the most important ways to take care of your body. Sleep deprivation — in both quantity and quality — has been linked with difficulty losing weight and weight gain. If you find yourself staying up late or feeling like you can’t sleep enough hours each night, consider adjusting your sleep routine to prioritize sleep. Sleeping well may help you lose weight more quickly.

4. You’re feeling stressed

Stress can make it much harder to lose weight. Stress increases cortisol and epinephrine production in your body. Short bursts of these hormones are normal. But if you’re chronically feeling stressed out, your body’s levels of stress hormones remain high. And that can lead to increased appetite and body fat.

Mindfulness, movement, and time in nature can help with stress levels if you think high stress is hindering your weight-loss efforts.

5. You aren’t taking a high enough dose of Wegovy

The higher your dose of Wegovy, the more weight you tend to lose. The maximum dose is 2.4 mg weekly, and many people stay at this maintenance dose for months. If you’re taking less than 2.4 mg weekly, and not losing very much weight, you could talk with your healthcare professional about taking a higher dose.

If even the highest dose of Wegovy doesn’t work for you, another GLP-1 medication might work better. You could try one of the other ones instead:

• Liraglutide (Victoza, Saxenda)

• Tirzepatide (Mounjaro, Zepbound)

Although semaglutide is thought to be the most effective of the GLP-1 medications for weight loss, it doesn’t work for everyone. Switching to a different one might make sense if your weight loss has stalled. And since Zepbound and Mounjaro work a little differently (they target GLP-1 as well as a different hormone called glucose-dependent insulinotropic polypeptide), they may be more effective for people who don’t lose weight on Wegovy.

6. You’ve hit a plateau

After about a year of taking Wegovy, your weight loss will probably plateau. There are several possible reasons for this plateau, including lifestyle and your body adapting to the medication. If your weight loss slows down or stops on Wegovy, and you still want to lose more weight, you might need to shake up your routine. Adding different types of movement or adjusting your diet can sometimes help restart weight loss. Another option is to switch to a different GLP-1 medication, which may trigger your body to start losing weight again.

7. Your hormones are out of balance

Menopause, postpartum hormones, thyroid problems, and adrenal problems can cause hormonal shifts that make losing weight difficult. One or more of the following symptoms might be a sign of hormonal imbalances:

• Low libido

• Fatigue

• Hot flashes

• Sleep difficulties

• Skin and nail changes

• Constipation or diarrhea

• Weight gain in your abdomen, with relatively thin arms and legs

• Acne

• A fatty “hump” on the back of your neck

You should talk with your primary care provider or endocrinologist (hormone specialist) if you believe hormone problems are preventing weight loss.

8. Your nutrition plan doesn’t fit your needs

Although most people find that their appetite decreases on Wegovy, some people may still be eating more calories than their body needs for fuel.

“There is a small group of people who eat emotionally or for reasons unrelated to hunger cues,” said Dr. Sonal Chaudry, a board-certified endocrinologist and assistant professor in the Division of Endocrinology, Diabetes and Metabolism at New York University. “They may also continue to eat even if they feel physically full. If calorie intake is not reduced, the person will not lose weight.”

If you’re not sure whether you’re eating the right amount for your body, you could check in with a dietitian or nutritionist to help you decide. This is important if you’re unclear on your nutritional needs, since getting too few calories can be dangerous for your health, too. And skimping on protein, in particular, can be problematic when you’re losing weight.

Dr. Mittal monitors her patients’ bloodwork and muscle mass while they take Wegovy to make sure they’re staying healthy as they lose weight. Make sure your healthcare professional or a dietician is helping you figure out the right amount of calories and protein your body needs.

And if you suspect there’s a deeper reason why you’re not eating nutritious foods, such as to manage stress or fill an emotional need, you’re not alone. It’s worth considering support from a therapist — or even self-help resources — to help you explore your relationship to food.

9. Your body needs a little bit more time

Dr. Mittal has reassurance for people who are taking lower doses of Wegovy: “Often, people may feel they are not losing weight. But this could be because they are still at lower doses, and in the process of working their way up to higher doses. At that point, they may start to see more weight loss.”

If you haven’t yet reached the maintenance dose of Wegovy, you may want to stay the course and see what happens over time. Body weight can fluctuate based on food and how much water you drink, so don’t be discouraged if the scale stays the same (or even goes up) for a few days.

If you’re not experiencing any significant side effects, you can safely follow the protocol for increasing your Wegovy dose over time. Talk with your healthcare professional if you haven’t lost very much weight after 3 months on the maintenance dose, Dr. Mittal said, since you’ll most likely want to switch your approach.

How can you increase weight loss on Wegovy?

There are some ways you may be able to increase weight loss on Wegovy. And the good news is that these strategies are not just beneficial for weight loss. They also will help you feel better, live longer, and stay healthier.

Consider making changes to your diet

In several of the research studies, participants combined intensive dietary counseling with Wegovy use. But it’s not always easy to know what makes up a “healthy diet.” And this can vary from person to person depending on their specific nutritional needs.

Many people benefit from seeing a registered dietician for more specific guidelines. But in general, some helpful steps to take are to:

• Eat less highly processed food.

• Eat plenty of lean protein.

• Eat lots of fiber in the form of fruits, vegetables, and legumes.

• Drink mostly water (avoid sweetened drinks).

• Avoid excessive alcohol.

• Avoid added sugars.

And if changes to your diet feel hard or overwhelming, remember that small changes over time are more sustainable. You don’t need to overhaul your food choices in one day. Take it one day at a time.

Move your body in a way that feels good to you

Exercise is good for both your body and your mind. It protects your heart and improves longevity. Exercise can also help you maintain weight loss.

To get the most benefit, it’s important to incorporate both aerobic exercise and strength training. Strength training, in particular, is very important to minimize muscle loss while you’re taking Wegovy. But there are many different ways to do this. This key to a sustainable movement routine is one that feels fun and enjoyable to you.

Examples of aerobic exercise are:

• Walking

• Hiking

• Bicycling

• Roller skating

• Swimming

• Tennis

• Golf (especially if you walk the course)

Examples of strength training are:

• Lifting weights

• Bodyweight resistance exercises

• Resistance band workouts

• Suspension trainer workouts

You don’t have to be a marathon runner to see benefits — any amount of movement is better than none. And it doesn’t need to be a dedicated workout. Try to find little ways to move more throughout your day.

Find social support

People who lose weight often surround themselves with positive support people. People who encourage you to stay active, eat nutritiously, and manage stress make wonderful cheerleaders. And even better if they’re willing to get active with you. Research demonstrates that people who exercise together are more motivated to work out. And exercising together can even improve your bond.