Ozempic plateau: what it is and how to break through it

You’ve been taking Ozempic (semaglutide) for a while, and for a long time, the numbers on the scale were consistently dropping. Then, the weight loss petered out, and you’re asking yourself, “What happened? Why am I not losing weight? Is this the dreaded Ozempic plateau?”

If the numbers on the scale are stalling, it’s normal to feel discouraged. But what most people don’t know is that a weight loss plateau is a common experience for people on any weight loss journey. There are a number of reasons why people may reach a weight loss plateau on Ozempic in particular. 

Ahead, we cover what an Ozempic plateau is, why it happens, and ways to break through this frustrating phenomenon. 

An Ozempic plateau is when your weight loss slows down or stops while you’re still taking the medication. 

While plateaus are frustrating, they are quite common in people taking Ozempic (semaglutide) or a similar medication, such as Wegovy (semaglutide), Zepbound (tirzepatide), or Mounjaro (tirzepatide). 

To learn more, we talked to an expert in obesity medicine who regularly treats people taking Ozempic: Daniel A. Nadeau, MD, MS, director of four diabetes centers from Maine to California and author. 

“As with all weight loss medications, the rate of weight loss with Ozempic slows as the months pass, eventually reaching a new equilibrium when calories in (reduced by Ozempic) equal calories burned,” says Daniel A. Nadeau, MD, MS, an obesity medicine expert, director of four diabetes centers from Maine to California, and author.

The time when an Ozempic plateau occurs varies. But Dr. Nadeau says it occurs “usually at around 6 months.” 

“A rate of 2 pounds of weight loss per week may occur initially,” he explains. “By three months, the loss may be half a pound per week, and by month six, no additional weight loss may be seen. Compared to other weight loss medications, Ozempic has less of a plateau.”

A plateau is also common with Wegovy, a brand-name version of semaglutide that’s specifically approved for weight loss. (Ozempic is approved for type 2 diabetes but is commonly used off-label for weight loss). 

Research shows that people taking Wegovy 2.4 mg weekly lost a significant amount of weight but hit a plateau after about a year (60 weeks). Most people maintained that lower weight for the rest of this two-year study.

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How common are Ozempic plateaus?

There isn’t much research available on how common Ozempic plateaus are. But weight loss plateaus in general affect about 85% of people trying to lose weight. 

Here is a look at the potential causes of an Ozempic plateau. 

Ozempic weight loss plateaus occur for several reasons, such as changes in your metabolism, hormones, and lifestyle. 

Changes in metabolism

One of the key reasons why weight loss slows is “because the body reduces its metabolism (calories burned),” as your bodyweight decreases, Dr. Nadeau says. 

Weight loss occurs when you burn more calories than you consume. This is called a net caloric deficit. A net caloric deficit often triggers rapid weight loss in the early stages of your weight loss journey. 

However, as your body loses weight, your metabolism adapts to your new food and exercise regimen. Meaning, your body isn’t burning as many calories as before, which makes it harder to achieve a net caloric deficit. This can happen during any attempt to lose weight, with or without a medication like Ozempic. 

Your metabolism may also slow if you’re losing muscle mass. This is your body’s way of protecting itself from losing too much weight. 

Therefore, it is a good idea to optimize your protein intake and incorporate resistance-based exercises into your workout routine to prevent muscle loss. 

Hormonal changes

Weight loss also triggers hormonal changes. 

As you lose weight, your body “releases more hormones like ghrelin, which drives appetite, and less leptin, a hormone which creates a sense of fullness,” Dr. Nadeau says. 

This signals your body to eat more and reduces your body’s sense of satiety — both of which make it more difficult to consume fewer calories. Essentially, “the body tries to maintain its weight,” Dr. Nadeau says. 

Lifestyle changes

It’s no secret that lifestyle changes play a significant role in weight loss. Eating a nutritious diet, increasing physical activity, drinking water, getting adequate sleep, and managing stress are all lifestyle habits that can help you lose weight, even while taking medications like Ozempic. 

Over time, though, many people find it harder to stick with the same healthy routines that helped them lose weight early on. That’s because the metabolic and hormonal changes (explained just above) can leave you feeling hungrier, more fatigued, and less motivated. This can feel discouraging and may lead people to loosen up on their diet and other healthy habits.

If you’re taking Ozempic and the numbers on the scale are stalling, you may be asking, “How do you break a plateau on Ozempic?” While it’s best to reach out to your healthcare provider if you’ve hit an Ozempic plateau, certain strategies can help you in the meantime. 

1. Change up your exercise routine

As we mentioned above, losing muscle mass can slow down your metabolism. If you’ve hit a weight loss plateau on Ozempic, Dr. Nadeau recommends considering adding resistance training to your exercise routine. 

This can help combat muscle loss, which often occurs with weight loss. Examples of resistance training include lifting weights and body weight exercises, like push-ups and planks. 

2. Modify your diet

If you’ve hit a weight loss plateau, changing your diet may be the key to reigniting weight loss. 

Ozempic works best when you’re eating nutrient-rich foods, like eggs, legumes, cruciferous veggies, whole grains, and chia seeds. But it’s also important to think about what you don’t eat. 

While no foods are completely off-limits during a weight loss journey, some foods can stand in the way of your goals. According to Dr. Nadeau, it’s best to cut out (or, if more doable, avoid) processed and fatty foods, such as potato chips, cookies, and deli meats. Also, try to eat more plants. 

Consuming more protein can also help prevent muscle loss, especially when combined with exercise. Additionally, increasing your protein intake may increase satiety, which helps you consume fewer calories. 

High-protein foods include: 

• Beef

• Pork

• Poultry

• Fish

• Shellfish

• Eggs

• Greek yogurt

• Legumes

• Nuts and nut butters

• Soy

3. Reduce stress

Research shows that stress is linked to weight gain by:

• Interfering with your brain and its ability to self-regulate, so it’s harder to stick to a diet

• Affecting your behavior, making you more likely to overeat high-calorie or high-fat foods

• Increasing the release of hormones that increase your appetite and reduce feelings of fullness

If you’ve been under a lot of stress lately, this may explain why you’ve hit an Ozempic plateau. 

To break through, try implementing stress management techniques, such as deep breathing exercises, progressive muscle relaxation (PMR) therapy, and guided imagery. After all, there is evidence that reduced stress leads to more weight loss. 

4. Limit alcohol consumption

Alcohol has been linked to increased calorie intake due to its high calorie content, effect on appetite-stimulating hormones, and tendency to encourage poorer food choices. Because of this, limiting your alcohol intake is another way you can try to break an Ozempic plateau. 

Instead of alcohol, try drinking more water or beverages that are low in sugar. If you need more tips on how to quit or reduce the amount you drink, talk to your healthcare provider. 

5. Implement a good sleep schedule

Like alcohol, not getting enough sleep is also linked to weight gain. Poor sleep can also make you more likely to eat higher-calorie foods, more frequent meals and snacks, more fast food, and fewer fruits and vegetables. Decreased sleep can also increase cortisol — the stress hormone — leading to increased fat. 

With this in mind, aiming for 7–8 hours of sleep per night is key to fighting through an Ozempic plateau. To help you sleep better, implement good sleep hygiene practices, like:

• Establishing a consistent sleep schedule

• Limiting daytime naps

• Limiting caffeine intake

• Keeping the room dark and avoiding bright lights

• Listening to soothing music, nature sounds, or a sleep story

• Keeping your bedroom at a cool temperature

6. Consult your healthcare provider

Reaching out to your healthcare provider is always a good idea, especially if you’ve tried the above strategies and you’re still stuck in a weight loss plateau on Ozempic. In some cases, your provider may adjust your Ozempic dosage to see if that helps. 

Traditionally, Ozempic dosing follows a gradual titration schedule — i.e. your dosage is increased slowly over time until you reach a maintenance dosage. This generally means it takes time for you to see the medication’s effects on your weight. But if your weight loss has hit a wall, your healthcare provider can help determine if changing your dosage is appropriate. 

Other times, a healthcare provider may consider an Ozempic alternative. There are several medications used for weight loss, and some have been shown to be more effective than Ozempic for weight loss. Ask your healthcare provider if switching to an alternative is an option. 

Other injectable medications that may be used for weight loss include: 

• Wegovy (semaglutide)

• Mounjaro (tirzepatide)

• Zepbound (tirzepatide)

• Saxenda (liraglutide)

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If you’re taking Ozempic and find your weight loss has come to a halt, you may have hit an Ozempic weight loss plateau. Here are some key points to keep in mind that can help: 

• An Ozempic plateau is when your weight loss slows down or stops, even though you’re still taking the medication. While plateaus are frustrating, they are quite common in people trying to lose weight. 

• Ozempic plateaus occur due to your body adjusting its metabolism, changes in hormones, and lifestyle changes, such as increased stress, not enough physical activity, and poor sleep. 

• Fortunately, there are several ways to break through an Ozempic plateau, including changing up your exercise routine, modifying your diet, reducing stress, limiting alcohol, and getting more sleep.

If you’ve hit a weight loss plateau on Ozempic, it is a good idea to talk to your healthcare provider. They can discuss strategies to help you get your weight loss back on track.