Why am I still hungry on semaglutide?

Semaglutide is a prescription medication that may be prescribed for weight loss (brand name Wegovy) or type 2 diabetes (brand name Ozempic, Rybelsus). Ozempic and Rybelsus can also be prescribed off-label for weight loss, although they contain lower dosage strengths of the active ingredient and tend to produce less weight loss than Wegovy. 

Whatever version of semaglutide you are taking, you’re probably aware that it helps control blood sugar levels over time, and reduces appetite and cravings—which can lead to weight loss. But what if you’re taking semaglutide and you’re still feeling hungry?

It’s normal to feel hungry on semaglutide, but you should feel less hungry than before you started taking semaglutide. If you’re still hungry on semaglutide, don’t worry–there are a handful of reasons why.

When you were prescribed semaglutide, your doctor probably mentioned that it would suppress your appetite and make you feel less hungry. So now that you’re still feeling hungry, it’s natural to wonder if the medication is even working. First, let’s understand how it actually works. 

Semaglutide works by mimicking glucagon-like peptide 1 (GLP-1), a gut hormone involved in regulating your appetite and blood sugar levels. When you take a GLP-1 drug like semaglutide, it slows down digestion, so you feel full sooner. It also interacts with the areas of your brain that manage your appetite and reward perception regarding food, sending signals when you’re full and reducing your cravings for certain foods. Together, these effects help curb hunger—but some people still feel hungry on semaglutide. Here are some reasons why.

While you should feel less hungry on semaglutide, you shouldn’t expect to never feel hungry again. The sensation of hunger is a way your stomach communicates to your brain that it’s time to refuel and give your body the energy it needs. 

Even when taking medication for weight loss, you still need to eat. That familiar feeling of hunger is your body’s way of making sure you do that.

While you’ll still feel hungry, you may notice that your thoughts around food have changed. “Food noise” describes those persistent, obsessive thoughts around food that can make it feel like all you’re thinking about is food. Many people who start GLP-1s like semaglutide report their food noise quiets down significantly. Not only that, but it changes. They feel less compelled to eat super sweet or rich, calorie-heavy foods both in general but also when they encounter certain cues they used to pair with those foods—such when they walk by a favorite restaurant, or see other people eating those foods in a commercial.

Semaglutide medications like Wegovy and Ozempic follow a titration schedule. You gradually increase your dosage over a period of weeks until you reach an effective dosage (this is called a “maintenance dosage”). This process can take 12–16 weeks for Ozempic and 16–20 weeks for Wegovy. 

Healthcare providers follow this dosing schedule to minimize semaglutide’s side effects while your body gets used to the medication. But, this ramp-up period also means that it will take a bit longer before you experience the full effects of semaglutide—including less hunger. You may find that the lower doses of the medications do not affect you as greatly as the higher doses will. 

“Some people initially experience a total absence of hunger [on semaglutide],” says Lauren Harris-Pincus, MS, RDN, and Dietitian Advisor for Ro. “Others may need higher doses to experience a significant change in hunger levels. People can also experience a return of hunger while on the medication. Each body is different and it’s important to work with your provider to find optimal dosing for you.” (Remember, your goal isn’t to have no hunger whatsoever, because hunger is an important way your body tells you it needs more fuel.)

The recommended maintenance dosage for Wegovy is 1.7 or 2.4 milligrams (mg) weekly, though depending on how people react to it some people are maintained at a lower dose. The maintenance dosage for Ozempic can be 1 mg or 2 mg weekly, though some people are maintained on doses like 0.5 mg. Again, it all depends on your body. If you are taking a lower dosage than that and still feeling hungry, you may want to check in with your healthcare provider to see if a higher dosage could be more effective for you.

Semaglutide works best with a reduced-calorie diet and exercise routine. If you’ve been taking semaglutide as prescribed, you may have started practicing portion control, or otherwise reduced how much food you’re eating. 

If you just recently started eating less, it’s normal to feel hungry. Trust that your body will recalibrate to your new caloric intake, and make sure that you’re filling up your tank with nutritious foods that make you feel more full, like fiber and protein—which we’ll cover in our next point.

Note: While semaglutide should be combined with lifestyle changes like a lower-calorie diet, you want to make sure that you’re still getting enough nutrients. If you’re still feeling hungry, it can be helpful to consult a dietitian to ensure that you’re following a balanced diet.

“Many other factors can also influence hunger,” says Harris-Pincus. “Eating meals high in protein and fiber can minimize hunger, while insufficient sleep and stress can increase it. It’s wise to evaluate diet and lifestyle factors before assuming you need more meds or that they are not working.”

Semaglutide is most effective when it’s combined with diet and exercise. If you haven’t adjusted your diet since starting semaglutide, now may be the time to start. Foods with “empty calories”—essentially, foods that pack in the calories but offer very little nutritional value—can leave you feeling unsatisfied and craving more. This is especially the case with ultra-processed foods high in sugar and unhealthy fats, which have been developed to be particularly addicting.

It sounds counterintuitive, but even what you do during your non-waking hours can affect your hunger levels during the day. When you don’t get a good night’s sleep on a regular basis, your levels of ghrelin (the hunger hormone) increase, while your leptin (the fullness hormone) levels decrease. 

Research suggests that short sleepers tend to snack more, especially at night, and on higher-calorie meals. One study calculated that regularly getting 5 or fewer hours of sleep per night is associated with a 45% increased risk of obesity compared to those with normal sleep duration. 

So, if you’re taking semaglutide, but you’re having trouble sleeping, you may want to take care of your sleep issues to help your hunger levels. 

Emotional eating, or stress eating, is a common coping strategy people use to deal with stress, depression, or anxiety. Emotional eating is eating in response to feelings, as opposed to hunger. 

Research suggests that emotional eaters tend to turn to less healthy foods—such as sweets, fast foods, and cereal—which are more likely to leave them feeling hungry and wanting more. At the same time, emotional eaters are less likely to eat foods that increase feelings of fullness, such as fiber- and vitamin-rich foods. 

Emotional eating is also linked with less sleep, which in turn is linked to stress, creating a vicious cycle of hunger. So, if you’re dealing with a lot of emotions, you might find yourself still craving food on semaglutide—even if you’re not actually hungry.

If you’re still hungry on semaglutide, consider these tips for reducing hunger and increasing satiety.

Revamp your diet

When it comes to beating hunger on semaglutide, reevaluating your diet is an important first step, according to Harris-Pincus. “Work with your provider or dietitian to find the right diet composition for you, especially the amount of protein needed per day. I generally recommend a minimum of 25 grams of protein per meal and 25 grams of total fiber per day. Many people who experience hunger later in the day are not consuming an adequate protein- and fiber-filled breakfast. It can make all the difference.”

Fiber-rich foods—including fruits, vegetables, and whole grains—are not only nutritious, but they have a strong, hunger-reducing effect. Protein is another macronutrient that makes you feel full, leading to less hunger. Swapping out less healthful foods for whole foods rich in fiber and protein can help curb cravings and keep hunger at bay.

Make exercise a regular habit

Even though it helps us burn calories, exercise has an appetite-suppressing effect - at least temporarily. The jury is still out regarding the longer-term effects, but there is some evidence exercise helps regulate hunger. , 

While you may feel hungrier when you first start increasing your daily physical activity, studies show that once you get used to having a regular workout routine, your body does a better job adjusting your appetite to how much you really need to eat to feel satiated. Both aerobic (e.g., running, bicycling) and resistance (e.g., yoga, weight lifting) types of exercise have this effect.

Get help for stress and anxiety

If you are feeling stressed, anxious, or depressed (or maybe a bit of all three), getting help can make you feel better and less hungry. When emotional eating becomes a habit, your brain learns to pair certain emotions with eating. Working with a therapist can help you break those patterns and develop healthier coping mechanisms instead. 

Various strategies, including mindfulness meditation, cognitive behavioral therapy, and lifestyle changes such as improving sleep and exercising more, have been found to be helpful in curbing emotional eating and relieving stress.

Improve your sleep

If you’re sleeping 6 or fewer hours per night, getting better sleep on a regular basis can not only help you feel less hungry, but also less stressed out—which can further reduce your hunger levels and likelihood of emotional eating. Aim for 7–9 hours of sleep per night.

Be patient 

If you're just getting started on semaglutide, know that it can take time—up to 12–20 weeks, depending on whether you’re taking Ozempic vs. Wegovy—for you to reach your maintenance dosage and experience the full effects. In the meantime, keep taking your Wegovy as prescribed. 

If you’ve already reached the maximum dosage and you’re still feeling hungry, talk to your healthcare provider. It’s possible that Ozempic or Wegovy is not the right medication for you; about 1 in 10 people will not see significant weight loss with semaglutide. Speak with your doctor to discuss potential alternatives.

“It’s normal to be hungry as a human,” says Harris-Pincus. “While semaglutide does suppress hunger, each body will respond differently.”

Once you are taking your maintenance dosage of Wegovy, you should notice appetite-suppressing effects such as:

• Fewer food cravings

• Feeling full sooner during a meal

• Less hunger generally

• Less “food noise” (intrusive, persistent thoughts about food)

But, you should still get hungry. As Pincus-Harris says, that’s part of being human. Hunger is your body’s way of telling you that it’s time to eat.

How long semaglutide takes to suppress appetite can depend on the individual, the dosage you are taking, and other factors such as your lifestyle and personal health situation. 

In some studies of semaglutide, people reported less hunger, fewer cravings, and better control over their eating within 12 weeks. In others, the appetite suppression was studied at week 20, and continued to improve for up to 2 years, at which point, participants reported:

• Less desire for salty and spicy food

• Fewer cravings for dairy and starchy foods

• Less difficulty resisting their cravings

• Better control over their eating

While semaglutide starts working as soon as you start treatment, it can take up to 4–5 weeks before the drug reaches a steady concentration in your bloodstream. And remember, the dosage is titrated over time so give it a chance to kick into gear before you assess how it’s working for you.

• You shouldn’t expect to feel zero hunger on semaglutide, but you should feel less hungry than before over time. 

• You may also notice your cravings for certain foods change or that you get full sooner during meals. 

• If you’re not noticing any difference, talk to your healthcare provider and try some of the suggestions above.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

October 26, 2024

Written by

Amelia Willson

Fact checked by

Beverly Tchang, MD and Raagini Yedidi, MD

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About the medical reviewers

Beverly Tchang, MD

Beverly Tchang, MD, is an Obesity Medicine Advisor for Ro. She is also an assistant professor of Clinical Medicine at Weill Cornell Medicine in New York and triple board-certified in Internal Medicine, Endocrinology, and Obesity Medicine.

Raagini Yedidi, MD

Raagini Yedidi, MD, is an internal medicine resident and medical reviewer for Ro.