How to get through a plateau on Wegovy

It can happen to anyone. You’ve been taking Wegovy (semaglutide) for a while, exercising and eating better, and you’re losing weight.

Then, all of a sudden, it seems like you’re not quite shedding the pounds as fast as you had been. It may feel like you’re barely losing weight at all. What gives?

Welcome to what’s known as the weight loss plateau. It’s a common experience for many while losing weight, even when you’re sticking to lifestyle changes like diet and exercise or adhering to a treatment regimen with medication like Wegovy.

A Wegovy plateau is when your rate of weight loss slows down significantly, despite the fact that you are still taking Wegovy. Nothing externally seems to have changed — you may still be exercising and dieting as you were before — but for some reason, the pounds just aren’t melting away like they had been. You may even gain a little weight during a plateau.

A Wegovy plateau is a lot like a typical weight loss plateau, with the key difference being that it occurs while the person is taking Wegovy to lose weight. “Hormones in our body protect us from losing too much weight,” shared Dr. Beverly Tchang, an endocrinologist who treats patients with obesity, and an advisor to Ro. “They cause the ‘weight loss plateau’ that everyone experiences, whether they are using diet, exercise, or medications.”

Plateaus are a normal part of weight loss journeys. Essentially, what happens is that your metabolism adapts to your new food and exercise regimen, and slows down your body’s energy usage in what it perceives of as a time of limited resources. This slowdown in your metabolism is part of your body’s natural adaptations often referred to as starvation mode. You may be aiming for a healthier weight, but your hormones don’t know that. Your body just senses that you’re eating less, so it responds as if you don’t have access to the same amount of food and resources, conserving energy (e.g. body weight and fat) to keep you alive. 

Learning how to work with your biology instead of fighting it is the key to maintaining steady weight loss and staying on track with your weight management goals.

Beyond a slowdown in weight loss, a Wegovy plateau may be accompanied by other changes, including:

• Increased hunger

• Increased fatigue

• Some weight gain

If you’re noticing these effects, you can thank your changing hormone levels. As part of your body’s survival response, it’s common for levels of ghrelin (the “hunger” hormone”) to increase, while levels of leptin (the “satiety” hormone) decrease. In addition to making you feel hungrier, these hormonal changes can make you feel tired, so staying physically active is even harder.

While the goal is to lose fat, some people may lose too much lean muscle mass when they start losing weight — especially if they’re not also taking steps to retain muscle through eating protein and strength training. Losing weight in a gradual way, while working to maintain and build muscle mass, can help counteract these effects and keep your metabolism working optimally. 

The highest maintenance dosage of Wegovy is 2.4 mg, administered once a week. Higher doses of semaglutide, the active ingredient in Wegovy, have not been studied, so it is not known whether they are safe or effective or might affect weight loss rates.

If you are already taking the 2.4 mg dosage of Wegovy, your healthcare provider may adjust your treatment plan to stimulate weight loss again. Ultimately, however, it “depends on the person and their goal,” says Dr. Tchang. “For many people, losing just 5% of their weight is sufficient to achieve multiple health benefits, and Wegovy helps 9 out of 10 people achieve this goal.” 

These health benefits can include improved blood pressure, quality of life, and even sexual function (by improving symptoms of conditions like erectile dysfunction for men). There’s even evidence that weight loss can improve symptoms of depression and reduce the risk of heart attack or stroke. Additional benefits can come with more weight loss, including relief from obstructive sleep apnea and prediabetes.

When you start a weight loss journey, it’s typical to lose more weight in the beginning. “In the clinical trials, people continued to lose weight throughout the first year of taking Wegovy, albeit more slowly in the second half of the year than the first half,” shared Dr. Tchang.

For example, in one study, people lost nearly 15% of their body weight within a year and a half of taking Wegovy. According to another study, people continued losing weight two years after starting treatment, although their rate of weight loss had indeed slowed down. “Once you reach your goal weight,” she said, “the hope is that the plateau lasts forever,” shared Dr. Tchang. “This means you're in the next phase: weight maintenance.”

Do not change your dosage of Wegovy without consulting a healthcare professional. 

If you’re not losing as much weight on Wegovy as you thought you would, don’t despair. It is entirely possible to push through a weight loss plateau once you reach it. Try these three tips.

1. Check in on your diet

Wegovy works best when it’s combined with a reduced-calorie diet and increased physical activity. Generally, this may mean reducing your current caloric intake by about 500 calories daily, but your healthcare provider may recommend something specific for you. 

If you haven’t reduced your food intake, now might be a good time to start. Also consider whether you can do more of the following:

• Avoid sugary and processed foods 

• Drink less alcohol and sweetened beverages, or avoid them altogether

• Eat smaller portions, more slowly

• Limit snacking, especially late at night

• Eat more vegetables, fruits, nuts, and whole grains

• Increase your protein intake to build muscle

2. Refresh your exercise routine

In some studies of Wegovy, participants are encouraged to exercise at least 150 minutes per week. If you’re not getting much physical activity currently, start there and pick up an activity you enjoy, such as walking for 20–30 minutes daily.

If you’re already exercising, you might try upping it to 200 minutes per week, which has been shown not only to produce more weight loss but also to prevent weight regain. 

Or, you might consider whether your current workout mix is optimal for weight loss. Any kind of exercise can be beneficial, but research shows that combining resistance training with aerobic exercise is particularly effective at producing weight loss while preserving muscle mass.

3. Destress and relax

How are you feeling? If you're stressed, sleep-deprived, or heaven forbid, both, it can negatively affect your weight loss progress.

Regularly sleeping fewer than seven hours per night can disrupt your hormone levels, affect your mood, and slow your metabolism — any one of which can make it tougher to lose weight. Sleep deprivation also increases your stress levels, which in turn encourages your body to hold on to fat. Plus, when you’re stressed or sleepy, you simply feel more tired and less motivated, which makes it even more challenging to stick to your diet and follow your workout plans.

If you think you’re in need of a bit more R&R — and who isn't? — consider incorporating some of the following into your daily routine:

• Adjusting your schedule to make room for more sleep

• Practicing deep breathing or progressive muscle relaxation exercises

• Spending more time outside

• Exploring guided imagery, visualization, or another type of meditation

• Journaling

• Aromatherapy

Finally, keep with it! Much as we might wish it was, weight loss is not a linear activity. There are ups, downs, and plateaus along the way. Stick with your new healthy habits, and talk to your healthcare provider for more guidance on what you can do.

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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

August 29, 2023

Written by

Amelia Willson

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.