10 reasons you’re not losing weight on Wegovy

If your weight loss has stalled on Wegovy, you probably feel pretty frustrated. Rest assured, it’s very normal to hit a Wegovy plateau at some point. Here are 10 reasons you’re not losing weight on Wegovy — plus, tips for moving past those frustrating stalls to start seeing results again.

If the scale isn’t moving while you’re taking Wegovy, some troubleshooting is in order. Let’s explore the 10 most common reasons for a Wegovy plateau.

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1. You may need to give it more time

The problem: You haven’t been taking Wegovy long enough to see significant results.

What to do about it: Channel some patience (easier said than done, we know). 

Recently started Wegovy? It’s important to understand that it can take some time to see results. (Rome wasn’t built in a day, after all.) 

So, if you’re not seeing results as quickly as you hoped, you may need to be a bit more patient. 

• Some people may start to see results within 4-8 weeks of treatment. 

• Others don’t start seeing significant results for up to 20 weeks, possibly longer. 

• Most people see their peak results by the one-year mark. 

2. You may need a higher dose

The problem: Your dose may be too low to get the results you expect. 

What to do about it: Speak to your healthcare provider about potentially increasing your dose if you’ve been at your current dose for at least four weeks and you’re handling side effects well. 

When starting Wegovy, your provider likely started you at the lowest dose (0.25 mg) to see how you respond to the drug before increasing your dose. As long as you tolerate the side effects, the typical dose increasing schedule is as follows: 

• Weeks 1–4: 0.25 mg injected once weekly

• Weeks 5–8: 0.5 mg injected once weekly

• Weeks 9–12: 1 mg injected once weekly

• Weeks 13–16: 1.7 mg injected once weekly

• Weeks 17 and beyond: 2.4 mg injected once weekly

This dosing schedule is a big reason it can take time to see significant results on Wegovy. The higher the dose you’re taking, the more weight loss you can expect to see. 

But it’s important to increase your dose slowly, since side effects also increase at higher doses. Work with your provider to figure out the dosing sweet spot that gets you to your goal without being interrupted by too many side effects. 

3. You may have a health condition that makes it harder to lose weight 

The problem: Some health conditions (e.g. diabetes, polycystic ovary syndrome) make it harder to lose weight.

What to do about it: Be patient, and speak with your healthcare provider about your options for managing your health conditions while on your weight loss journey.

Some health conditions can make it harder to lose weight with Wegovy. Most notably, people with type 2 diabetes have a more challenging time losing weight than those without — even when they are on Wegovy or using other weight loss medications. 

Research on semaglutide (the active ingredient in Wegovy) shows that those with diabetes lost less weight than those without diabetes. In one study:

• People with diabetes lost around 7% of their body weight after six months of treatment

• People without diabetes lost nearly 12% of their body weight in the same time period 

Conditions like diabetes can make weight loss more challenging and may contribute to a Wegovy plateau. But remember, weight loss is still possible and worth pursuing.

4. You may take another medication that interferes with weight loss

The problem: Some medications can cause weight gain, which can undermine your weight loss efforts.

What to do about it: Talk to your healthcare provider about other treatment options (if any) that may not impact your weight as much. But never (and we mean never) stop taking any medication without first consulting your provider. 

Many types of medications can cause weight gain, including: 

• Drugs for high blood pressure, especially beta blockers and some calcium channel blockers

• Antipsychotics and other psychotropic drugs (including many antidepressants)

• Anti-seizure medications

• Corticosteroids

• HIV medications

• Certain diabetes medications, such as insulin, sulfonylureas, and thiazolidinediones

The last category is a bit ironic, since the active ingredient in Wegovy — semaglutide — is also used to treat diabetes under the brand name Ozempic and is known to promote weight loss. The difference comes down to how these medications work in the body, which can either support weight loss or lead to weight gain.

If you suspect a medication you take might be responsible for your Wegovy plateau, don’t stop taking the medication on your own. Speak with your healthcare provider first to come up with a plan of action together. 

Sometimes you can’t safely discontinue a medication contributing to weight gain and that’s okay. Focus on other lifestyle adjustments to maximize your weight loss efforts. 

5. You may need to change your eating habits

The problem: You might not be in enough of a calorie deficit to see results.

What to do about it: Focus on reducing your calories while prioritizing a nutrient-rich diet.

Wegovy works best when combined with healthy lifestyle changes, including adjustments to your diet. In fact, the drug is approved in combination with a reduced-calorie diet (and exercise, for that matter).  

One large trial showed that semaglutide was most effective for weight loss when participants lowered their caloric intake by 500 calories daily. 

And, frankly, that makes sense given that a calorie deficit is necessary for weight loss. So, if you haven’t reduced your caloric intake yet, now might be a good time to start. 

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

Consider speaking with a dietitian for help adjusting your diet for weight loss while still getting the nutrients your body needs.

6. Your exercise plan may need some attention

The problem: You’re not getting enough exercise (or the right kind of exercise) to support your weight loss and overall health goals.

What to do about it: Increase your physical activity (walking counts!) in any way you can.

In clinical trials of Wegovy, participants were encouraged to exercise at least 150 minutes per week. And  If you’re not getting much physical activity currently, start slow and pick an activity you enjoy, such as walking for 20–30 minutes daily.

If you’re already exercising regularly, 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. 

You might also consider whether your current workout regimen 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 promoting weight loss while preserving muscle mass. This is because an increased muscle mass can boost your metabolism even at rest.

7. You may need more sleep

The problem: You aren’t getting the recommended amount of sleep per night to support your goals.

What to do about it: Work on improving your sleep hygiene and giving yourself the space and time to get enough shut-eye (ideally, 7–9 hours) each night.

If you can’t remember the last time you got a good night’s rest, that could be impacting your weight loss on Wegovy (or lack thereof). 

Studies show that people who don’t get the recommended 7–9 hours of sleep per night are more likely to have obesity or overweight. 

When you don’t get enough shut-eye or your sleep quality is poor, your appetite regulation gets out of whack. This can leave you feeling hungrier and more likely to seek out comfort foods, which tend to be high in calories (hello, Oreos!). 

Poor sleep has been shown to increase caloric intake by 250 or more calories per day, which could definitely throw off your weight loss goals. 

Improve your sleep hygiene with the following tips and you just may jumpstart better results from Wegovy: 

• Maintain a consistent bedtime and wake-up time

• Limit caffeine later in the day

• Get sun exposure as early as you can when you wake up 

• Dim lights in the evening to prepare for bed

• Avoid electronics (especially blue light) close to bed

Try to stay within the recommended window of 7–9 hours, as too much sleep could also potentially interfere with your weight loss goals.

8. Your stress levels may be too high

The problem: Your stress could be keeping the number on the scale from moving down as much as you’d like. 

What to do about it: Take steps to relax and lower your stress levels with strategies such as meditation and breathwork. 

One of the side effects of our go-go-go culture is that stress levels are higher than ever. In fact, about 35% of the world reports feeling significant stress. In addition to being a pain to deal with, stress is highly correlated with obesity.

Stress affects essential hormones involved in appetite, like ghrelin and leptin. It also increases the risk of abdominal fat. 

So, what can you do about this? Everyone needs to find what works for them, but employing the following strategies have all been shown to help reduce stress:

• Mindfulness

• Yoga

• Meditation

• Journaling

• Psychotherapy 

9. You may have hit a weight loss plateau

The problem: Your weight loss has stalled due to a Wegovy plateau.

What to do about it: Focus on the tips shared above and speak with your healthcare provider about your options to re-jumpstart weight loss.

Plateaus are a common, albeit frustrating, part of most weight loss journeys, and they happen on Wegovy, too. 

Put very simply, weight loss plateaus happen when your metabolism catches up to your weight loss. It slows down to match your current caloric intake and physical activity. 

Sometimes, plateaus resolve on their own, and you start losing weight again without putting in any extra effort. Other times, you may need to take some action to kick things back into gear. 

To push through a plateau, revisit the tips above. You may need to focus on your: 

• Diet

• Exercise

• Sleep

• Stress levels

You may also need to talk with your provider about how you’re managing other medical conditions, including whether any medications could be contributing to weight gain and if dose adjustments or medication changes might help.

10. You may need a different weight loss drug 

The problem: Wegovy doesn’t work for everyone, and you may need a different drug if the tips above aren’t helping. 

What to do about it: Speak with your healthcare provider about your options, which may include other weight loss drugs like Zepbound (tirzepatide). But never stop a medication without first consulting your provider and following their guidance.

Wegovy works well for most people, but a good percentage of folks don’t get their desired results from the drug. 

According to one large observational study, over 84% of people taking 2.4 mg of semaglutide (the active ingredient in Wegovy) consistently for a year lost at least 5% of their body weight. But that means about 16% of people did not achieve those results. 

If you’re in the group of people who don’t respond well to Wegovy, talk with your healthcare provider about your options. They may recommend switching to another weight loss medication, such as Zepbound. In select cases, other treatments may be considered including surgical weight loss options.

Many people taking Wegovy begin losing weight within a few weeks of starting the drug. But they tend to experience more significant results over a longer period. Most studies show peak weight loss at a year or more on the drug, though individual results may vary. 

One trial showed an average loss of about 2% of body weight by week 4, with peak weight loss of about 17% of body weight by week 68. Here’s a look at the average weight loss timeline shown over two years in most studies:

After 68 weeks (about 17 months) on Wegovy, weight loss slowed and even reversed a bit. But most weight loss was maintained through the second year of treatment. 

It’s important to note that you won’t continue losing weight indefinitely on Wegovy. Your body will naturally slow down your weight loss to meet your changing metabolic needs as your body weight decreases.

While you’re looking at the numbers, keep in mind that many Wegovy trials did not include people with type 2 diabetes. Though you can still lose weight on Wegovy if you have type 2 diabetes, progress may be slower. The medication works differently for everyone, so your results may vary.

Not everyone loses significant weight on Wegovy, though it works well for most people. In a large, real-world clinical trial, around 84% of people lost at least 5% of their body weight by week 68. But, again, that means that around 16% of participants lost less than that. 

If you’re not losing weight on Wegovy, it could be related to one (or more) of the reasons shared above. For example, if you have diabetes or take certain medications, you may have a harder time losing weight. Or you might need to re-evaluate lifestyle factors, such as your diet, exercise routine, sleep, and stress levels. 

If you’ve addressed those factors and you’re still not losing as much weight as you’d like on Wegovy, it’s worth speaking to your healthcare provider about other options available to you.

If you’re not losing as much weight on Wegovy as you expected, talk to your healthcare provider. They can offer advice on what steps you can take to improve weight loss on Wegovy. Depending on your situation, those steps will likely include some of the tips below.

Start strength training

Wegovy works best when used alongside diet and exercise. Any increase in physical activity (including walking) is a step in the right direction. But research shows that the combination of resistance training and aerobic exercise can be particularly powerful for improving body composition. 

Resistance training can help boost muscle mass, burn body fat, and rev up your metabolism. You can use free weights, weight machines, resistance bands, and even your own body weight to provide resistance during your workouts.

Eat more filling foods

Protein and fiber are part of any healthy diet. But they can be especially helpful when trying to lose weight, since both increase feelings of satiety, or fullness. 

If you feel full sooner while eating, you may not only eat less during that meal, but also feel less hungry afterward. Take a look at the chart below for some good sources of protein and fiber.

Get a good night’s sleep

Not getting enough sleep (~7–9 hours per night) has been shown to contribute to obesity. 

And the quality of sleep matters, too. Studies show that people who sleep better while attempting to lose weight tend to lose more weight and fat than those who don’t sleep well. 

Try the following sleep hygiene tips to improve your shut-eye:

• Go to bed and wake up at the same time every day, even weekends

• Develop and follow a consistent bedtime routine

• Exercise on a regular basis

• Limit or avoid exposure to light or bright screens later in the day

• Avoid caffeine, alcohol, or heavy meals later in the day

• Try meditation or another relaxation practice

Manage your stress levels

Speaking of meditation, it’s a great way to relieve stress, which can play a big role in your weight management. Other stress management techniques include:

• Deep breathing exercises

• Progressive muscle relaxation

• Guided visualization

Play around and see what works for you. And if you feel like you might need even more support, consider reaching out to a mental health professional, such as a therapist. 

Yes, there are other medication options if you’re not losing weight on Wegovy in the way you’d expect. The most effective alternative on the market is another injectable weight loss drug called Zepbound (tirzepatide). 

In a head-to-head study comparing semaglutide (Wegovy) and tirzepatide (Zepbound) in those with obesity but without diabetes, nearly 50%  of participants taking tirzepatide lost over 20% of their body weight compared to around 27% of participants taking semaglutide.

If you’ve tried the strategies above and you’re still not losing weight, it’s time to speak with your healthcare provider about your options. 

You’ll also want to reach out to your healthcare provider if you’re finding the side effects intolerable. They may recommend the following:

• Changes in your routine to help make the medication more tolerable

• Over-the-counter medications to help address your side effects

• Adjusting your dose of Wegovy

• Even trying another medication

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It can be frustrating to hit a Wegovy plateau or to feel like you’re just not losing weight on Wegovy. A number of reasons could explain why this is happening, and there are several strategies you can try before giving up on Wegovy altogether. 

• Not losing weight on Wegovy could be explained by several factors, and there are several ways to troubleshoot. 

• Some medical conditions and medications can make it harder to lose weight, in which case your healthcare provider may be able to help you manage your medications to best support your weight loss journey.

• Lifestyle factors like diet, exercise, sleep, and even stress levels can make a big impact on your Wegovy weight loss progress.

• It’s normal to hit a Wegovy plateau at some point, so try not to get too frustrated, but if you’ve addressed your lifestyle and other health conditions and you’re still not losing weight, speak with your healthcare provider about possibly adjusting your dose or switching to another weight loss treatment.