6 reasons Wegovy isn’t working

You’ve started taking Wegovy—a huge step toward losing the weight you and your healthcare provider have determined is right for you and your health.

The only problem? It’s just not working the way you’d hoped. 

You watch all the commercials and read all the articles talking about how effective Wegovy is, and you wonder, “Why am I not losing weight on Wegovy?”

Let’s take a look at what could be going on. 

Wegovy (semaglutide) is a type of drug called a glucagon-like peptide-1 receptor agonist (GLP-1 for short). It’s an FDA-approved weight loss drug that gets injected subcutaneously (right under the skin) once weekly into your stomach, thighs, or upper arms. 

Wegovy is highly effective at helping people with obesity lose weight (one clinical trial resulted in participants losing an average of 15% of their body weight by week 68 of the trial when taking 2.4 mg of Wegovy weekly). Most people start seeing results much sooner than that, though. 

Many people taking Wegovy begin losing weight within a few weeks of starting the drug, but it can take up to 20 weeks to see significant results. The studies available at this point have shown continued weight loss for up to 68 weeks, but it may continue past that point.

Wegovy works very well for many people, but if you’re not seeing the results you were hoping for, you’re probably feeling quite frustrated! It’s possible Wegovy isn’t right for you, but before stopping, let’s do some troubleshooting. Side note: you should not just stop taking the medication without consulting your healthcare provider. 

Some key things might be getting in the way of your success with this drug, so it’s worth exploring these options before assuming the medication isn’t right for you. 

1. You may need to give it more time

It’s tempting to want to see quick results when you start anything new, and efforts to lose weight are certainly no exception. You’ve probably tried many things in the past to lose weight before turning to Wegovy, so you know that losing weight is hard. The way Wegovy is talked about in the media, though, it’s no wonder many people think it’s a miracle drug for dropping weight quickly! 

If you started Wegovy recently, it’s important to understand that it can take some time to see results. Some people don’t start seeing significant results for up to 20 weeks, possibly longer. Most people see their peak results by the one-year mark. 

You may need to be more patient if you’re not seeing results as quickly as you hoped. Some people may see results within 4-8 weeks of treatment, but that may not be true for everyone. 

2. You may need a higher dose

When starting Wegovy, your provider likely started you at the lowest dose (0.25 mg) to see how you tolerate 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 up to 20 weeks to see significant results. The higher the dose you’re taking, the more weight loss you can expect to see. 

You might ask: Why wouldn’t your provider just give you a higher dose off the bat? 

Well, just like results are dose-dependent, so are side effects. The higher the dose you take, the more likely you’ll experience side effects. Your provider will only increase your dose if you’re tolerating the side effects. The main side effects are related to gastrointestinal complaints—, nausea, vomiting, and diarrhea. If you were experiencing uncomfortable side effects but they’ve improved (which often happens with side effects!), your provider may have kept you at a lower dose for a while and it may be time to try increasing your dose. It’s not necessary for everyone to be at the highest dose, though. If you are experiencing good results at a lower dose, you can stay at that dose since your schedule is at the discretion of your healthcare provider.

3. Other conditions or medications may affect how quickly you can lose weight

Some health conditions (or medications to treat certain 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—on Wegovy or using any other weight loss method. 

With semaglutide in particular, studies show that those with diabetes who take this drug lose less weight than those without diabetes. One study resulted in people with diabetes losing around 7% of their body weight after 6 months versus those without diabetes losing nearly 12% of their body weight in the same time period. 

There are also certain medications—such as antipsychotics and steroids—that can cause weight gain. If you’re taking one of these medications while you’re on Wegovy, these medications could slow down your weight loss, but it’s important to talk to your doctor before changing any of your medications. 

Even if you have one of these conditions or are taking one of these medications, you can still lose weight on Wegovy. It’s important to understand that your results may not be as dramatic as you’d like them to be, but they may still be worthwhile!

4. You may need to adjust your lifestyle habits

Wegovy is meant to be used alongside diet and exercise to help with weight management. If you’re not losing as much weight on Wegovy as you expected, it might be time to reassess your food intake and physical activity levels. 

One large trial showed that semaglutide was most effective for weight loss when participants lowered their caloric intake by 500 calories daily and increased their physical activity to 150 minutes of moderate-intensity exercise (like walking) per week. 

One of the ways Wegovy works is by decreasing appetite, which can help with caloric reduction, but if you’re not seeing great results, it’s possible you need to dial back your food intake a bit more. You may find it helpful to prioritize a high-protein diet, which can increase satiety in many people. An added benefit of a high-protein diet is it can help you maintain muscle mass while losing weight, which can be an issue when losing weight rapidly.  

Exercise is an essential part of weight maintenance—and overall health!—so if you’re not getting regular physical activity, try to prioritize that as you continue your efforts to lose weight. 

5. You may need to prioritize sleep and stress management

Diet and exercise are not the only things outside medications that can affect your weight. High stress levels are associated with higher levels of obesity, as is poor sleep. 

When you’re stressed, you may not have the energy or headspace to exercise and eat well. You may also overeat high-sugar or high-fat foods to give yourself the rush of dopamine you need to deal with stress. 

When you don’t get enough sleep or your sleep quality is poor, your appetite regulation gets out of whack, and you may feel hungrier than you would otherwise. Fatigue also contributes to stress levels, which can be a vicious cycle. 

Improving stress levels and sleep quality are no easy feat, especially in our high-stress environments, but it’s worth trying to address these issues. Whether trying something like meditation or improving your sleep hygiene, working on these things may help you see better results from Wegovy. 

6. You may have hit a weight loss plateau

Plateaus are a common, albeit frustrating, part of most weight loss journeys. Here’s how they work. Thanks to Wegovy and lifestyle changes like diet and exercise, you may start losing weight. In the beginning, the weight comes off quickly. Then, after some time goes by, your rate of weight loss slows down significantly. In other words, it plateaus.

Put very simply, weight loss plateaus occur when your metabolism catches up to your weight loss and slows down to match your current caloric intake and physical activity. Sometimes, plateaus resolve on their own, and you start losing weight again. Other times, you may need to take some action to kickstart your weight loss again—perhaps by changing up your diet, amping up your physical activity, or something else. 

Strength training is one approach people may take to push through a weight loss plateau. Resistance exercise helps build lean muscle mass, which can sometimes decrease during weight loss.. Building muscle can reset your metabolism and help you start losing weight again. 

While most people lose weight on Wegovy, some people will not lose as much, or as quickly. For example, in one clinical trial, 86.4% of people lost at least 5% of their body weight by week 68 — which means almost 14% of participants lost less than that. 

There could be a number of reasons why Wegovy does not work for these so-called “non-responders.” In some cases, other underlying health conditions may affect how much weight loss one experiences on Wegovy. In a clinical trial, 83.5% of people with obesity lost at least 5% of their body weight by week 68, but only 67.4% of people with obesity and type 2 diabetes did.

Sometimes, it simply takes longer for people to lose weight on Wegovy. In one study, 88% of people hit the 5% weight loss milestone by week 20. However, many of the other 12% of participants did eventually hit that milestone by week 68, with an average weight loss of 6.4%. 

Even if you don’t lose weight as quickly as others do on Wegovy, it doesn’t necessarily mean you won’t eventually lose weight. And, taking Wegovy can still drive other benefits for your health, including improvements in blood pressure and cholesterol. But, if you’ve been taking Wegovy for five months and you haven’t lost 5% or more of your body weight, you may want to check in with your healthcare provider in case you are one of these “non-responders.” They may want to adjust your dosage, switch you to another GLP-1 medication, or have you make additional lifestyle changes to improve your weight loss on Wegovy.

Wegovy is meant to be taken long-term. If you’ve seen some weight loss with Wegovy—even if it’s not as much as you’d like—you can expect to regain at least some of the weight when you stop taking it, unless you replace the drug with another weight loss medication that works similar to Wegovy, such as Saxenda. 

Some people may find it off-putting that they’d need to stay on a drug long-term to continue seeing results, but it’s no different than any other weight loss effort; if you lose weight by changing your diet and then return to eating the way you had before, of course, your weight will revert back to where it was! 

Also, it’s essential to understand that obesity is a disease that, like many other diseases, sometimes requires medications to get it under control. If someone has insulin-dependent diabetes, they must take insulin every day, potentially for the rest of their life. Taking Wegovy for obesity is no different. 

If you’re not enjoying as much weight loss as you expected to on Wegovy, 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 might include some of the tips below.

Start strength training

Wegovy works best when combined with diet and exercise. Any increase in physical activity is a step in the right direction, but research shows that resistance training can be particularly powerful when your goal is weight loss. It 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 you eat, you may not only eat less during that meal, but feel less hungry afterwards as well. Take a look at your daily diet and consider if you’re including enough protein and fiber in your meals. We’ve listed some good sources of both in the chart below.

Get a good night’s sleep

Sleeping too much or too little can both contribute to obesity. Instead, aim for a healthy 7–9 hours of sleep per night. Studies show that people who sleep better while losing weight tend to lose more weight and fat than those who don’t sleep well. To sleep well, adopt the following sleep hygiene tips:

• 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. Other stress management techniques include:

• Deep breathing exercises

• Progressive muscle relaxation

• Guided visualization

Play around and see what works for you. A small study of adults with obesity found that people who consistently work on managing their stress levels tend to lose more weight.

Consider Wegovy alternatives

If you and your healthcare provider have attempted to troubleshoot as best as you can, but you’re still not seeing the results you want from Wegovy, it might be time to try something else. The most effective alternative on the market is a drug called Zepbound (tirzepatide). 

Zepbound is a slightly different type of drug than Wegovy. Like Wegovy, it acts on the GLP-1 receptor but also on a different receptor in the brain called GIP receptor. GIP stands for glucose-dependent insulinotropic polypeptide, another hormone responsible for regulating blood sugar and appetite.  

One large study showed over half of participants lost 20% or more of their body weight at the highest dose of Zepbound.

While other weight loss drugs are available, Zepbound has proven to be the most effective to date. If you aren’t happy with your Wegovy results, speak to your provider or connect with a provider at Ro about whether Zepbound is right for you.

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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.

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Current version

May 22, 2024

Written by

Rachel Honeyman

Fact checked by

Raagini Yedidi, MD

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About the medical reviewer

Raagini Yedidi, MD

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