Why Am I Not Losing Weight on Semaglutide?

Why is Semaglutide Not Working? 

You may begin a GLP-1 treatment plan with certain expectations. And if your progress looks different than expected, this doesn’t necessarily mean anything is wrong. Many factors can influence your individual experience.

Semaglutide is a GLP-1 receptor agonist—a prescription medication that belongs to a class of medications acting on receptors involved in appetite regulation and blood sugar control. 

Most treatment plans start with a low dose that’s gradually increased over several weeks or months. In turn, this gives your body time to adjust and also helps minimize side effects, such as nausea.

If your experience does not match your expectations, factors such as being early in your treatment plan, nutrition, health conditions, or other medications may play a role. GLP-1 medications, including those that contain semaglutide, can cause side effects (such as nausea, vomiting, diarrhea, or constipation) and are not right for everyone. Talk with your healthcare provider about the risks and benefits for you.

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Reasons for a Semaglutide Weight Loss Plateau

While it’s always important to discuss any concerns with a licensed healthcare provider, here are the top reasons you may not be experiencing results.

You’re Still in Early Treatment.

GLP-1 treatment typically begins at a low dose and is gradually increased over several months to help your body adjust and reduce side effects. This means that many individuals don’t reach a therapeutic dose until about 16 to 20 weeks (or three to four months). 

If you are still early in treatment, regular provider check-ups can ensure your plan makes sense for you and your needs or goals.

Your Calorie Intake May Still Be Too High.

Semaglutide may reduce appetite and help you feel satisfied with less food. But it doesn’t override your already existing eating habits. 

You might be surprised how quickly liquid calories from alcohol, sugary drinks, or even coffee additions add up without triggering the same fullness signals. This means it may be important to track your intake with a food journal, or to work with a registered dietitian, who can help you spot patterns you may not notice on your own and make targeted adjustments.

You’re Not Getting Enough Protein.

When you’re eating less overall, the quality of what you eat matters even more. 

Protein plays a key role in preserving lean muscle mass during weight loss, and muscle is a metabolically active tissue that helps your body burn calories at rest. If your diet is low in protein, you may lose muscle along with fat, which may slow your metabolism over time and make continued progress harder. 

This means you’ll want to make sure you prioritize lean protein sources, such as chicken, fish, eggs, legumes, or Greek yogurt, at every meal.

Metabolic Adaptation Is Kicking In.

Your body is remarkably good at protecting itself. As you lose weight, your metabolism may slow down in response—a survival mechanism that helped our ancestors endure periods of scarcity. 

This metabolic adaptation means you may need fewer calories to maintain your new weight than someone who was always at that size. It’s frustrating, but it’s also normal. 

Additionally, strategies such as incorporating strength training, cycling your calorie intake, or adjusting your dose under the guidance of your licensed healthcare provider may help you work through this phase.

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An Underlying Health Condition May Be Involved.

Hypothyroidism, polycystic ovary syndrome (PCOS), insulin resistance, and hormonal imbalances can all influence how your body stores and burns fat. If you’ve been consistent with your medication, nutrition, and activity but still aren’t seeing results, it may be worth discussing additional testing with your healthcare provider to rule out contributing factors.

Other Medications Could Be Working Against You.

Some prescription medications are associated with weight gain or can make losing weight more challenging. These may include certain antidepressants, antipsychotics, corticosteroids, beta-blockers, and some diabetes medications. Thus, if you’re taking other prescriptions alongside GLP-1 medication, talk to your provider about whether any of them could be influencing your progress.

The Scale Isn’t Telling the Whole Story.

Weight is only one metric, and it’s not always the most accurate reflection of progress. If you’ve been more active, you may be building muscle while losing fat, which can cause the number on the scale to stall even as your body composition improves. 

This means that other metrics may be better indicators of your progress, such as your clothes fitting differently, increased energy, or improved lab markers. 

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Final Thoughts

Weight loss is rarely linear. At the end of the day, your healthcare provider can help you troubleshoot what’s happening and adjust your treatment plan if needed. Ultimately, results vary from person to person, but a licensed healthcare professional can help you determine what’s best for your specific situation.

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