Not losing weight on semaglutide? Here's why that might be happening

Weight loss medications have been long touted as a possible solution to help you lose weight, especially for those suffering from a weight-related health condition.

There have been many different versions of the weight loss drug over the past few decades as we look for long-term weight loss results that won't cause weight regain. And semaglutide — the active ingredient in Wegovy — is one weight loss medication that is gaining popularity, not just in the UK but globally.

Losing weight can be a tricky thing. You're living a healthy lifestyle, working on your diet and getting plenty of exercise, but you're still plateauing.

If you're taking semaglutide to assist with weight loss and not seeing results, then you're probably wondering what's going on. Read on as we look at some of the main reasons you might not be seeing weight loss.

How does semaglutide work for weight loss?

Unlike other weight loss medications, semaglutide has been shown in clinical trials to be one of the most effective treatments available for weight loss [1]. But how does it help you lose weight?

Semaglutide is present in multiple drugs. One is Ozempic, a weekly injection that was developed to help diabetics manage and control blood sugar levels. 

Another one is Wegovy which, unlike Ozempic, is licensed for the management of weight loss in the UK and is one of our medication offerings here at Juniper. Plus, as Wegovy is administered in higher doses, it provides greater weight loss results. 

After eating, your digestive system produces a hormone called GLP-1 that regulates insulin secretion to control your blood sugar levels [2].

Semaglutide mimics the same hormone, which is why it works so well to treat diabetes or insulin resistance.

It also reduces your appetite by sending signals to your brain that you've eaten and feel full, giving you a reduced appetite. The medication acts like this natural hormone to keep you feeling fuller for longer and helps slow down the rate your stomach empties food into your digestive system.

Clinical trials found that using semaglutide as a weight loss medication was incredibly effective as it reduced participants' hunger, and food cravings and decreased the desire for fatty, energy-dense foods [3].

Wegovy is used as part of Juniper's Weight Reset Programme, where it comes as a pre-filled injection pen that looks similar to an epi-pen and only requires a weekly injection.

When is the best time to take semaglutide?

Semaglutide is best taken once a week on the same day each week [4]. They can be taken with food or without. The time of day you take the medication doesn't really matter, as long as you are consistently taking it on the same day each week.

How long can you lose weight with semaglutide?

One trial found that after 2 years on semaglutide, patients were still losing weight [5].

Although there is technically no limit to how long you can take semaglutide weekly, at Juniper, our prescribers mostly recommend sticking with the program for at least a year.

It's important that your program is tailored to you, that's why our prescribers will speak to you about the right duration of time to be on the medication, depending on how much weight you are looking to lose, as well as your overall health goals.

It's also important to make lifestyle and habit changes alongside weight loss medication to ensure that you'll continue to experience sustainable weight loss in the long term.

This is why our Weight Reset Programme takes a holistic approach that includes clinically-proven medication as well as 1:1 health tracking, lifestyle coaching and access to a private community where your successes are celebrated.

Can semaglutide cause weight gain?

Both Ozempic and Wegovy can cause some side effects, although the most common side effects are generally temporary as your body adjusts to taking the medicine.

Semaglutide has also been shown in clinical trials by its pharmaceutical manufacturer to be more effective for weight loss compared to other GLP-1 medications. Although many lost weight, some people did gain weight in the trials.

Semaglutide is not usually known to cause weight gain, although some people may experience some initial bloating during the first few weeks.

Why am I not losing weight on semaglutide?

If you're not losing weight on semaglutide, there could be a few reasons why.

1. You're looking for drastic changes, quickly

While semaglutide can help you experience significant weight loss, it does take time.

So, if you've just started Wegovy, for example, and are expecting weight loss to happen straight away, it's important to remember that:

a) Everybody reacts to semaglutide differently, and

b) Weight loss always takes patience — even if you are on medication.

Try to approach your journey with the medication as one to help you achieve gradual, sustainable weight loss outcomes.

2. You don't have the right calorie intake

It's still important to be in a caloric deficit to lose weight — meaning you should be consuming fewer calories than you're burning.

That's why our programme uses behavioural science to set you up for sustainable lifestyle changes that will stick (and our dietitians can help you determine what the right deficit for you is).

3. Your dosage might be off

It's required that you start on a dose of 0.25mg for the first 4 weeks, which allows your body to get used to the medicine and helps to reduce the risk of side effects.

After the initial 4 weeks, you can begin increasing the dosage — be sure to talk to your prescriber about this as you may not have increased your dose and that could be wreaking havoc with your weight loss efforts.

4. You've hit a plateau

It's normal to eventually hit a point where your weight loss slows down, especially if you're not working on keeping or building up your muscle mass.

Losing muscle along with fat slows your metabolism and can slow down your weight loss. Once your body adjusts, your weight loss journey should pick up again.

5. You haven't found the right healthy lifestyle changes

The true 'secret' to long-term weight management is being able to establish healthy habits like regular exercise and a healthy diet you can actually stick to long-term.

This will ensure you achieve sustainable weight loss and can carry it out into the future.

6. You need a stronger support network

Successful people surround themselves with successful people.

Research shows people have greater success with weight loss when they do it together, which is why we give you access to a community of women who are also on a Juniper journey so you can share the experience together.

7. You're not getting enough sleep

Getting at least 8 hours of sleep a night is critical to helping your body lose weight.

Though the exact link between sleep and weight is still under investigation, the main hypothesis is that poor sleep quality may increase your levels of ghrelin and leptin — two hormones that influence your appetite levels.

Plus, some studies have found that sleep-deprived people can often gravitate towards higher-calorie foods [7].

To prevent this, try to practice good sleep hygiene to ensure you're giving yourself the best opportunity for a good night's sleep.

8. You're skipping doses

Just like any other medication, it's important that you take semaglutide according to your clinician's instructions.

By sticking to your schedule, you can maximise your treatment response (while also minimising side effects).

Of course, sometimes life gets in the way, so if for some reason you do forget to take a dose (or more) of semaglutide and are unsure what to do, be sure to contact your healthcare provider.

9.  You're too stressed

Yes, your stress levels can impact your weight loss results and they may just be the reason why you're not seeing the results you were hoping for.

This is because excess cortisol levels can promote overeating (making it harder to stick to that caloric deficit we mentioned before), slow down your metabolism, decrease muscle mass, and contribute to sleep hygiene issues.

10. You're not drinking enough water

Staying hydrated is key for pretty much every process in your body, and weight management is no exception.

While drinking enough water isn't the one and only way to lose weight, not doing so can certainly be a barrier to your success.

This is because water can help boost your metabolism, suppress your appetite, reduce cravings, improve your digestion (so your body uses all the nutrients in your food effectively), and make it easier to exercise.

How long does it take for semaglutide to start working for weight loss?

Semaglutide helps reduce cravings and suppress appetite, which helps you consume fewer calories. Each person has a different starting weight, metabolic weight and possibly even different underlying health conditions.

Once you start on an injectable medication, you may find it takes a few weeks to start seeing results, although some people may see changes in a week.

Your prescriber will start you on the lowest dose of the medication in order to give your body time to adjust to the medication. You’ll begin to notice that your appetite is reduced and you’re experiencing increased satiety.

In general, most people lose a minimum of 5% of their starting weight when they use semaglutide.

How can I maximise my body weight loss on semaglutide?

You can assist the medication by lowering your overall calorie intake, moving your body where possible and limiting your alcohol consumption.

Although there are no specific rules or diets to accompany using semaglutide, reducing the number of processed foods in your diet whilst increasing fibre-rich whole foods can help with lowering your overall calorie intake.

When it comes to exercise, the UK Chief Medical Officers' Guidelines recommend adults participate in 150 minutes of moderate activity and 75 minutes of vigorous activity every week [6].

It is also recommended to reduce the amount of time spent sitting and incorporate 2 days per week of strengthening exercises.

Our Weight Reset Programme takes a multipronged approach to weight loss, helping you meet your goals in a healthy and sustainable way.

And, when combined with lifestyle changes, almost one-third of people who take this GLP-1 medication for weight loss lose around 10% of their body weight.

If you are at all concerned about the rate of your weight loss on semaglutide, it's best to consult with your healthcare provider.

Juniper's clinicians are standing by to support you through each stage of your journey as you strive for a healthier lifestyle. The Juniper Weight Reset Programme prescribes Wegovy, which contains semaglutide — check your eligibility here.

Why am I not losing weight on Mounjaro?

If you’re on Mounjaro and are not seeing the results you were hoping for, the reasons we listed before may also apply.

Perhaps you’ve hit a weight loss plateau, have not made the necessary lifestyle changes to support your goals or are not taking the appropriate dosage — whatever it may be, it’s best to have a chat with your prescriber.

They can give you expert advice on what next steps you should take to get back on track and make your medication work for you.