Why am I not losing weight on Wegovy?

Feeling frustrated because the weight isn't coming off despite being on Wegovy? You're not alone. Many people turn to this weight loss drug for its proven effectiveness in aiding weight loss, but how long does it take to see those results?

Well, weight loss journeys are deeply personal, and the rate at which you shed pounds can vary, with several factors at play, from your genes to your lifestyle choices, and more.

If you're wondering why you might not be losing weight as quickly as expected, read on. We'll explore potential reasons this might be happening and offer practical tips to help you make the most of your Wegovy treatment.

How long does it take to notice weight loss on Wegovy?

Wegovy typically works quite quickly, with most people noticing a significant decrease in appetite within the first 1-3 days and weight loss in the first 4 weeks of treatment [1].

Though weight loss — and how fast it occurs — will vary from person to person, clinical trials on the effectiveness of Wegovy found that those taking the medication lost 15% of their initial body weight, versus the placebo group who only lost 2.5% [2].

Plus, according to the same trials, patients on Wegovy lost:

• At least 6% of their weight by week 12
• At least 10% by week 20
• At least 15% by a year

Is it normal not to lose weight on Wegovy?

Although Wegovy can lead to significant weight loss, it doesn't work the same for everyone. In the clinical trials we mentioned before, nearly 14% of patients were actually "non-responders," meaning they lost less than 5% of their initial weight in 68 weeks [2].

Now, being a "non-responder" doesn't necessarily mean Wegovy isn't working, period. Particularly if you're losing weight at a steady rate, but not as much or as quickly as you were expecting, that might just be the way your body responds to the medication. It might literally be in your genes.

But if you think there might be something else at play, keep on reading.

9 reasons why you're not losing weight on Wegovy

If you're on Wegovy but not losing weight, here's what might be happening:

1. It hasn't been long enough

Weight loss doesn't happen overnight — whether you're on a weight loss medication or not.

We mentioned before that most people start noticing weight loss within the first 4 weeks, so if it hasn't been that long yet, you likely need to give the drug more time to take effect.

Even if it has been 4 weeks, everybody reacts differently to Wegovy, so timelines will differ.

If you're worried the medication simply isn't working for you, share your concerns with your doctor, but remember to have realistic expectations and to focus on sustainable weight loss, rather than quick fixes.

2. Your dosage is off

When you first start taking Wegovy, your doctor will prescribe you 0.25 mg per week, which is the starting dose.

This remains your dose for 4 weeks, but after that, it will likely go up (as long as you're not experiencing adverse side effects). Usually, this increase happens every 4 weeks, until you reach 2.4 mg per week, which is the maintenance dosage.

Now, if you're not losing weight, you might not be on the right dose for your specific circumstances. If you suspect this may be the case, speak with your doctor about the possibility of upping your dose.

3. You haven't adjusted your dietary habits

Taking Wegovy without adopting a healthy, reduced-calorie diet won't take you far. You may notice initial weight loss, but in order for it to continue (and for you to keep it long-term), you need to adjust your diet.

Perhaps you've gotten into the habit of snaking between meals, are an emotional eater or can't resist a visit to the fridge late at night. Or maybe you're not sure what a healthy portion looks like for you, and end up overeating without even realising.

Whatever it might be, this is the time to address your unhealthy eating habits, so that they don't hinder the effectiveness of your Wegovy treatment.

4. You're not exercising enough

Along with eating a balanced diet, exercising is an important part of the weight loss equation — and studies have found that Wegovy is most effective when coupled with at least 150 minutes of moderate-intensity aerobic exercise per week [3].

If you're currently living a sedentary lifestyle, incorporating more movement into your day-to-day can make a huge difference.

The best part is that this "movement" can be whatever suits your routine, schedule and preferences — from swimming to Pilates, yoga, boxing, and even incidental exercise.

5. You're not getting enough sleep

Though the connection between sleep and weight is still a little fuzzy, there are a few hypotheses as to how poor sleep quality may interfere with your weight management efforts.

One is that sleep deprivation may increase your ghrelin levels (the hunger hormone) and decrease your leptin levels (responsible for making you not crave food when your body doesn't need more calories) [5].

Sleep deprivation is also believed to affect your food choices, making you gravitate towards higher-calorie, higher-carb foods [6].

6. Your stress levels are too high

Stress can increase your cortisol levels, potentially leading to weight gain. This can happen because:

• You're turning to food as a way to deal with stress — what's called 'emotional eating' — and as a result, consuming too many calories
• Cortisol is raising your blood sugar levels, causing blood sugar to get stored as fat
• Stress is affecting your sleep hygiene and leading to the issues we mentioned before

7. You have underlying health conditions

If you're leading a healthy lifestyle and seemingly doing everything right, there might be a health condition to blame for the lack of progress you're seeing.

For example, studies suggest that people with diabetes who take semaglutide medications like Wegovy usually lose less weight than people without diabetes [4]. Thyroid issues and hormonal imbalances can also disturb your weight loss efforts.

Plus, some medications, like steroids and antidepressants, may cause weight gain or slow down weight loss.

8. You've hit a weight loss plateau

After a while of being on a weight loss journey, your body starts to adjust to your new habits, causing weight loss to slow down (or even stop). Specifically for Wegovy, it seems like a year in is when the weight loss plateau tends to occur [7].

Although they can be disheartening, weight loss plateaus are really common.

Overcoming a plateau is all about tweaking your lifestyle, for example by making your exercise routine more challenging, readjusting your calorie deficit, or upping your Wegovy dosage with the guidance of your doctor.

9. You're not drinking enough water

Drinking water isn't the big secret to weight loss, but not drinking enough of it sure can be an obstacle to success — and one that many may overlook.

Did you know, for instance, that drinking water can boost your metabolism by up to 25% for 1 hour after you have it [8]? Or that drinking about 2 cups should be enough for your body to register fullness [9]? Or even that drinking water before a meal can reduce the amount of food you eat [10]?

How to increase weight loss on Wegovy

A few healthy habits you can adopt to boost your Wegovy weight loss results include:

Eating a healthy diet

There are two things to consider here: quantity (your calorie intake) and quality (the foods you eat).

Your doctor will be able to give you personalised nutrition advice, but speaking generally, you should:

• Be in a calorie deficit. This means consuming fewer calories than what you burn, leading your body to start using its stored energy reserves, which will help you lose weight and body fat.
• Prioritise protein. Protein is the most satiating macronutrient and studies have found that eating a high-protein diet (with more than the standard protein intake) leads to weight loss and enhances body composition [13].
• Get your 5-a-day. Fruits and veg are usually low in calories, so they're a great addition to your diet if you’re looking to lose weight. Plus, they've got plenty of other health benefits, from better immunity to a healthier gut, lower risk of several diseases, and more.
• Don't skip meals. It can be tempting to skip meals in an effort to speed up the weight loss process, especially as Wegovy reduces your appetite and silences your food noise, but it's actually not a great idea. Chances are, you'll be even hungrier later and end up overeating.
• Stay hydrated. It will help boost your metabolism and keep cravings at bay. Sparkling water and lemon water also count here!

As for what foods to avoid, nothing is completely off-limits. However, for the best weight loss results, try to limit your consumption of sugary foods and drinks, ultra-processed foods, greasy and fatty foods, artificial sweeteners, and alcoholic drinks.

Moving regularly

Getting into exercise when you're a beginner can be intimidating, but you don't need to from 0 to lifting hundreds of kilos at the gym.

You can start slow, try different types of movement to find out what you enjoy (this is crucial for staying motivated!), and once you find it, create a routine you can follow consistently.

One type of exercise worth trying is weight training, where you use resistance (think dumbbells, barbells or even your body weight) to cause muscle contraction, increasing your muscle mass, strength and endurance.

Though often associated with bulky bodybuilders and hyper-muscular gym-goers, weight training is actually a great way to lose weight, as it increases your resting metabolic rate, meaning you burn more calories when you’re not exercising [11].

Cardio is another great option (particularly for fat loss) and no, it doesn't have to be running if that's not your cup of tea. Walking, swimming, rowing, cycling and dancing, for instance, are all considered cardio activities.

When you're keen on something low-impact, there's also Pilates. Though the intensity level isn't quite up there when compared to strength training or cardio, Pilates can still contribute to weight loss.

Whatever you choose, with exercise also comes the after-burn effect, where your body keeps burning calories at a high rate until it goes back to its resting state. Although this effect is highest right after you're done with your workout, it can actually last for up to 38 hours [12]!

Managing your stress levels and sleeping habits

A two-in-one tip: keeping your cortisol levels low and your sleep quality high will help get your weight loss journey back on track. If it's stress you struggle with, these tips may help:

• Try somatic exercise
• Start a food diary to identify unconscious habits you may have around food
• Find healthier versions of your usual comfort foods
• Practice mindful eating
• Find a good support system, whether that's your family, friends, partner or a mental health professional

As for getting better rest:

• Keep a regular sleep schedule
• Make sure your room is dark and quiet when it's time to sleep
• Avoid eating late at night
• Avoid drinking coffee in the afternoon
• Create a relaxing bedtime routine (journalling, meditation, yoga, reading — whatever gets you closer to a good snooze)

Can you switch to other weight loss medications?

The short answer is, yes, you can switch from Wegovy to other weight loss drugs like Mounjaro or Saxenda — but you should only ever do it with the guidance of your doctor.

They can let you know if this is the right course of action for you, and if so, advise you on when to make the switch, which dosage to start on with your new medication, and when to increase your dose until you reach maintenance.

When you access weight loss medications through Juniper's Weight Reset Programme, you get unlimited follow-up consultations with your clinician, so you can get all your questions answered. address all your concerns and, if needed, change your weight loss plan.

You also get ongoing support from health coaches and dietitians, who will help you build healthy habits you can take far into the future (along with your weight loss results).

Our team of experts will be there every step of the way to help you work through any challenges you're experiencing during your journey. This holistic approach sets you up for sustained weight loss, rather than a quick-fix solution.

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