Jump to: How do you maximise the results of semaglutide? | 1 – You’re not in a calorie deficit | 2 – You’re in a weight-loss plateau | 3 – Your current dose isn’t high enough to promote lower hunger | Take home message
The main reasons you’re not losing weight on semaglutide (Wegovy) might be that you’re not eating in a calorie deficit, you’ve hit a weight-loss plateau, or the current dose that you’re on isn’t high enough to lower your hunger to the point where you’re eating less.
Other factors may also contribute to this, such as other medications or health conditions impacting our ability to lose weight.
Not everyone responds the same way to semaglutide (Wegovy). A randomised controlled trial involving over 1,900 people living with obesity showed that 7% of participants discontinued their medication due to adverse events and side effects.
Wegovy is a powerful medication that significantly impacts the gastrointestinal tract and directly communicates with the appetite centre in the brain, the hypothalamus.
Unfortunately, these effects will result in negative responses for some people that aren’t tolerable to enable them to continue leading fulfilling lives.
Additionally, 86.4% of individuals in this study lost at least 5% of their body weight, an impressive amount. Still, that means 13.6% of participants lost less than 5%.
A weight loss intervention is typically considered successful if participants achieve more than 5-10% of weight loss. So, for some people, semaglutide doesn’t lead to clinically meaningful weight loss.
How do you maximise the results of semaglutide?
To maximise the results of semaglutide, it’s essential to make positive changes to our diet and lifestyle.
Semaglutide (Wegovy) is only approved for weight loss as an adjunct to lifestyle interventions.
So, there’s no evidence that semaglutide can work sustainably in the long term without us also eating a healthy diet, getting active, and improving our emotional health.
At Second Nature, we’ve launched a Wegovy-supported programme that combines our NHS-trusted weight-loss programme to maximise the results of semaglutide.
Wegovy will help you find your off switch by reducing hunger and food-seeking behaviours. Our award-winning programme will provide the practical tools to change your mind about healthy living and keep the weight off for good.
We’d generally recommend trying our weight-loss programme first, as it’s cheaper and research shows it’s the best weight-loss programme in the UK.
Now, keep reading as we dig deeper into the three reasons you’re not losing weight on semaglutide.
1) You’re not in a calorie deficit
The evidence is clear: we must eat within a calorie deficit to lose excess body fat. When we eat below our energy balance, our body has to find the energy required to fuel our body’s primary functions by burning excess fat.
Semaglutide works by interacting with the brain’s appetite control centre, the hypothalamus, to lower hunger and food-seeking behaviours.
Research suggests that semaglutide can reduce our energy intake by around 40% compared to individuals not taking semaglutide.
However, we eat for more reasons than physical hunger, and some people might continue to eat enough food that prevents them from achieving a calorie deficit due to psychological, environmental, or habitual reasons.
Additionally, suppose our baseline diet was rich in ultra-processed foods and refined sugars, and we continue to eat this way whilst on semaglutide. In that case, we may still eat more calories than we need to lose weight.
So, it’s essential we transition to a diet based on whole foods to maximise the results of semaglutide.
Head to our NHS-trusted meal plan for a free diet plan to help kickstart your weight-loss journey.
Key points:
We need to eat in a calorie deficit to lose weight
If our baseline diet is rich in ultra-processed foods and we continue to eat this way on semaglutide, we may still consume more calories than we need to lose weight
It’s essential to eat a diet based on whole foods to support sustainable weight loss
2) You’re in a weight-loss plateau
Suppose we’ve lost some weight on semaglutide, but then we hit a plateau, and we can’t budge the scales any more. In this case, we’re likely in a weight-loss plateau.
Weight-loss plateaus are extremely common, normal, and a necessary part of the weight-loss process. Being on semaglutide doesn’t prevent us from experiencing weight-loss plateaus.
We have a full guide explaining weight-loss plateaus. However, as a quick summary:
Our brain receives signals from many hormones, letting it know how much energy we’re eating and how much fat we have stored. We call this the brain’s ‘set point’.
Weight-loss plateaus occur when our brain senses that we’re consuming fewer calories than normal and our fat stores are decreasing it ‘slows down’ our metabolism
Evolutionarily, we’re wired to protect fat to ensure survival
So, weight-loss plateaus are a survival mechanism in the brain to try and protect us from starvation
Fortunately, we can gradually lower our brain’s set point by continuing to lead a healthy lifestyle and being consistent in our habits
Key points:
Weight-loss plateaus are a necessary and normal part of the weight-loss process. Semaglutide doesn’t prevent weight-loss plateaus from occurring.
Weight-loss plateaus occur when our brain senses we’re losing fat and eating less, so it slows down our metabolism to protect our remaining fat stores
We can overcome weight-loss plateaus by being consistent with our healthy habits
3) Your current dose isn’t high enough to promote lower hunger
Semaglutide reduces appetite and hunger, helping you eat fewer calories; this effect is almost immediate when you start Wegovy.
However, you might notice the effect of lower hunger wearing off after 4-5 days post-injection in the first month of taking Wegovy.
It can take 4-5 weeks for Ozempic to reach a level in the body we call a steady state. A steady state is when the drug’s levels in the body remain consistent rather than spiking and falling.
Interestingly, this initial weight loss is no different to other weight loss treatments or the impact of diet interventions on weight loss. The real effect of semaglutide is seen beyond three months.
Semaglutide is a long-acting medication that’s started at a lower dose to reduce the number and severity of side effects as it’s built up to a higher maintenance dose.
Additionally, we might find that our body adapts to the lower doses, and hunger can increase. However, we might find this reverses when we move up a dose.
If you’re unsure about the dosing schedules of Wegovy and its impact on the body, read our in-depth guide on Wegovy.
Key points:
The lower doses of Mounjaro can wear off after 4-5 days
It can take up to 4-5 weeks for the medication to reach a ‘steady state’ where its levels are consistent in the blood
Weight loss may be steady at the beginning but become more consistent as you increase your dose
Take home message
As we’ve covered in this article, there are many reasons why you might not be losing weight on semaglutide. For many of us, there’s likely a way of maximising our results on semaglutide to kickstart our weight loss.
However, a small percentage (~10-20%) of individuals are unlikely to respond well to the medication for various reasons.
If you’re currently on semaglutide and are unsure why the medication isn’t having the desired effect, we’d recommend speaking with your GP or local healthcare team.
loss for everyone, and some individuals may experience a weight loss plateau. These effects can be due to various factors, such as inconsistent use of the medication, insufficient lifestyle changes, and individual genetics.
The main reasons you're not losing weight on semaglutide (Wegovy) might be that you're not eating in a calorie deficit, you've hit a weight-loss plateau, or the current dose that you're on isn't high enough to lower your hunger to the point where you're eating less.
Consider adding more cardio or strength training to your routine. 3. Speak with your provider if you have hit a plateau with semaglutide. They may recommend adjusting your dose or switching to a different medication.
So with each higher dose, we should continue to see more and more weight loss. Remember that this is the average weight loss. We did have patients who lost a moderate amount but we also had patients losing over 15 pounds and even over 20 pounds in the first month!
There could be several reasons why you're not losing weight on Ozempic — from being too stressed out to not exercising or sleeping enough. You may need to change up your diet or have your healthcare provider adjust your dosage. Or, it could be as simple as not giving the drug enough time to work.
The reasons vary, from the need to make lifestyle tweaks like diet and exercise to metabolic issues and side effects from other medications. GLP-1 medications are best if taken long-term, but shortages, price, and side effects like GI discomfort are potential barriers for some.
“Whereas, the higher doses that are really good for weight reduction. On average, patients lost eight kilograms (17.5 lbs) at 50 milligrams, which is nearly twice as much weight loss that we saw with the lowest dose.”
You may see some weight loss in the 4 weeks of semaglutide treatment, but the full effect can take several months. After 68 weeks, adults lost about 35 lbs (15.9 kg) in studies, on average. Your doctor will slowly increase your dose when you start treatment to help lessen stomach side effects like nausea and diarrhea.
To maximize the results from Semaglutide or Tirzepatide, establishing an exercise routine is essential. Regular physical activity helps improve insulin sensitivity and glucose control, which enhances the effects of these medications.
To maximize weight loss while taking Ozempic, focus on a diet rich in nutrient-dense, whole foods. Opt for a variety of fruits and vegetables, lean proteins, whole grains, and healthy fats. These foods not only help you stay satisfied but also provide essential vitamins and minerals to support overall health.
Eating certain foods while taking semaglutide may increase or cause GI-related side effects, such as nausea, bloating, and diarrhea. The drug slows digestion, leaving patients feeling fuller longer. However, the longer foods stay in the stomach, the more likely it is that they'll cause discomfort.
Semaglutide may not be working due to several reasons, such as inconsistent medication adherence, lower dosage, diet adjustment, reduced physical activity, and lifestyle changes.
That said, it can be very easy to start second-guessing yourself and question whether you're still doing the right things – particularly when the weight doesn't seem to move for 4+ weeks. Our experience at Second Nature is that weight-loss plateaus can last as long as eight to twelve weeks.
There were variations in the weight-loss response. Individual changes in body weight with semaglutide and placebo were striking; still, 67.8% achieved 5% or more weight loss and 44.2% achieved 10% weight loss with semaglutide at 2 years, compared with 21.3% and 6.9%, respectively, for those receiving placebo.
The bioavailability of semaglutide is 89% when injected subcutaneously. Peak concentrations occur 3 days after injection, and steady state is achieved by Week 5 when injected once weekly.
"Within about two weeks, I had already lost a few pounds," Schorr said. "Everyone was like, 'Oh, you already are looking like you're losing weight in just the first few days.'" Schorr said she lost 50 pounds over the course of 11 months.
If GLP-1 agonists don't seem to be working for you, talk with your healthcare provider. You may need to adjust your medication dose or give your current dose more time to work. Ozempic and Wegovy work best when paired with a diet that limits ultra-processed foods, fried foods, sugary drinks, and alcohol.
In clinical trials, people taking Ozempic have lost an average of 13–15 pounds in the first 10 months of taking the medication. How much weight you lose on Ozempic can depend on a range of factors, including dosage, lifestyle modifications, and others.
“Consider decreasing high-calorie options like sugary foods or simple carbohydrates as an initial step.” Tracking daily calorie amounts and focusing on nutritious foods—like fruits and vegetables, lean protein, and whole grains—may help to ease you off the plateau, he says.
Swap simple carbohydrates (sugary foods, white bread, pasta, rice) for complex carbs (wholemeal pasta, brown rice, whole grains) Eat plenty of fruit and vegetables (at least half of your dinner plate should be vegetables) Eat more lean protein (turkey, white fish) than fatty proteins (red meat)
On average, short-term effects of Semaglutide can begin as early as the first 1 to 4 weeks of use. During these initial weeks of use, you may notice a reduced appetite. An increase in feelings of fullness after eating will also be noticeable. Additionally, you will begin to see early signs of weight loss.
"You may have a decreased appetite, but inadequate intake can equally equate to fatigue, malaise or dizziness, among other more serious issues like malnutrition," Dr. Worley says. "Semaglutide also leads to a decrease in the rate of gastric emptying, and so we need to account for this, as well.
Which Drug is More Effective? After many studies, results showed that Tirzepatide stimulates more weight reduction than Semaglutide. However, Semaglutide has been around much longer than Tirzepatide, which means we have a better understanding of its long-term effects.
Semaglutide is administered via a weekly injection, with a half-life of approximately one week. If you miss your weekly dose, the medication's effectiveness will decrease during that missed week. However, once you restart the medication, you can quickly get back on track.
Introduction: My name is Carlyn Walter, I am a lively, glamorous, healthy, clean, powerful, calm, combative person who loves writing and wants to share my knowledge and understanding with you.
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