Wegovy, Saxenda, and Mounjaro have emerged as promising new medications that can cause dramatic weight loss. Wegovy (semaglutide) is a prescription weight loss medication that is FDA-approved for weight management in adults and children over 12 with overweight or obesity. Ozempic (semaglutide) is a prescription medication that’s FDA-approved for the treatment of type 2 diabetes and chronic kidney disease in diabetic patients but is sometimes prescribed off-label for weight management because it works identically to Wegovy. These medications, part of a class known as GLP-1 receptor agonists, mimic the naturally occurring hormone glucagon, impacting appetite and digestion. While many experience significant weight loss with these drugs, some encounter plateaus or find they don't work as expected. It is important to note that Ozempic and Mounjaro are only approved for diabetes at this time, but many people are trying them for their weight loss properties.
This article explores why Wegovy might not be working for some individuals, offering insights and strategies to optimize weight loss efforts. It is important to note that Dr Norman's experience with Wegovy is his personal experience and yours may be very different. Weight loss with GLP-1 medications takes time - it can take up to 20 weeks to see visible results
How Wegovy Works
Semaglutide, the active ingredient in Wegovy and Ozempic, is a synthetic version of the natural hormone GLP-1, which works in part by regulating insulin release and slowing your stomach emptying to manage blood sugar and promote feelings of fullness. GLP-1 agonists like Wegovy work by:
- Slowing down digestion.
- Signaling the brain to create a feeling of fullness, thus reducing appetite.
- Stimulating insulin release from the pancreas to prevent blood sugar spikes.
Both Wegovy and Ozempic are prescribed alongside lifestyle changes like diet and exercise.
Reasons Why Wegovy Might Not Be Working
Despite its effectiveness, Wegovy isn't a guaranteed solution for everyone. Several factors can contribute to a lack of weight loss while on the medication.
Read also: Sustainable weight loss using Wegovy
1. Insufficient Time
Weight loss results take time! Keep in mind that the longer you take Wegovy or Ozempic, the more apparent your weight loss results will be. Many people don’t start seeing visible weight loss with Wegovy until the 20-week mark.
For example, clinical trial participants taking 2.4 mg of semaglutide each week (the maximum allowed dosage for Wegovy) lost an average of 2% (about 5 lbs) of their body weight after 4 weeks of treatment. That number increased to 15% (around 35 lbs) after 68 weeks. Weight loss results may take even longer on Ozempic, which has a maximum allowed dosage of 2 mg of semaglutide per week.
2. Unhealthy Diet
Wegovy and Ozempic are not prescribed alone. When providers prescribe semaglutide, they also advise healthy lifestyle changes like regular exercise and a healthy diet. Unhealthy eating habits like snacking between meals, overeating during meals, or eating a high-calorie diet may prevent you from getting where you want to go. Wegovy will do most of the work in helping you lose weight, but if you don’t put forth some effort it will fail and you will not lose the amount of weight that these drugs are capable of.
3. Lack of Exercise
Trials show that semaglutide is most effective for weight loss when patients get at least 150 minutes of moderate-intensity aerobic exercise each week. That’s equal to about 21 minutes a day or 30 minutes a day, 5 times per week. Aerobic exercise can be brisk walking, swimming, dancing, cycling, weight lifting, or jogging. Even yard work counts!
4. Stress and Lack of Sleep
Did you know that high stress levels are associated with overweight and obesity? This is because stress encourages the release of cortisol, a natural hormone that plays a role in metabolism. It gives us a surge of energy but also encourages us to overeat or crave foods that aren’t as healthy.
Read also: Weekly Wegovy Progress
In addition to managing your stress, it’s vital that you get enough sleep. Not getting enough sleep is linked to high cortisol levels and an increased risk of obesity. Aim for 7-8 hours of sleep per night.
5. Underlying Health Conditions and Medications
If you’re not losing weight on Wegovy or Ozempic, it might not be due to anything you are or aren’t doing. It may be that an underlying medical condition is to blame. Conditions like hypothyroidism can make it hard to lose weight.
Additionally, certain medications, like antipsychotics and some blood pressure medicines, may cause weight gain. They may also slow weight loss.
6. Individual Factors
Individual factors can significantly impact weight loss on Wegovy. These factors include genetics, age, sex, body composition, and overall health. For example, some people may have a slower metabolism due to genetic factors, which can affect their weight loss progress.
7. Snacking Between Meals
If you have a habit of snacking in between meals, then you need to break that habit or Wegovy won’t work. Once the feeling of fullness is gone a few hours eating, it is very easy to eat again. This often happens out of habit. Or it happens because there is food around. Snacking in between meals is easy to do. Once the sense of fullness is gone, you are free to eat again. Thus, snacking between meals is the true Achilles Heel of these miracle diet drugs.
Read also: Weight Loss Guide Andalusia, AL
8. Type of Food
I have little doubt that Wegovy will not work as intended (as fast, as much, or not at all) if the user does not change the TYPE of food that they eat. The drug will keep you from eating as much-that is what it is very good at. But you still have the choice to order the biggest burger and the super-size fries that you dip into mayonnaise.
9. Weight Loss Plateaus
Weight-loss plateaus are extremely common, normal, and a necessary part of the weight-loss process. It can take 4-5 weeks for Ozempic to reach a level in the body we call a steady state. The point at which your metabolism is equal to how much energy you intake through food is when the plateau hits,” said Dr. Ng.
Strategies to Maximize Wegovy's Effectiveness
To enhance weight loss results while taking Wegovy, consider the following strategies:
1. Healthy, Reduced-Calorie Diet
Talk to your provider about your dietary habits to see if there is anything you can adjust. They will likely recommend that you focus on eating nutritious food like vegetables, fruits, and whole grains while avoiding foods high in saturated fats or sugar. Eat within a calorie deficit to lose excess body fat.
2. Regular Exercise
Ask a healthcare provider for some suggestions on starting your fitness routine. Jumping into high-impact, strenuous exercise leaves you at risk for burnout or injury. Work with your provider or a weight loss specialist to craft an exercise regimen that is appropriate for your needs and experience level.
3. Stress Management and Sleep Hygiene
Practice good sleep hygiene by turning in and waking up at the same time every day. Wind down before bed and avoid using your phone, laptop, or tablet right before trying to sleep. While these devices are a central part of nearly all of our lives, they can hurt the quality of your sleep.
4. Address Underlying Conditions
If you have been maintaining healthy habits while taking Wegovy or Ozempic and are not losing weight, talk to your provider. They may screen you for other health conditions. Before starting treatment with semaglutide, tell your provider about your medical history and any medicines you are taking. This will reduce your risk of harmful drug interaction side effects. It will also give your provider a fuller picture of your health and potential barriers to weight loss.
5. Adjusting Calorie Intake
To overcome plateaus, ensure you’re adjusting your calorie intake downward as you lose weight, increase physical activity (particularly strength training), and maintain consistency with your medication schedule. As you lose weight, you require fewer calories for maintenance.
6. Gut Health
Incorporate gut-friendly whole foods into your diet, such as fermented vegetables, fruits, and whole grains. Studies show that people with diabetes lose less weight on semaglutide compared to people without diabetes.
7. Professional Guidance
Consider working with a healthcare provider or registered dietitian to identify any factors affecting your weight loss on Wegovy. A registered dietitian can help fine-tune what you eat with a personalized nutrition plan that works for your weight loss goals and lifestyle. They can be your guide and personal motivational coach as you navigate your weight loss journey.
Alternatives to Wegovy and Ozempic
Wegovy and Ozempic are not the only GLP-1 medications on the market. If you’re not seeing results, your healthcare provider may elect to increase your dosage. They may also prescribe a different medication instead.
Other GLP-1 or GLP-1/GIP medications that are FDA-approved for weight loss include Saxenda (liraglutide) and Zepbound (tirzepatide). Discuss these options with your provider, as well as possible drug interactions and side effects.
Potential Side Effects and Risks
It is important to be aware of the potential side effects associated with Wegovy:
- Possible thyroid tumors, including cancer.
- Inflammation of your pancreas (pancreatitis).
- Gallbladder problems.
- Increased risk of low blood sugar (hypoglycemia), especially those who also take medicines for diabetes such as insulin or sulfonylureas.
- Dehydration leading to kidney problems.
- Severe stomach problems.
- Increased heart rate.
- Depression or thoughts of suicide.
- Food or liquid getting into the lungs during surgery or other procedures that use anesthesia or deep sleepiness (deep sedation).
The Importance of a Holistic Approach
Weight loss with Wegovy and other GLP-1 medications is most effective when combined with a holistic approach that includes lifestyle changes, dietary adjustments, and, if necessary, addressing underlying health conditions. Remember that weight loss is a journey, not a race, and sustainable changes lead to long-term success.