Why am I not losing weight on Wegovy?

When starting Wegovy, it can take a while for your body to respond to the medication and start shedding weight. Some people also find their weight loss plateaus at some point, which is completely normal. There are certain things you can do to improve your weight loss results and other things that may hinder them. For example, you may need a higher dose, you may need to give it more time or you might not have found the right healthy lifestyle changes. This guide covers these potential reasons and more.

Sometimes, even with Wegovy, weight loss might not happen as expected. Some of the common reasons why you’re not losing weight on Wegovy include:

1.) You may just need to give it more time

Losing weight with Wegovy does not always happen overnight. It can take a while for your body to respond to the medication and start shedding weight.

Be patient and consistent with your treatment, as gradual weight loss over time is often more sustainable and healthier. It’ll also help you create long-lasting habits that’ll keep the weight off, even when you stop taking Wegovy.

2) You may need a higher dose

The initial dose of Wegovy might not be enough for you to start seeing weight loss. While Wegovy can start working from the first dose, it can take some time for the effects to build up, and stronger doses provide stronger appetite suppression, making it easier to stick to your calorie deficit.

Wegovy injections

The Wegovy injection comes in 6 different dosages, each referring to the amount of semaglutide in each injection:

• 0.25mg
• 0.5mg
• 1mg
• 1.7mg
• 2.4mg
• 7.2mg

Everyone who takes the injections will follow the Wegovy dosage schedule, beginning with the lowest dose of 0.25mg and gradually increasing to the highest maintenance dose of 7.2mg over 20 weeks. Some people also choose to stay on the other maintenance dose of 2.4mg. You’ll spend at least 4 weeks on each dose before moving to the next one. This is to reduce side effects and let your body get used to the medication.

Wegovy pill

The Wegovy pill dosage schedule differs slightly from the injection because when taken by mouth, semaglutide has a higher maximum dose. This is due to how the body absorbs it, but it does not mean the pill is stronger.

The pill comes in 4 doses:

• 1.5mg
• 4mg
• 9mg
• 25mg

You’ll start on the lowest dose of 1.5mg, before moving up every month until you reach the maintenance dose of 25mg. This is also to reduce the medication's side effects.

3) You haven’t found the right healthy lifestyle changes

Wegovy, diet, and exercise are always prescribed together. If you’re not seeing weight loss, it could be a sign that you need to adjust your diet or exercise routine.

A major study found that significant weight loss on Wegovy was achieved when participants reduced their daily calorie intake by about 500 calories and engaged in at least 2 hours of moderate exercise, such as walking, every week.

You should focus on a range of exercise and movement, such as:

• cardio, like running, power walking, following an exercise video or joining an exercise class, and swimming
• strength training, such as lifting weights, pilates, and exercises like pull-ups, lunges, and planks
• general activity, such as walking more, taking the stairs, housework, and standing up more often

➤ If you need help with your diet, you can learn more about what to eat and what to avoid while taking Wegovy in our guide.

4) You’re stressed out

Stress can be a significant barrier to weight loss, even when you’re taking Wegovy weight loss injections or pills. When you’re stressed, your body produces more cortisol, a hormone that can make losing weight harder. This can lead to stress eating or make your body hold onto weight, especially in the abdominal area.

There are many ways we can reduce stress, and what works for you might be different than what works for someone else. Some things we suggest include:

• yoga
• meditation
• breathing exercises
• being active
• getting outside in nature
• connecting with people

Putting stress on yourself to lose weight also won’t help. Try finding ways to reduce this, such as being kind to yourself during this time and not beating yourself up if you fall into old habits. Weight loss and breaking habits such as snacking will take some time. Small, consistent changes are easier to follow than large changes that feel impossible to stick to.

5) You’re not getting enough sleep

Getting enough sleep is essential for weight loss. Lack of sleep can disrupt your appetite regulation, leading to increased hunger and cravings for unhealthy foods. This can make it harder for Wegovy to be effective.

Sleep experts recommend 7 to 9 hours each night of high-quality sleep. You can use a wearable device to monitor your sleep and make changes to your bedroom and bedtime routine to improve how well you sleep. This could include not eating right before bed and limiting or avoiding alcohol or caffeine, especially close to bedtime.

6) You may have an underlying health condition

An unseen health issue can affect weight loss, even when using Wegovy. Conditions like thyroid disorders, hormonal imbalances, or insulin resistance can interfere with how your body loses weight.

Particularly for those with type 2 diabetes, losing weight can be more challenging while on Wegovy. Research indicates that individuals with diabetes who take semaglutide (the active ingredient of Wegovy) tend to lose less weight compared to those without diabetes.

This is due to blood sugar imbalances that can make losing weight and burning fat and sugar harder for your body. This may mean you need a little more time to reach your weight loss goals.

8) You need a stronger support system

Losing weight on Wegovy can often be more successful when you have support behind you. This could mean seeking guidance from healthcare professionals, joining support groups, or involving family and friends in your weight loss journey. You could also join a local gym class for motivation.

9) You’re not maintaining a healthy diet

A key factor in losing weight with Wegovy is sticking to a healthy diet. If your diet still includes high-calorie, processed foods, or lacks essential nutrients, it can significantly hinder the effectiveness of the medication.

It’s important to pack your meals full of vegetables and proteins and cut out unhealthy foods. Even sugary drinks and alcohol can add excess calories that you may not have noticed. If you need to, try using a calorie counter to give you a better idea of what you’re consuming each day.

10) You’re not drinking enough water

Staying well hydrated is essential for weight loss and is especially important if you get any side effects from Wegovy, such as nausea, constipation, or vomiting. Drinking more water can:

• reduce the chances of increased hunger and appetite from your body confusing thirst for hunger
• cause more consistent weight loss
• aid your metabolism, which can be very important if you get constipation on Wegovy
• support your overall health, as staying hydrated helps the body to function at its best
• replace extra calories from sodas and juices – if you’re missing flavoured drinks, you can add extra flavour to your water with frozen or fresh fruit, herbal tea bags, or a low-calorie squash

Although there is no exact amount you need to drink while taking Wegovy, you should stick to the recommended 6 to 8 glasses per day, which is recommended by the NHS.

To maximise the weight loss potential of Wegovy, it’s important to make certain lifestyle choices while using the medication.

Effective strategies to enhance your weight loss on Wegovy include:

It’s not usually necessary to stop taking Wegovy if you’re not losing weight. Instead, it’s better to:

• make sure you’re following all the right diet and exercise changes
• wait until you reach a higher dose
• see if you’re in a weight loss plateau, which is normal on weight loss journeys – this usually resolves with some changes to diet and exercise, or just with time
• make sure you’re taking Wegovy properly, according to the patient information leaflet, such as not missing doses or taking the pill on an empty stomach
• check that you’re getting enough sleep and staying hydrated
• work on any stress in your life that may be causing your weight loss to slow or stall
• check with your GP if you also have other symptoms, such as fatigue or an increased appetite – this could be a sign of an underlying health condition that may be affecting your weight loss
• look in the mirror and see how clothes fit, just because the scale is not changing it does not mean your body is not – you may just be gaining muscle, especially if you’re doing more strength training

Your doctor may recommend stopping Wegovy if you’ve made all the right lifestyle changes, and it’s been 6 months on treatment with no significant weight loss.

What happens when you stop taking Wegovy?

Feelings of fullness will wear off. This can cause some people to struggle to stick to their diet, leading to weight gain. If you have side effects, these will also wear off within a few days to a few weeks as the medication leaves your system.

You’re more likely to maintain your weight if you can continue following the same diet you were on before, including following a healthy calorie deficit for weight maintenance. If you’re stopping Wegovy because you’re not losing weight on it, you can still try another medication, such as Mounjaro. Switching from Wegovy to Mounjaro means you do not need to take a break between weight loss medications, and you may be able to start at a higher dose than the starter dose.

Wegovy is not the only option when it comes to weight loss treatment, as there are several Wegovy alternatives available in the UK via prescription. If you want to use an injection, alternatives include:

• Mounjaro (tirzepatide) – mimics 2 hormones, GIP and GLP-1, to reduce appetite and hunger levels and improve how your body uses fat and sugar, and is also taken once weekly
• Nevolat (liraglutide) – mimics GLP-1 for appetite and hunger suppression and is taken once daily

If you’d like to try a weight loss pill, in the UK you can access:

• Wegovy pill (semaglutide) – an oral alternative to the injection, mimics GLP-1 to reduce hunger and increase fullness, taken once daily on an empty stomach
• Xenical (orlistat) – prevents fat digestion and absorption, reducing calorie intake from meals, taken up to 3 times a day with meals, and can be found in a lower dose over the counter called alli or Orlos
• Mysimba (naltrexone hydrochloride and bupropion hydrochloride) – works a bit like Wegovy by affecting the parts of the brain that regulate hunger and appetite but on different pathways, and is taken up to twice a day

You should look at and potentially adjust several aspects of your treatment and lifestyle. But first, speak with your doctor to discuss your current dosage and the possibility of underlying health conditions that might be affecting your weight loss.

It’s also crucial to review your diet and exercise habits to ensure they align with your weight loss goals. Also, consider factors like adequate sleep, stress management, and hydration as these can have a significant impact on weight loss too.

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