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The top 3 reasons you’re not losing weight on Ozempic
The top 3 reasons you’re not losing weight on Ozempic
Not everyone who takes Ozempic drops pounds quickly or continuously. Here’s what might be happening and what to do if your weight loss stalls.
Lisa Baker, RN, BSN
Table of Contents
If you’ve been working on weight changes for a while, medication-assisted weight loss might sound easy: Take a regular dose of your prescribed medicine and watch your body effortlessly transform!
But if you’ve started taking Ozempic® and you’re not seeing the results you hoped for, don’t panic. Here are three reasons you might not be losing the weight you want to on Ozempic—at least not yet—and what you can do.
You need more time to lose weight on Ozempic
It’s important to understand that Ozempic (semaglutide) doesn’t make you lose weight by magically melting the pounds away. (Nothing does!) Instead, it helps kickstart your weight loss journey by reducing feelings of hunger and increasing feelings of fullness after eating, enabling you to eat less and to choose your food more intentionally.
Ozempic works by activating hormone receptors in your body called GLP-1 receptors. GLP-1, or glucagon-like peptide 1, is a natural hormone that helps regulate sugar and appetite and slows digestion. When Ozempic triggers its receptors, the main effect is an increase in insulin. This lowers blood sugar, which is why Ozempic is FDA-approved as a treatment for type 2 diabetes.
But these receptors also signal your brain that you’re full, making it easier to stop eating even after a smaller portion than you might usually eat. In addition, Ozempic slows down how quickly food moves through your digestive tract, which helps you feel full longer. This all adds up to eating less, which is why Ozempic is prescribed off-label for weight loss.
However, the appetite-suppressing effect of Ozempic isn’t usually apparent at first. This is in part because it tamps down appetite and hunger more significantly at higher doses. When taking Ozempic, people typically start at a low dose to reduce side effects and gradually increase their dose over a few months, as directed by a health care provider. And, the effect the medicine has is cumulative—meaning it needs to build up in your body to reach a level that causes the changes its meant to.
What can you do if it’s not working yet?
If you’re just getting started and you’re eager to see more benefits, it’s important to be patient. Individual results vary from person to person, as does the most effective dose, so you may need to wait to see what will work for you.
Starting at a low dosage and increasing gradually, over a period of months, is important in order to minimize the side effects of Ozempic. Common side effects include gastrointestinal symptoms like nausea, diarrhea, vomiting, stomach pain, and constipation. But there are more serious side effects as well, including gastroparesis (stomach paralysis).
If you experience severe stomach problems that won’t go away, including abdominal bloating or pain, acid reflux, a feeling of fullness after eating just a few bites of food, nausea, and vomiting (including vomiting undigested food eaten a few hours earlier) talk to your provider as these may be symptoms of stomach paralysis.
Also, although rare, in animal studies semaglutide caused thyroid c-cell tumors. Ozempic’s “black box” warns of the risk of these tumors. If you have trouble swallowing, develop hoarseness, or feel swelling or a lump in your neck, contact your health care provider immediately. The FDA’s boxed warning also says not to take Ozempic if you have a personal or family history of multiple endocrine neoplasia syndrome type 2 or medullary thyroid cancer. Ozempic is not recommended for those with insulin-dependent diabetes or have experienced diabetic ketoacidosis. So, if that’s you, Ozempic isn’t the right fit. (Find detailed side effect and risk information for Ozempic here.)
While your provider is adjusting your Ozempic dose, you can focus on lifestyle changes like mindful eating, getting plenty of water and sleep, and regular exercise. Your Found membership includes health coaching and, through the app, access to behavior change education and a supportive community of other people on a weight loss journey. So, take advantage of those resources to work on the healthy habits you want to build.
You’ve hit a weight loss plateau on Ozempic
On the other end of the spectrum, it could be that you’ve been taking Ozempic long enough that your weight loss has hit a plateau.
In one large study, weight loss on semaglutide plateaued at about 68 weeks, or after about a year and four months. There are several reasons for this. First, our bodies tend to want to maintain homeostasis or stay the same, so yours may respond to weight loss with hormone and endocrine changes that help hold onto weight. Second, as we lose weight, we tend to need fewer calories to maintain our new weight. Thus, we typically need to continually reduce how much we’re eating if we want to continue losing weight.
What can you do if you’ve stopped losing weight on Ozempic?
First, know this: If you’ve reduced your weight by 5% to 15% on Ozempic, you’ve likely already gained significant health benefits. You may have succeeded in lowering your blood sugar, reducing your blood pressure, and improving your overall health.
But if you’re short of those marks or you and your health care provider agree you need to lose more weight for better health, you may need to switch up your approach. Talk with your provider or your Found health coach about other lifestyle changes or weight care options that might be effective for the next phase of your journey.
You need to make more lifestyle changes to lose weight on Ozempic
Ozempic isn’t a high-speed train to your dream weight; it’s a tool that can augment the effects of other healthy lifestyle modifications. In the clinical trials supporting weight loss with Ozempic, participants used the medication alongside diet and lifestyle changes as an additional therapy. You’ll likely need to do the same to get the biggest benefits from Ozempic. If you’re not seeing the changes you expected, consider making additional lifestyle changes.
How can you maximize your weight loss on Ozempic?
Although exercise is great for improving your cardiovascular health and body composition, your diet is the biggest single factor that influences changes in your weight. Fortunately, you don’t need to go on a strict diet while taking Ozempic, and the medication will help enhance the effect of the healthy diet changes you make.
It’s harder to stick to a diet if you make some foods off-limits, so consider small changes like eating vegetables and fruit at the beginning of every meal. Follow those up with lean proteins and fiber-rich foods, and save foods high in fat and sugar for last. Combined with the appetite-suppressing effect of Ozempic, this approach can help you fill up on filling, lower-calorie foods first and eat fewer calories overall.
Finally, if you feel you need more support to achieve your health goals, take advantage of all the programs and support offered with your Found membership. And remember, medication-assisted weight loss is only one part of your journey.
As a Found member, you also have access to your MetabolicPrint™︎ assessment to better identify your body’s unique needs and weight loss obstacles; consultations with a Found-affiliated clinician who can tailor your prescription to your needs; access to one-on-one support from your health coach and the encouragement of the Found community in the app.
About Found
Found is among the largest medically-supported telehealth weight care platforms in the country, having served more than 250,000 members to date. To discover your MetabolicPrint and start your journey with Found, take our quiz.
Found is not affiliated with Novo Nordisk A/S, the owner of the registered trademark Ozempic®. This content does not provide medical advice and does not substitute for a consultation with a doctor or health care provider. Certain medications are only FDA approved to treat conditions other than weight but may be prescribed to help aid in weight loss. Prescriptions are up to a medical provider’s discretion. For key risk information by drug, visit the Found medication page.
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Published date:
March 14, 2025
Sources
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