Why am I not losing weight on Wegovy?

If you’re taking Wegovy® (aka semaglutide) for weight loss and not seeing the buzzed-about weight loss results you anticipated, what’s going on? 

Widely touted in the media, this FDA-approved prescription glucagon-like peptide-1 RA medication—or GLP-1 receptor agonist—can lead to an average loss of almost 15% of total body weight when taken once a week, according to the results of a double-blind clinical trial funded by Novo Nordisk (Wegovy’s manufacturer) and published in 2021 in The New England Journal of Medicine. But that average? It’s just that: an average. 

Of the 1,961 study participants given semaglutide (Wegovy’s active ingredient), 1,047 (86.4%) lost 5% or more of their body weight. That 5% is important to note since it’s one of the U.S. Food and Drug Administration’s (FDA) benchmarks of whether or not a weight-loss medication is effective. But there were also 914 participants (13.6%) taking semaglutide (Wegovy) who didn’t lose 5% of their body weight. That means, for those folks, the medication was not effective. If you've been taking this medication and the results aren't living up to the hype, you wonder, "Why am I not losing weight on Wegovy?"

Let’s look behind the curtain at factors that might prevent some people from losing weight while taking Wegovy, as well as potential next steps for sustainable weight loss.

Why am I not losing weight on Wegovy?

“Everyone's body will respond differently,” says Rekha Kumar, MD, MS, chief medical officer at Found Health. “Wegovy isn’t the right medication for everybody.” At Found, every individual gets consultations with a provider who specializes in obesity medicine and matches a prescription to their biology.  

When medicine isn’t working, maybe it isn’t addressing the root cause of your obesity or it’s just not a match for your circumstances. Regardless, it’s worth working with a medical professional to help you figure out what’s going on. “I recommend seeing an obesity medicine specialist to look at the rate of your weight loss and if you’re using the proper technique to administer the medicine,” adds Dr. Kumar. ”They can evaluate your medical condition to see what biological blockers to weight loss might be playing a role.”

When looking for answers to the question, "Why am I not losing weight on Wegovy?," here are some factors to discuss with your health care provider to help determine why you’re not seeing the results you expected while using Wegovy. 

Unexpected responses

For some, Wegovy just doesn’t work when prescribed for weight loss. “There are non-responders [for whom] Wegovy may not be the right medication fit,” Dr. Kumar notes. For others, effectiveness might not match initial expectations. “If Wegovy has stopped a trajectory of weight gain, that could be success—but [it might] look different than expected. Always talk to your doctor to interpret your response to medicine.”

Lifestyle 

This weight-loss medicine is meant to be paired with healthy lifestyle changes, like regular physical activity and eating nutritious foods, to reach your weight-loss goals. As the 2021 study found, for patients “with overweight or obesity, 2.4 mg of semaglutide once weekly, plus lifestyle intervention, was associated with sustained, clinically relevant reduction in body weight." When weight loss is slow or not happening at all, it’s essential to review dietary habits and whether the medicine is being taken correctly, Dr. Kumar explains, adding it’s also important to include regular exercise. 

Medications and medical history

Consider what’s going on within the entire system of your body. For example, are you taking any other medications? Do you have a health condition or a genetic predisposition to obesity? What’s your family history? Have you experienced hormone changes? “Some people may not see the expected results due to other medical conditions that impede the rate of weight loss. Other medicines may interfere with the ability to lose weight,” says Dr. Kumar. Some people may experience metabolic adaptation, where the body adapts to regain weight. “Age and hormonal status [also] need to be factored in,” she adds.

Genetics and phenotype

Since thousands of unique genes make up our bodies, weight management approaches may work better when tailored to each person’s unique biology. Found’s MetabolicPrint,™ a unique tool our clinicians use to assess your metabolic health, enables your Found provider to personalize your weight care medication to your unique phenotype or profile. These MetabolicPrint profiles are four categories that can help determine which biological factors are at play for each individual: Brain-Gut Disconnect, Constant Cravings, Mood Responses, or Slow Metabolism. Using your unique MetabolicPrint profile, your provider targets your prescription to work with your biology, Wegovy, for example, may be a suitable match for people with a Brain-Gut Disconnect profile who don’t feel full no matter how much they’ve eaten since this medicine mimics a hormone that plays a part in regulating appetite and slows digestion which, in turn, causes you to feel fuller longer. (However, if you have a dominant Constant Cravings profile, you probably don’t seem to feel full no matter how much you’ve eaten. If so, your provider may prescribe naltrexone and bupropion off-label to help reduce appetite and cravings.) “Found can help out with personalizing your treatment plan and choosing the medication that most appropriately matches [your] biology and root cause of obesity,” Dr. Kumar explains.

Unmanageable side effects of Wegovy

Sometimes, the side effects of taking Wegovy for weight loss may be so severe that you decide to stop taking the medicine. In this case, any weight you may have lost could return, undermining your weight loss efforts. Common side effects of GLP-1 medications such as Wegovy include nausea, vomiting, diarrhea, and acid reflux. More serious but less common side effects include pancreatitis, gallbladder disease, and worsening of diabetic eye disease. Those with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasias should not use these drugs. Find detailed side effect and risk information for Wegovy and other medications here.

How to make a personalized weight care plan

Your Found membership includes a MetabolicPrint assessment to uncover the root cause of your overweight or obesity to tailor your weight loss plan, consultations with a provider who can target the prescription to work with your biology, an in-app behavior change program, and health coaching. Find the most effective plan for your biology and what you need for weight loss with Found. Our clinicians can prescribe a wide range of medications, including GLP-1s, to personalize the best treatment for you. 

Access to GLP-1s prescriptions is now available as part of Found's weight-loss toolkit. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate or affordable for you, our providers will work with you to determine an effective medication for your health profile.

About Found

To discover your MetabolicPrint and start your journey with Found, take our quiz. Found is among the largest medically supported weight care clinics in the country, having served more than 200,000 members to date.