Stopped losing weight on Ozempic? A Registered Dietitian explains why

Key Points

• If you hit a weight loss plateau on Ozempic, Wegovy, and Mounjaro, you’re not alone.
• Or, like some people, you may struggle to lose weight in the first place on these drugs.
• Weight loss is complicated; many factors may impact your weight on Ozempic.
• A Registered Dietitian can help you learn what works best for your body.

Ozempic, the popular weight loss drug, comes as a deep sigh of relief to many who struggle with their weight. Apart from weight loss, it can also balance insulin levels, improve heart health, and offer freedom from relentless food thoughts.

Medications like Ozempic shifted the discussion on obesity and weight gain from "willpower" to recognizing the biological link between our gut and brain. 

Even celebrities like Oprah, who long struggled with weight, now openly share their use of anti-obesity medication, rejecting any stigma attached to it.

However, what happens when you’re on Ozempic, but the scale refuses to budge?

You may ask yourself, “Why did I stop losing weight on Ozempic?”—you’re not alone.

Here, we explore why you may experience a weight plateau on Ozempic.

How does Ozempic help with weight loss?

Ozempic is an FDA-approved medication to treat people with type 2 diabetes. The active ingredient, semaglutide, mimics GLP-1, a natural hormone that regulates insulin levels.

The groundbreaking drug also results in weight loss, so it is being used off-label as an antiobesity or weight loss solution. (Wegovy, another brand, is FDA-approved for weight loss).

Here’s how Ozempic helps you lose weight:

• Reduces your appetite: Ozempic slows your digestion, making you feel less hungry, and helps you eat smaller portions.
• Triggers insulin release: People with type 2 diabetes may not respond well to insulin, which leads to elevated blood sugar levels. Ozempic stimulates the pancreas to release insulin, which helps prevent blood sugar spikes after a meal.
• Lowers the amount of fat storage: GLP-1 agonists like Ozempic make you feel full faster, so you may not eat in excess. As a result, less food may be converted to fat for storage. Also, controlling your blood sugar levels prevents the glucose in the blood from being stored as fat.
• Boosts your metabolism: Ozempic can rev up your metabolism, which helps your body burn calories more efficiently.

Ozempic weight loss plateau: why does it happen?

Ozempic can help you lose 15% or more of your body weight, studies show. Online users report even greater weight loss numbers. However, at some point, many hit a weight loss plateau.

Here are some reasons why you cannot lose more weight on Ozempic:

1. Other underlying conditions may be at play

Registered Dietitian Rita Faycurry RD explains, “Ozempic and other GLP-1 agonist medications address specific issues in the body affecting weight loss, particularly related to insulin resistance. However, other preexisting conditions may prevent you from losing weight on Ozempic.”

These reasons include:

• A gut imbalance that is causing digestive issues.
• Food sensitivities that lead to bloating.
• Low thyroid levels, known as hypothyroidism, can slow your metabolism down, leading to weight gain.
• Mental health conditions like depression, anxiety, and certain eating disorders.

Adds Faycurry RD, “For example, some people on Ozempic continue to binge eat even though the drug is supposed to control hunger signals in the brain. This news may be frustrating to hear if you struggle with uncontrollable cravings but don’t lose hope. It just means that you may also need to deal with other factors behind your cravings, in addition to being on Ozempic.”

If you’re battling a weight loss plateau on Ozempic, a Registered Dietitian can guide you with personalized support. Use Fay to find a Registered Dietitian near you, covered by insurance.

2. The body fights against ‘starvation mode’

Our body’s main goal is survival, which means keeping our vital organs like the heart and lungs functioning. To do so, it needs energy from the food we eat.

When we lose weight rapidly, our body starts to panic that we’re about to enter starvation mode. As a result, it begins to actively fight against weight loss and burns calories slowly. It may be why you find it hard to keep the weight off long term with Ozempic, Wegovy, or Mounjaro.

3. Ozempic is new; there are unknowns

Ozempic, Wegovy, and other such medications are gamechangers in the management of type 2 diabetes and weight loss. However, they are new drugs, and we may not fully understand exactly how they work.

Faycurry RD elaborates, “Some of my clients on Ozempic mention gastrointestinal issues, a lack of energy, the inability to enjoy their food, and being unable to listen to their bodies’ natural hunger and fullness cues. As a community, we still have a lot to learn about these meds.”

Similarly, the Ozempic weight loss plateau may be part of the design or not; it may be too soon to tell.

4. Lifestyle factors may need adjustments

• Your dose may not be right for you: You may have been using a recommended dose when you started, but weight loss needs recalibration and re-evaluation at regular intervals. A healthcare professional can help adjust your medication based on how your body reacts to the medication.
• Your body may need another medication: Our bodies respond differently to medication; what works for someone else may not be right for you. If you're certain about dosage, have improved your diet and lifestyle, and addressed underlying health conditions, talk to your healthcare provider if an alternative medication is right for you.
• Evaluate your nutrition: Drugs like Ozempic and Wegovy can reduce cravings for sugary and fatty foods, giving you the mental freedom to make better choices. However, without addressing potential issues in diet and lifestyle like exercise, smoking, alcohol intake, and others, you may be disappointed with your weight loss on Ozempic.

It can be complicated to figure out why you’re not losing weight on Ozempic. You don’t have to do it alone. Fay can help you find a Registered Dietitian near you, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.