Weight gain on Ozempic? A Registered Dietitian's weight loss tips

Key Points

• Some people gain weight on Ozempic, Wegovy, or Mounjaro.
• You can lose weight on Ozempic; replenish micronutrients, balance your plate, fix your gut health, and much more.
• To learn why you’re gaining weight on Ozempic and what works best for you, consider reaching out to a Registered Dietitian.

Find yourself gaining weight on Ozempic? Instead of singing the Ozempic jingle, “Oh Oh Oh Ozempic,” you may wonder, “Oh oh oh, why me, Ozempic?”

Indeed, for all the incredible Ozempic weight loss success stories, celebrity endorsements, clinical results, and more, some people find the numbers on the scale going up instead of down.

If you've struggled with your weight for a while, you may have tried many diets and faced social stigma, low self-esteem, and more. When you finally get your hands on Ozempic and do not see the weight loss results you expected, it can be extremely heartbreaking.

However, do not lose hope. Let’s explore some reasons why you may be gaining weight on Ozempic, and what you can do about it.

How to lose weight on Ozempic

Registered Dietitian, Rita Faycurry, RD, notes, “Ozempic and Wegovy can be effective, but they're not magic. Even participants in the drug trials had to change their diet and exercise. These drugs might help people stick to their dietary goals better, but others may have to address a few more underlying issues before they can lose weight.”

Here are some tips to help give you the results you’re looking for before, during, and after Ozempic:

1. Replenish your micronutrients

Faycurry explains, “Sometimes, people on Ozempic end up with micronutrient deficiencies, particularly if they are not eating enough nutritious foods, skipping meals, or not eating enough, in general. In these cases, metabolism may slow down. Some of these individuals may have had nutrient deficiencies prior to getting on Ozempic as well. A dietitian can assess these nutritional deficiencies and help correct them.”

Micronutrients refers to vitamins and minerals. Micronutrient deficiencies can cause health issues, some of which may prevent you from losing weight.

Some micronutrient deficiencies that may cause weight gain include:

• Vitamin D deficiency: A Vitamin D deficiency may lead you to gain weight.
• Selenium deficiency: Selenium is a mineral that your body needs for various functions, like producing thyroid hormones. If you don't have enough selenium, it can lead to hypothyroidism and weight gain. Seafood, beef, turkey, chicken, beans, and lentils are great sources of selenium.
• Magnesium deficiency: Having too little magnesium doesn't directly make you gain weight, but it is associated with insulin resistance, which can cause weight gain, especially belly fat. While Ozempic is meant to regulate insulin response, it may not be as effective in some people.

A Registered Dietitian can help you balance your micronutrients and get your weight loss plans on track. Fay is an easy way to locate a Registered Dietitian near you, covered by your insurance.

2. Eat balanced and inclusive meals

A general rule of thumb for a balanced plate is:

• Fill half your plate with non-starchy, whole vegetables
• A quarter of the plate with lean protein, and
• The rest can be healthy fats like vegetable oils, fish, eggs, nuts, or seeds.

If you want to include fruit, consider replacing a quarter of your veggies with whole fruit.

Rita Faycurry, RD, says, “If you have an eating disorder or are in recovery, avoid calorie counting or weighing yourself unless instructed by your healthcare provider. Instead, balance your meals based on the guidelines offered above. Eat a variety of veggies and fruits for the nutrients you need.”

3. Eat when depressed or when having “one of those days”

Faycurry adds, “If you have depression, anxiety, mood disorders, fatigue, or an eating disorder, you already know that some days are harder than others. On tough days, be gentle with yourself and opt for simpler ways to eat well.”

Here are some tips to balance your plate when you’re depressed:

If you can use a stove and a saucepan

Consider heating up a can of low-sodium soup with vegetables. You could also add half a can of beans and a handful of spinach to the soup for protein and fiber.

If you can’t cook or the kitchen is too overwhelming

Grab a handful of nuts, no-prep veggies or fruit, and some protein like a few slices of lean meat like ham or chicken slices, a cheese stick, or a few spoons of nut butter.

Another option is to hard boil a few eggs in advance. According to the FDA, you can store hard-cooked eggs in the refrigerator for 7 days. Add them to a store-bought salad or lettuce, or just eat one with some bread and peanut butter when you’re too exhausted.

Buy no-prep fruits and vegetables

Fruit like bananas, apples, or berries are easy choices for those difficult days. Whole vegetables like cherry tomatoes or pre-cleaned spinach eliminate the need for a cutting board or knife.

Ordering food home? Add veggies

Consider a protein-and-veggies combination like a chicken pizza with veggie toppings, a side salad with pepperoni pizza, or a Chinese chicken and broccoli. A chicken burrito or tofu burrito bowl with veggies can give you a mix of protein, carbs, and fats.

When you’re battling an eating disorder or other mental health conditions, it is very hard to stay on top of your health goals, even if you’re on Ozempic.

A Registered Dietitian can help. Fay is a hassle-free way to find a Registered Dietitian near you, covered by your insurance.

4. Eat the right amount of protein

According to the Institute of Medicine (IOM), 10% to 35% of your calories should come from protein. What works best is a nutritional plan that estimates protein intake for each person based on personal needs, age, and any health issues.

What happens if you eat too much protein?

According to Faycurry, RD, “Not many people know that excess protein in our diets is converted to fat! It’s important to get the right amount. Too much protein can also lead to digestive issues like constipation, especially if you’re not getting enough water or fiber.”

5. Fix your gut health

You may eat all the right foods and balance your plate, but is your gut absorbing nutrients from your food for nourishment?

Poor gut health can lead to weight gain from bloating, water retention, and constipation.

Signs of an unhealthy gut include:

• Frequent gastric issues, including gas, bloating, constipation, diarrhea, or even heartburn
• Poor sleep
• Abdominal pain
• Intense sugar cravings.

Poor gut health can be due to many reasons, including:

• Food sensitivities or allergies
• A bacterial imbalance
• Digestive issues
• Autoimmune conditions like IBS (irritable bowel syndrome)
• Side effects of Ozempic, Wegovy, Mounjaro, and similar drugs.

6. Get enough sleep

A lack of sleep can cause weight gain. Side effects of Ozempic include diarrhea, which may affect your sleep. However, Ozempic may help you avoid sugar and alcohol, potentially improving your sleep. It varies from person to person.

If you have trouble sleeping, consider the following tips.

Lower your stress

Before bed, try a calming routine. You can do things like a skincare routine, take a warm shower, or practice meditation or deep breathing. If your thoughts race at night, jot them down on a notepad by your bed to clear your mind.

Limit your caffeine intake

Caffeine is a strong stimulant, and that 5 pm coffee might be keeping you awake. It takes up to 10 hours to fully leave your body. Half the caffeine is still in your body after 6 hours!

Try to switch to decaf and avoid caffeine after noon, including Diet Coke. Regular Coke has 32 mg of caffeine per 12-ounce can, while Diet Coke has even more, with 42 mg in the same size can.

Limit sugar and alcohol after 7 pm

Try to limit stimulants like sugar and alcohol intake after 7 pm to help you sleep better. 

If you are able to practice moderation, go ahead and indulge once in a while when out with friends, once in a while. 

However, if you struggle to moderate and end up binging, consider learning how to break free from binge eating.

7. Hit the Ozempic weight plateau?

If you shed pounds on Ozempic when you first started but eventually stopped, you may have reached the dreaded ‘Ozempic weight plateau.’ Weight plateaus are normal; it’s just your body’s way of protecting you from starvation.

It can also be hard to sustain weight loss with Ozempic, Wegovy, and Mounjaro in the long term.

If you want to know why you stopped losing weight on Ozempic, consider discussing your situation with a Registered Dietitian.

8. Get personalized support

There may be many other reasons why you’re not losing weight on Ozempic. These include:

• Not building enough muscle: Consider strength training.
• Hormonal imbalances: Estrogen, menopause, and more may cause weight gain.
• Effects of other drugs: For example, SSRI antidepressants like Mirtazapine, Lexapro, and Zoloft may cause intense food cravings.
• Ozempic may not be right for you, but there are alternatives: Talk to your healthcare provider if a similar drug with a different active ingredient may work for you.

Weight loss is complex, and no two people are alike. Even on Ozempic, the right lifestyle changes are needed to help you achieve a healthy weight.

A Registered Dietitian can help guide you with a custom nutrition plan. Fay can help you find a Registered Dietitian near you, covered by your 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.