Why you’re not losing weight on Zepbound? (and what to do about it)

Key Points

• Zepbound (tirzepatide) is a weight-loss drug that helps you lose weight by reducing appetite and burning fat
• Reasons for not losing weight on Zepbound include low dosage, inconsistent use, poor diet, lack of exercise, hormones, underlying conditions, and weight loss plateaus
• Zepbound works best when paired with diet and lifestyle changes
• A registered dietitian can develop a personalized plan to help you lose weight on Zepbound in a sustainable way

Social media and news articles cover many success stories about losing weight on Zepbound (tirzepatide), the weight loss drug. Seeing these dramatic transformations can lead to high expectations. 

But here's the reality: not everyone loses the same amount of weight on Zepbound. Weight loss results vary from person to person, even on medication.

If you’re not losing weight on Zepbound, it’s natural to be frustrated. However, let’s explore some reasons why Zepbound may not be working for you and a few strategies to jumpstart your weight loss.

How does Zepbound work?

Zepbound is a weight loss medication that works by lowering your appetite, making you feel full for a longer time after meals, and reducing your cravings. These effects are designed to help you eat fewer calories and burn fat while preserving muscle mass.

Zepbound mimics two hormones in your body: GIP and GLP-1.

• GIP (Glucose-Dependent Insulinotropic Polypeptide): This hormone helps the body use sugar more effectively and may enhance the effects of GLP-1, leading to better appetite control and weight loss.
• GLP-1 (Glucagon-like Peptide-1): This hormone slows digestion, reduces hunger, and helps the body release insulin to control blood sugar.

Now that you understand how Zepbound works let’s look at the kind of weight loss results you could expect.

Zepbound and weight loss: What to expect?

In a clinical trial, people on Zepbound (Tirzepatide) lost 15-20% of their body weight in a little over a year (72 weeks). However, results varied depending on the dose and individual differences.

If you’ve been on Zepbound for a while and haven’t seen much progress, don’t worry—there might be factors that you can adjust.

Let's dive into the most common reasons why you might not be losing weight on Zepbound and what you can do about it.

Why you’re not losing weight on Zepbound

Nutrition makes a big difference. 

It's natural to think that since Zepbound reduces your appetite, you will eat less food and lose a lot of weight. However, the amount and types of food you eat play important roles in your success.

Research shows combining Zepbound with healthy eating and regular exercise leads to greater weight loss. So, while Zepbound can help control your hunger, making healthy food choices remains important for your weight loss journey.

Even with a reduced appetite, consuming highly processed foods, added sugars, or eating large meals may affect your progress. Consider working with a registered dietitian to create a balanced, sustainable eating plan with lean protein, fiber-rich vegetables, and healthy fats.

Exercise matters

Zepbound may help control your appetite, but exercise remains important for optimal results.

Exercise improves insulin sensitivity, boosts metabolism, and helps prevent muscle loss during weight loss. Even simple activities like a moderate-intensity walk daily and strength training a few times a week can make a difference.

The US CDC recommends about 150 minutes of moderate activity each week. This number boils down to just 20 minutes a day.

Review your medication dosage

A clinical trial showed that after 72 weeks, people who took 5 mg of Zepbound (tirzepatide) lost 16% of their body weight, those at 10 mg lost 21%, and those at 15mg experienced a 22.5% weight loss.

However, most people start Zepbound at 2.5 mg. This is the starter dose to help your body get used to the medication. It also helps you and your doctor evaluate your response to the drug. While this is a starting point, your dosage may increase over time.

So, if you just began taking Zepbound, plan for an adjustment period where you may not see the weight loss results you expect.

Note: Moving to a higher dose too quickly might cause more side effects. Please do not make any changes to your dose or stop taking your medication without consulting a healthcare provider.

Skipping or missing doses

Taking Zepbound as prescribed is essential. Missing doses or using improper injection techniques can slow your progress. It’s best to follow your healthcare provider’s recommendation.

Hormonal imbalances and underlying conditions

Hormones play a crucial role in metabolism. If there is any type of hormonal imbalance in your body, it could affect your weight loss results—even if you’re on Zepbound.

For example, people with type 2 diabetes can still lose weight on Zepbound, just not as much as those without diabetes. In one trial, 82% of people with type 2 diabetes lost at least 5% of their body weight after 72 weeks on Zepbound (10 mg weekly). For people without diabetes, this number was even higher; 96% achieved the same weight loss goal.

Several other conditions can affect your weight loss progress, including thyroid issues, PCOS (polycystic ovary syndrome), and changes that happen during menopause. Everyday factors like chronic stress and poor sleep can also affect your weight loss journey.

Dealing with these health issues does not mean you cannot lose weight—it just means you might need extra support and guidance to reach your goals.

If your weight loss has stalled, consider discussing your concerns with a weight loss dietitian to get a personal evaluation and a custom nutrition plan to help you get back on track.

Natural weight loss plateaus

It's common for weight loss to slow down or pause temporarily. This pause is called a weight loss plateau. It happens when your body adapts to changes in diet and exercise, slows your metabolism, and adjusts to its new normal.

If you've hit a weight loss plateau, try to stay consistent with your medication and make small changes to get back on track. This might mean adding a few more minutes to your daily walk, choosing more nutritious foods, or lowering your alcohol intake. If you would like expert help with figuring out what to do, consider advice from a registered dietitian.

Final Thoughts: How to lose weight on Zepbound

Zepbound has been shown to help with weight loss. While it works differently for each person, studies show it can lead to meaningful results when used as prescribed. Some people may see steady progress, while others might experience slower results or plateaus.

Successful weight loss with Zepbound comes from combining the medication with healthy lifestyle changes. Making better food choices, staying active, getting enough sleep, managing stress, and addressing any health conditions all play important roles alongside your treatment.

Finding the right balance of these changes can be challenging, but you don't have to figure it out alone. A registered dietitian can help create a personalized plan that fits your life. They'll work with you to develop strategies for long-term success and adjust your plan when needed.

Frequently Asked Questions (FAQs)

How do I maximize my weight loss on Zepbound?

Focus on a healthy diet, regular exercise, proper hydration, and staying consistent with your medication. Working with a registered dietitian can help optimize your results because they create a personalized nutrition plan that fits your specific needs, preferences, and goals.

How quickly will I start losing weight on Zepbound?

Most people see some weight loss within a few weeks, but significant changes usually occur after a few months. Research shows that people using Zepbound (tirzepatide), on average, lose 15-20% of their body weight over 72 weeks. However, weight loss results tend to vary from person to person.

Will I lose weight on 2.5 mg of Zepbound?

While 2.5 mg is just the starting dose, Zepbound studies looked at weight loss on higher doses. Remember that everyone's results are different—what works for one person may not work the same for another. Talk to your doctor about what results you might expect, and consider working with a registered dietitian who can help create a custom eating plan that works for you.

Zepbound vs. Ozempic: What’s the difference?

Both Zepbound and Ozempic are US FDA-authorized medications available only with a prescription. However, only Zepbound is approved for weight loss in people without diabetes. Ozempic, on the other hand, is a diabetes drug (although some healthcare providers offer it off-label for weight loss).

The main ingredient in Ozempic is semaglutide, which mimics the chemical GLP-1 in the body. This hormone slows your digestion down, tells your brain that you’re full faster, and triggers insulin release to control blood sugar levels.

Zepbound (tirzepatide) also helps you reduce your appetite and manage blood sugar levels but mimics two types of hormones: GLP-1 (same as Ozempic) and GIP, which boosts the effects of GLP-1.

If you’re trying to learn whether Zepbound or Ozempic is better for you, a healthcare provider will help you make an informed decision.

Zepbound vs. Wegovy: What’s the difference?

Both Zepbound and Wegovy are FDA-approved medications that need a prescription. While both help with weight loss, they work differently in your body.

Wegovy contains semaglutide, which mimics a natural hormone (GLP-1) in your body that helps control hunger. It tells your brain you're full faster and helps reduce food cravings.

Zepbound works differently—it contains tirzepatide and mimics two hormones, GLP-1 and GIP, instead of one. GIP works together with GLP-1 to help control blood sugar and hunger signals.

When it comes to weight loss, if you’re not losing weight on tirzepatide or another weight loss drug, consider working with a registered dietitian to help you break through your weight plateau.

Start losing weight today. Find a weight loss dietitian who accepts 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.