You did it. You started your weight loss journey! You’ve spoken to a healthcare provider and got a prescription for Wegovy. This is a huge first step in fighting off obesity.

But you’ve been taking Wegovy for a while. You’re not losing weight. What gives?

You may not see the results you were hoping for for several reasons. This article will explore some of the most common reasons you aren’t losing weight on Wegovy and what to do about it.

What is Wegovy?

Wegovy (semaglutide) is a prescription weight loss medication made by Novo Nordisk. It is used to help patients with overweight or obesity lose weight and keep it off.

Semaglutide—the active ingredient in Wegovy—is classified as a glucagon-like peptide-1 receptor agonist (GLP-1). It is a synthetic version of the natural hormone GLP-1. which regulates insulin release, reduces glucagon secretion, and slows stomach emptying to manage blood sugar and promote satiety.

Unlike other GLP-1 medications (like Ozempic or Rybelsus), Wegovy, with a higher semaglutide dose, is FDA-approved for weight management in adults and children over 12. It's prescribed alongside lifestyle changes like diet and exercise to reduce calorie intake and cravings for high-fat or high-sugar foods.

Why am I not losing weight on Wegovy?

You may not be hitting your weight loss goals while taking Wegovy for several reasons.

Weight loss results take time. On average, clinical trial participants taking Wegovy had lost about 2% (about 5 lbs) of their body weight on the fourth week of treatment. Some may lose more, and some may lose less.

Keep in mind that results become more apparent the longer you take Wegovy. After a 68-week clinical trial, the average patient lost 15% (or 35 lbs) of their body weight. Over 30% of participants wound up losing 20% (46 lbs) or more during this time. Those results don’t just happen overnight. That’s over a year of weekly semaglutide injections and healthy lifestyle habits.

Many people don’t start seeing visible weight loss effects of Wegovy until the 20-week mark. If you’re frustrated by not losing weight, take stock of how long you’ve been using the medication. Consider talking to your prescribing provider if it has been over 20 weeks. They can help determine whether a higher dose may help you reach your goal.

Be patient with yourself and the process.

Wegovy is not prescribed alone. When providers prescribe Wegovy, they do it along with healthy lifestyle changes. These include regular exercise and a healthy diet.

If you have been struggling to lose weight while using Wegovy, ask yourself if you are maintaining these practices.

Unhealthy eating habits like snacking between meals, overeating during meals, and eating a high-calorie diet may prevent you from getting where you want to go. Talk to your provider about your dietary habits to see if there is anything you can adjust. They will likely recommend that you focus on eating nutritious foods. These include vegetables, fruits, and whole grains. You should avoid foods high in saturated fats or sugar.

Talk to a healthcare provider about your diet and possible changes you can make. They may be able to suggest a sustainable meal plan and caloric intake recommendation to make sure you are getting the nutrition you need.

Trials show that Wegovy is most effective when patients get at least 150 minutes of moderate-intensity weekly aerobic exercise. 150 minutes over a 7-day week is just over 21 minutes per day. Aerobic exercise can be brisk walking, swimming, dancing, cycling, or jogging. Even yard work counts.

Getting at least 150 minutes of aerobic activity per week will also help reduce your risk of cardiovascular complications. For example, it can lower your risk of high blood pressure.

A healthcare provider can provide some suggestions as to how you can start your fitness routine. Jumping into high-impact strenuous exercise leaves you at risk for burnout or injury. Work with your provider or a weight loss specialist to craft an exercise regimen that is appropriate for your needs and experience level.

High stress levels are associated with overweight and obesity. Stress encourages the release of cortisol. Cortisol is a natural hormone that plays a role in metabolism. It gives us a surge of energy but also encourages us to overeat or crave foods that aren’t as healthy.

Exercise relieves stress. Getting more physical activity can keep cortisol levels down. It also has extra benefits, like those noted above. Get more exercise and use other stress-reduction techniques like deep breathing and meditation.

In addition to managing your stress, It's vital that you get enough sleep. Aim for 7-8 hours of sleep per night.

Not getting enough sleep is linked to high cortisol levels and an increased risk of obesity. Practice good sleep hygiene by turning in and waking up at the same time every day. Wind down before bed and avoid using your phone, laptop, or tablet right before trying to sleep. While these devices are a central part of nearly all of our lives, they can hurt the quality of your sleep.

Discuss your sleep and stress with your healthcare provider. Incorporating healthy sleep habits into your daily routine may help you start seeing the results you want.

If you’re not losing weight on Wegovy, it might not be due to anything you are or aren’t doing. It may be that an underlying medical condition is to blame. Conditions like hypothyroidism and type 2 diabetes can make it hard to lose weight.

Additionally, certain medications, like antipsychotics and some blood pressure medicines may cause weight gain. They may also slow weight loss.

If you have been maintaining healthy habits while taking Wegovy and are not losing weight, talk to your provider. They may screen you for other health conditions. Before starting treatment with Wegovy, tell your provider about your medical history. Also, tell them what medicines you are currently taking. This will reduce your risk of harmful drug interaction side effects. It will also give your provider a fuller picture of your health and potential barriers to weight loss.

Are there alternatives to Wegovy?

Wegovy is not the only weight loss drug on the market. If you’re not seeing results, your healthcare provider may elect to increase your dosage. Or, they may prescribe you another medication.

Other FDA-approved weight loss medications include Saxenda (liraglutide) and Zepbound (tirzepatide). They may prove to be more effective than Wegovy.

Discuss these options with your provider, as well as possible drug interactions and side effects.

Should I talk to a doctor?

There are many reasons why you aren’t getting the results you want while taking a weight loss drug. The four detailed above are among the most common. They are also entirely fixable.

Remember that weight loss is a journey. It doesn’t happen overnight (although it would be nice if it could). If you’re frustrated by the process, talk to a healthcare provider. Ask about your treatment and what you can do to improve it. It may be that a simple lifestyle change will help accelerate the effectiveness of Wegovy. Or, you may have a medical condition that requires treatment before you can get the full impact of weight loss medication.

It’s essential that you work closely with a licensed healthcare provider during your weight loss journey. They can monitor your condition. They can also track the efficacy of any prescription medication you are taking.

Getting help on Sesame

Sesame offers an online weight loss program to help you through the process. This subscription renews every 3 months. It includes a video consultation with a weight loss doctor or specialist and a GLP-1 prescription if appropriate. It also includes insurance coordination for medication coverage. Plus, you get 90 days of unlimited messaging with your provider.

Sources:

• Beccuti, G., & Pannain, S. (2011). Sleep and obesity. Current opinion in clinical nutrition and metabolic care.
  
• Childs, E., & de Wit, H. (2014). Regular exercise is associated with emotional resilience to acute stress in healthy adults. Frontiers in physiology.
  
• Cuevas, A. G., Chen, R., Thurber, K. A., Slopen, N., & Williams, D. R. (2019). Psychosocial Stress and Overweight and Obesity: Findings From the Chicago Community Adult Health Study. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.
  
• Hewagalamulage, S. D., Lee, T. K., Clarke, I. J., & Henry, B. A. (2016). Stress, cortisol, and obesity: a role for cortisol responsiveness in identifying individuals prone to obesity. Domestic animal endocrinology.
  
• Wilding, J., Batterham, R. L., Calanna, S., et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. The New England Journal of Medicine.