Why Am I Not Losing Weight with Semaglutide?

You've been taking semaglutide for weeks but haven't noticed any changes to the number on the scale. What gives? Semaglutide is a popular medication used for weight loss, so why aren't you losing weight with it? 

In this article, we'll explore some of the common reasons why semaglutide may not be working for you and provide tips that can help boost your weight loss.

Your Semaglutide Dosage is Too Low

When it comes to semaglutide, one size does not fit all. The dosage needed to start shedding pounds can vary quite a bit from one person to the next. While your friend may have lost weight right after starting on the lowest dose, you may need to go higher to see the number on the scale go down.

Research on semaglutide has found that, in general, higher doses lead to increased weight loss for more people. Here's a look at the average amount of weight loss seen at different dosages in studies:

• 0.5 mg: Those taking 0.5 mg per week lost around 8.2 pounds over 30 weeks. For some, this small dose is enough to kickstart their weight loss journey. ¹
• 1 mg: Bumping up to 1 mg per week resulted in an average weight loss of 13.2 pounds over 40 weeks. ²
• 2 mg: This dose led to an average of 15.2 pounds shed over 40 weeks. ²

While the 2 mg dose led to more weight loss on average, that high of a dose may not be necessary for you. The FDA recommends gradually increasing your semaglutide dose until you find the amount that helps you lose weight steadily and consistently. ³ Once you find your effective dose, stick with that. A higher dose is not always better and may lead to more side effects. The goal is to find the lowest dose that provides results for you. ³

You Have an Unhealthy Lifestyle

Semaglutide alone won't make the pounds melt away. For the best weight loss results, semaglutide needs to be combined with lifestyle changes like eating fewer calories and exercising more. ³

Think of it this way - weight loss is a math equation. To lose weight, you need to burn more calories than you consume. Semaglutide can help reduce your calorie intake by curbing your appetite. But if you're still eating high-calorie foods and staying inactive, you may not create the calorie deficit needed for weight loss.

To lose one to two pounds per week, you'll need a 500 to 1,000 calorie daily deficit. ⁴ Here's how to calculate your target:

1. Estimate your maintenance calories. Multiply your current weight by 15. This is about how many calories your body burns daily with moderate activity.
2. Subtract 500 to 1,000 calories. This gives you your target for daily calorie intake. But don't go below 1,200 calories per day for women or 1,500 for men without medical supervision. Too few calories can lead to nutrient deficiencies. ⁴

You can also help accelerate your weight loss through other diet and lifestyle changes:

• Up your protein. Aim for 0.8 grams of protein per kilogram of body weight. Protein increases satiety so you eat less. ⁵
• Move more. Whether it's brisk walking or strength training, engaging in regular exercise not only burns calories but also helps regulate blood sugar levels effectively. Strive for at least 150 minutes of moderate- to vigorous-intensity aerobic exercise each week, complemented by strength training sessions 2 to 3 days per week for optimal results. ⁶

You Haven’t Given Semaglutide Enough Time

If you’ve recently started taking semaglutide for weight loss, don’t get discouraged if you haven’t noticed the pounds dropping off yet. Weight loss with this medication is a marathon, not a sprint.

When you first start semaglutide, your doctor will prescribe a low dose and gradually increase it over the course of four months. ³ Here's a typical dosage timeline:

• Month 1: Your doctor will start you on a low dose of 0.25 mg. This introductory dose probably won’t lead to weight loss, but it lets your body get used to the medication.
• Month 2: Your doctor will increase your dose to 0.5 mg. At this point, some people start to lose weight, but others need to go up to a higher dose.
• Month 3: Your doctor will increase your dose to 1 mg. This is a common dosage for weight loss.
• Month 4: If you haven’t seen much progress on 1 mg, your doctor will increase your dose to 2 mg.
• Month 5: If additional weight loss is needed, your doctor will increase your dose to a maximum of 2.4 mg. ³

This gradual increase allows your body to adjust to the medication. But it also means you won't see the full weight loss effects right away. Research shows that weight loss progresses steadily over several months on semaglutide:

• After 3 months, patients lost an average of 14 pounds
• After 6 months, patients lost an average of 27 pounds ⁷

For reference, the participants in this study took semaglutide 1.7 mg or 2.4 mg. ⁷ Overall, they achieved weight loss at a rate of 1 pound per week, which experts say is a safe, sustainable rate of loss. ⁸

If you’ve been taking semaglutide as prescribed for a few months but haven’t lost much weight, talk to your doctor. You may need a higher dosage or there could be other issues impacting your weight loss.

You’re Stressed Out

We all know stress is bad for our health, but you may not realize just how much it can sabotage your weight loss efforts. When we're under chronic stress, our bodies release higher levels of the hormone cortisol. ⁹ This can:

• Increase your appetite
• Lead to overeating unhealthy comfort foods ⁹

To successfully lose weight and keep it off long-term, finding healthy and effective ways to manage stress is crucial. Here are some proven strategies:

• Exercise: Physical activity is not only great for your body but also helps in reducing stress levels. Mind-body exercises like yoga, tai chi, and pilates combine physical activity with mindfulness and meditation to lower cortisol levels. So, make sure to include them in your exercise routine for better stress management.
• Social support: Having a support system is crucial in managing stress levels. Spending time with friends and family or joining a support group can provide emotional and social support, which can help in reducing stress. ⁹

You’re Not Taking Semaglutide Consistently

Unlike some medications that you take only when needed, semaglutide works best when you take it at the same day each week. ³ But why is consistent weekly dosing so critical?

It all comes down to the drug's half-life. The half-life is the amount of time it takes for the concentration of the drug in your body to be reduced by half. ¹⁰ For semaglutide, the half-life is about one week - conveniently right around the time for your next dose. ¹¹

Pharmaceutical companies determine the ideal dosing frequency based on a medication's half-life. The aim is to reach steady state - where the drug level in your system stays stable. At steady state, the amount of medication entering your body equals the amount leaving it. ¹² For semaglutide, it takes 4 to 5 weeks to achieve steady state with weekly dosing. ¹¹ Missing or delaying doses can disrupt this steady state, impacting the drug's effectiveness.

If you miss a dose and your next scheduled dose is more than two days away, take the missed dose as soon as possible. However, if your next dose is within two days, skip the missed dose and resume your normal dosing schedule. It's important not to double up on doses to make up for a missed one. ³

Conclusion

Semaglutide can be an effective tool for weight loss, but it is not a magic pill. To achieve meaningful and long-lasting weight loss, lifestyle changes are essential. Focus on exercising regularly, eating a balanced and nutritious diet, reducing portion sizes, and being more mindful about the calories you consume each day.

If you've made positive lifestyle changes but are still struggling to lose weight, talk to your doctor. They may need to increase your semaglutide dosage or switch you to a different medication to help stimulate your weight loss.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical conditions, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.