Written by Kyle Ustach | BScEcon
Fact checked by Andrew Lenau, ISSA CPT & Sports Nutritionist
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For many people, losing weight is incredibly challenging, and it can seem increasingly difficult the older and heavier you get. People who struggle with obesity or losing fat often turn to supplements and weight loss medications to increase their chances of a transformation.
One weight loss medication that has exploded in popularity is semaglutide, a drug originally designed for type 2 diabetes treatment. While there are countless incredible success stories of significant weight loss with semaglutide, there are others who have still struggled to lose weight, despite assistance from the weight loss drug.
In this article, we will examine why losing weight on semaglutide may be challenging for you. Then, we'll discuss things you can do to ensure this weight loss treatment is effective, so you can get back on track with your weight loss journey.
Table of Contents:
- What Is Semaglutide?
- 7 Reasons You're Struggling With Weight Loss on Semaglutide
- How to Lose Weight On Semaglutide
- Semaglutide Side Effects
- FAQs
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What Is Semaglutide?
Semaglutide is a compound that belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. When we eat and digest food, our body produces GLP-1, a hormone produced in the intestines and released into the gastrointestinal tract. Taking semaglutide mimics this natural process, increasing insulin and reducing glucagon production, which lowers blood sugar levels.
As such, semaglutide was initially prescribed to treat type 2 diabetes but expanded to manage obesity and chronic weight management. This hormonal response to control blood sugar levels is vital to burn body fat. In higher doses, semaglutide can also trigger the brain to reduce appetite and help keep you feeling full for longer.
Ozempic, Rybelsus, and Wegovy are the only three semaglutide medication brands that are FDA-approved. Novo Nordisk, a Danish-based pharmaceutical company specializing in diabetes medications, produces all three.
Taken weekly, Ozempic is by far the most popular of the three for weight loss and diabetes treatment. While Ozempic and Rybelsus are both approved for treating type 2 diabetes mellitus, Ozempic is the only one that can be prescribed for weight management. It's also used to help reduce the risk of heart attack, stroke, or death in patients with heart disease or type 2 diabetes mellitus.
Rybelsus is the first and only GLP-1 receptor agonist available orally, a daily tablet created as an alternative to Ozempic injections. Novo Nordisk realized that subcutaneous injections limited the user pool, so oral medication became necessary. Despite Rybelsus only being approved for type 2 diabetes treatment, it is often used to help people lose weight.
For more information about these two semaglutide brands, check out our article comparing Ozempic vs. Rybelsus.
Wegovy is unique because it is only prescribed for weight loss and management, not diabetes. Wegovy has higher dosages to ensure it acts as an appetite suppressant and increases satiety. Similar to Ozempic, Wegovy is injected once a week.
Finally, you have the option of using the generic non-branded version of semaglutide which is a fraction of the price and should deliver similar results. For those who desire to lose weight but don't want to break the bank, make sure to check below if you qualify for semaglutide treatment from our partner, Fountain GLP.
7 Reasons You're Not Losing Weight on Semaglutide
If you find semaglutide isn't working as you'd like, one of the following may be the reason you're not losing weight.
1) Low Dosage:
One of the main reasons that semaglutide may not be working is the dosage. Depending on which brand of medicine you use, the dosages are slightly different.
Wegovy and Ozempic injections are similar in dosage, starting at 0.25 mg before elevating to 0.5 and 1.0 mg. Ozempic tops at 2.0 mg, whereas Wegovy has 1.7 and 2.4 mg options.
Rybelsus tablets come in 3 mg, 7 mg, and 14 mg. Regardless of the drug, everyone starts at the lowest dosage for the first four weeks to assess how the body reacts; then, the dosage increases as needed or if a weight loss plateau is reached.
One study compared weight loss results at various doses of oral semaglutide over 52 weeks. The 1,606 participants were divided into three dosage groups of daily oral semaglutide: 14 mg, 25 mg, and 50 mg. The results showed an average weight loss of 17.5 pounds at 50 mg, 14.8 lbs at 25 mg, and 10 lbs at 14 mg1. This clearly shows that higher dosages result in more significant weight loss.
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2) Haven't Been On It Long Enough:
If you ask yourself, "why am I not losing weight on semaglutide?", consider how long you have been taking it.
While some people experience instant results, it can take four weeks or longer to kick in. So, if you're three weeks on semaglutide and have no weight loss, you just need to be patient!
One study measured weight loss results on weekly semaglutide injections in 175 patients after three and six months. The results showed an average loss of 5.9% total body weight loss after three months compared to 10.9% at six months2.
Be patient; you should experience steady weight loss once it fully kicks in.
We dig deeper into this here: How Long Does It Take Semaglutide To Work
3) Unhealthy Diet/High Calorie Intake:
Any time you take semaglutide or any other weight loss medications, your diet should be in check to maximize results. A poor diet can be a significant reason for not losing weight on Ozempic, Wegovy, Or Rybelsus.
To maximize healthy weight loss, you should eat four to six smaller, balanced meals more frequently throughout the day rather than a few large meals. Eating large meals causes a spike in blood sugar levels, so eating smaller meals more frequently is better to help stabilize blood sugar levels.
Eating healthy meals and avoiding highly processed foods, such as fatty foods and sugary items, is also important. Stick to vegetables, healthy fats, fiber, lean proteins, and complex carbohydrates that stabilize blood sugar levels and keep you feeling full longer. Avoid high-calorie foods and maintain healthy dietary habits to help reach your weight loss goal.
For those who need help with their diet, our Muscle-Building Meal Plan will help keep you full while supporting your weight loss goals.
4) Time Of Dosage Administration (Mainly for Oral Semaglutide):
When and how you take your dose of oral semaglutide (Rybelsus) can affect the results. Semaglutide injections, however, can be taken at any time, with or without food, as long as it's the same day of the week.
To maximize absorption of oral semaglutide, you must take it first thing in the morning at the same time every day, with water, and 30 to 60 minutes before your first meal. Studies also show that the food you eat following the dosage can affect weight loss results. One study found that eating a breakfast with healthy fats led to greater satiety, fewer cravings, and better eating control3.
5) Not Drinking Enough Water:
One of the tips for maximizing weight loss on semaglutide is to drink tons of water. The idea is that drinking more water helps control hunger and improves overall health. Staying hydrated is also essential to help avoid negative side effects like nausea or headaches.
While drinking more water is generally good advice regardless of the situation, studies show the amount of water you drink does not affect oral absorption of semaglutide. While complete tablet erosion occurred slightly quicker with 240 ml of water compared to 50 ml of water, they reached maximum semaglutide concentration simultaneously. They concluded the amount of water at dosing does not matter for erosion4.
6) Using Alcohol/Drugs:
Avoiding alcohol can significantly improve one's health and weight loss goals, regardless of what medications or supplements they take.
Avoiding alcohol when taking semaglutide is especially vital because alcohol affects blood sugar levels. Alcohol consumption on semaglutide increases the risks of becoming hypoglycemic or hyperglycemic. Anecdotal research shows that people report semaglutide severely enhances the effects of alcohol, hitting the user harder and staying in their system longer.
In the r/Semaglutide sub-Reddit, the thread "Is it ok to drink alcohol while on semaglutide?" has several posts that share alcohol horror stories. Several users reported that alcohol use makes them sick, especially at higher doses of semaglutide.
One user posted: "Drinking on it makes me so sick. Like the effects of the hangover were much worse." (source)
A different user added: "I don't advise it. It's painful, in many ways!" (source)
Based on the long list of terrible experiences, it would be wise to avoid alcohol when using semaglutide. You should consult your doctor or healthcare provider if you take other drugs to avoid negative interactions.
7) Not Exercising Regularly:
If you take semaglutide and don't change your diet or exercise consistently, you won't experience the results you're hoping for.
While semaglutide can help produce amazing weight loss results, it is not a magic pill or one-step solution. Weight loss occurs due to a caloric deficit, so burning calories is imperative. Try to exercise at least three to four times a week, if not daily, to maximize weight loss on semaglutide.
How To Lose Weight On Semaglutide
Luckily, if you are struggling to lose weight on semaglutide and are guilty of any of the factors above, there are solutions for achieving successful weight loss.
Follow these tips to maximize weight loss on semaglutide. And if you need more inspiration to help keep you focused on your weight loss goals, you can read about semaglutide's weight loss potential in our article: How Much Weight Can You Lose On Semaglutide?
1) Increase Dosage When Needed:
Everyone starts at the lowest dosage of semaglutide for the first month to slowly introduce the drug to the body to minimize side effects.
If you can handle the side effects and are not losing weight, try increasing the dosage to the next level. Be sure not to exceed the maximum daily dosage, as side effects significantly increase.
2) Maintain A Healthy Diet:
Portion control and nutrient-dense food are essential to maximize weight loss on semaglutide. Lean proteins, whole grains, vegetables, and healthy fats are essential to maintain healthy blood sugar levels and decrease cravings.
Avoid processed foods, fatty foods, and items high in sugar, including sugary beverages. If you need help getting started, our article on the 16 Best High Protein Low Fat Foods highlights some of the best foods you can eat. We also have a great 4 Week Weight Loss Meal Plan to help get you on track.
3) Eat More Often & Slower:
Eat small portions more frequently throughout the day rather than a few large meals. Eating a big meal can cause blood sugar levels to spike and cause food cravings. If you eat smaller portions slowly, it helps provide a steady nutrient intake, which will increase satiety and keep you feeling full longer.
4) Drink Plenty Of Water:
Staying hydrated is essential for losing weight and maintaining overall well-being. Drinking lots of water will keep you full and reduce hunger or food cravings. It will also help your body flush toxins and support your overall health.
If you struggle to drink enough water throughout the day, I recommend investing in a water bottle that you really like. Sometimes the little things help and buying a great water bottle that keeps your drinks extra chilly and looks cool is all you need.
Check out these water bottles on Amazon to instantly boost your hydration levels.
5) Exercise Consistently:
The two most important factors in your weight loss efforts are diet and exercise. Regular exercise will help burn the calories needed to lose weight, improve energy levels, help regulate blood sugar levels, improve sleep, improve mental health, and several other benefits that promote overall well-being.
If you're unsure where to begin, head to our article on the Best Workout Splits to find your perfect fit.
6) Get Support:
Having someone to help keep you in check and guide you on your weight loss journey can be beneficial. This could mean having a dietitian create a meal plan, a personal trainer to design a workout routine, a doctor to monitor your dosage, or simply a friend that keeps you motivated.
7) Stay Consistent And Be Patient:
It can be frustrating when we don't see instant results, but you must stay dedicated, maintain healthy habits, and embrace the journey. The longer you are consistent with your diet, exercise, and dosage schedule, the greater the weight loss progress you will have.
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Semaglutide Side Effects
The purpose of starting at a low dosage and slowly increasing is to avoid side effects. Monitor the side effects below and alert your healthcare provider if they persist or worsen.
The most common semaglutide side effects include:
- Nausea
- Vomiting
- Diarrhea
- Headache
- Injection site reactions
More rare side effects might occur, in which case you should seek immediate medical attention:
- Bleeding
- Burning feeling in the chest
- Pancreatitis
- Hypoglycemia
- Loss/change of taste
If you have underlying health conditions, semaglutide could be dangerous. Some people who should avoid taking semaglutide include: those with thyroid issues or thyroid cancer; those with gastrointestinal disorders; anyone with a history of pancreatitis, kidney or liver issues, or cardiovascular disease; and women who are pregnant, breastfeeding, or planning on becoming pregnant.
FAQs
These are some of the most commonly asked questions with semaglutide.
Does semaglutide work for everyone?
Although most people will experience sustainable weight loss on semaglutide, it does not work for everyone. A small percentage of people may not respond to the drug, or the side effects are too harsh to justify taking it.
Can you gain weight on semaglutide?
It is extremely rare, but it is possible for semaglutide to cause weight gain.
How does Ozempic work for weight loss?
The Ozempic medication will promote significant weight loss by increasing insulin levels to lower blood sugar and break down fats for energy. It also reduces appetite and helps you feel fuller longer by slowing the absorption rate of food entering the small intestine during digestion.
How fast does semaglutide kick in?
Semaglutide begins lowering your blood sugar levels almost immediately. Most users will experience weight loss in the first week, but it takes about four weeks to kick in fully.
What happens if you don't eat on semaglutide?
If you don't eat on semaglutide, tou will have low blood sugar levels, which can cause hypoglycemia and several adverse effects, including dizziness, confusion, and shakiness.
How long can you lose weight on semaglutide?
Clinical trials have been done for up to 68 weeks, showing safe use of semaglutide. It is safe to use long-term, with several users staying on for over a year to maintain weight loss.
Semaglutide Not Working? There's A Solution!
If you are on semaglutide and not losing weight, there is likely a solution to your problem. It may be you're on too low of dosage, not following the proper dosing schedule, or you haven't been taking the medication long enough. Other causes can be an unhealthy diet, using alcohol or drugs, and not exercising consistently.
Luckily, all those reasons can be reversed by living a healthier lifestyle and staying consistent with your diet and exercise routine. And, for the most part, following the medication guidelines, exercising consistently, and making healthy lifestyle changes can transform your body.
Interested in seeing how semaglutide stacks up against other weight loss medications? Check out our article on Liraglutide vs Semaglutide. Looking for weight loss solutions you can buy over the counter? These 7 Best Appetite Suppressants may be just what you need!
References:
- "Higher Doses of Oral Semaglutide Improves Blood Sugar Control and Weight Loss." ScienceDaily, www.sciencedaily.com/releases/2023/06/230627225228.htm. Accessed 27 Aug. 2023.
- Ghusn, Wissam, et al. "Weight Loss Outcomes Associated with Semaglutide Treatment for Patients with Overweight or Obesity." JAMA Network Open, vol. 5, no. 9, 19 Sept. 2022, p. e2231982, jamanetwork.com/journals/jamanetworkopen/fullarticle/2796491?resultClick=1, https://doi.org/10.1001/jamanetworkopen.2022.31982.
- Gibbons, Catherine, et al. "Effects of Oral Semaglutide on Energy Intake, Food Preference, Appetite, Control of Eating and Body Weight in Subjects with Type 2 Diabetes." Diabetes, Obesity and Metabolism, vol. 23, no. 2, 27 Nov. 2020, https://doi.org/10.1111/dom.14255.
- Bækdal, Tine A., et al. "Relationship between Oral Semaglutide Tablet Erosion and Pharmacokinetics: A Pharmacoscintigraphic Study." Clinical Pharmacology in Drug Development, vol. 10, no. 5, 22 Mar. 2021, https://doi.org/10.1002/cpdd.938.
Kyle Ustach
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