The Most Effective Hormone Replacement Therapies
Semaglutide can provide remarkable results in obesity reduction. However, it does not work the same in all patients, and some patients have complained that it did not work for them at all. Former British Prime Minister Boris Johnson was among a few high-profile people who said that said they were not losing weight on semaglutide. Semaglutide has been proven to provide substantial loss in most people, but Johnson’s announcement should serve as a reminder that it does not work for everyone.
Semaglutide not working at all is an uncommon occurrence; we have rarely seen a total failure on this medication in our patients. If we do see a patient where semaglutide stopped working, there is almost always a reason we can figure out why and can resolve their particular issue of " Why am I not losing weight on semaglutide."
Basically, the reasons why you may not be losing weight on semaglutide fall into one of two categories: there is something about your body that is preventing the drug from working as it normally would, or you may not be using the drug correctly, or are expecting it to work without combining it with the healthy diet, regular exercise and reduced calorie intake that makes it most effective.
In the first case, there is little that can be done other than perhaps reworking your dose to overcome the issues that could be making you resistant to the drug. But more often than not, if semaglutide stops working, it’s because of something you are not doing right in your weight loss efforts that can be corrected.
The main point is not losing weight on semaglutide is rarely an unsolvable problem by your healthcare provider.
Before you jump to the conclusion that your semaglutide injections “aren’t working,” please understand that it takes time for semaglutide to start working, and initial weight loss could be slow.
Semaglutide results in the first four weeks of use might be minimal. Many people who think the drug is not working simply have not given it enough time. You may see some results in the first four weeks on semaglutide, but as you enter eight weeks and beyond, that is when you will really start to notice significant weight loss.
The drug has been found by health professionals to be quite effective in helping people lose large amounts of weight. In clinical trials, participants lost an average of 15% -16% of their body weight. But that was after being on the injectable medication for 68 weeks, after achieving the maximum 2.4 mg once-a-week dose. You will likely start to see meaningful weight loss results sooner than that, however, do keep in mind that in many patients, it can take several weeks or even months until they start to see substantial obesity reduction on this and similar medications.
The aforementioned trials concluded that patients could lose weight up to and through the 68th week of using the drug, but we have seen our patients continue to lose weight beyond that mark. Continued weight loss on semaglutide past week 68 is especially possible when combined with healthy habits, regular exercise, reduced caloric intake, and the behaviors for weight management advice we provide medical weight loss patients.
One study found that among obese adults who were simultaneously encouraged to eat appropriately, be physically active, and live a healthier lifestyle, two years of weekly injections led to an average weight loss of 15% vs. only about 2-3% in the placebo group.
The reasons why a person may not be losing weight on semaglutide can vary. Several things factor into your ability to lose weight with or without approved weight loss drugs. Your unique genetics, age, the amount you eat, and how much exercise you get all play a role in how well semaglutide does or does not work for you.
Here are the five most common reasons why you may be experiencing slower-than-expected weight loss on semaglutide or you feel that your semaglutide stopped working.
The most common reason we see semaglutide failure is because users stop taking it due to uncomfortable side effects. This is what happened with Boris Johnson; he was not happy with the typical gastrointestinal side effects . However, severe side effects with the drug are rare, and most of the common ones can usually be dealt with. Like waiting for it to work, the best thing you can do about side effects is to be patient. The most common side effects such as nausea, diarrhea, and other gastrointestinal distress, usually fade out in time. If they do not, there are ways we can help you to mitigate them. It is quite unusual in our practice to have to take a patient off of this medication due to side effects. The key is to discuss any side effects with your health provider, and we can work together to resolve them.
Maybe the reason semaglutide is not working is you are not taking a high enough dose – yet. Semaglutide is purposely “titrated,” meaning you are started out at the least effective dose, 0.25 mg injected once weekly for the first month so that your body is given a chance to get used to the medication. Then, over the next several weeks, we slowly build up to the maximum dose of 2.4 mg after about the 17th week. So, if it seems like semaglutide is not working, especially early on, it may not kick in till you reach your maximum dose.
There are some people who simply do not respond to GLP-1 medications. No drug is 100% effective. That does not prevent them from being approved. Every drug class has to work for a certain amount of people per set guidelines to be certified as “effective” in treating the given condition for which it is prescribed. For weight loss drugs like semaglutide, the guideline is if a patient loses more than 5% of their body weight within 3 months.
If it turns out you are a non-responder as close to 13% in the clinical trials were, you may need to try another weight loss medication or a custom compounded version of semaglutide.
There are several medical conditions that can affect how well semaglutide works for you. For example, people with type 2 diabetes do not respond as well to the drug as those who are non-diabetic. A 2022 study published in JAMA found that people with diabetes only lost about 7% of their body weight after 6 months on the injections, as opposed to those without diabetes who lost nearly 12% of their body weight in the same time period.
Sometimes, it’s not the condition itself but the medications used to treat them that can negatively impact semaglutide’s effectiveness. Drugs to treat hypertension and some emotional disorders, for example, have been found to slow down weight loss in patients using GLP-1 agonists.
If you have any of these conditions, it does not mean that you cannot and should not take semaglutide to lose weight, but you must keep in mind that it may not work as well for you as it might for someone who does not suffer from such ailments.
Another quite common reason for not losing weight on semaglutide is you are failing to follow our advice on diet, regular exercise, and other lifestyle changes. We cannot stress enough the role of exercise and physical activity in weight loss and maintenance. We have seen many patients who think semaglutide is some kind of magic drug that means once you are on it, you can just eat whatever you want, whenever you want. They also make the mistake of thinking they do not have to worry about working out either. We are afraid to tell you that semaglutide simply does not work that way for sustainable weight loss.
Maybe you could lose a few pounds if you take it weekly and do absolutely nothing else. But if you want to really achieve your weight loss goals, you must also make adjustments to your diet and physical activity.
One of the largest trials studying semaglutide found that the drug yielded the most effective weight loss results in participants who dropped their caloric intake by at least 500 calories daily and increased their physical activity to 150 minutes of moderate-intensity exercise (like walking) per week.
As we said earlier, in the clinical trials, patients continued to lose weight for up to 68 weeks, and there were those who continued to do so for two years and beyond. Semaglutide has been designed for long-term use. As long as you set reasonable goals, keep up a healthy lifestyle, and are not troubled by side effects, there is little research to suggest that you will reach a point where semaglutide stops working for you.
In fact, the opposite is true; if you have been effectively losing weight on this medication and you do choose to stop, there is a good chance that the weight you lost will come back. So, as long as it’s working for you, there is no reason to voluntarily stop using semaglutide.
If the idea of being on a drug as part of your weight loss journey for the rest of life seems daunting, just think of the alternatives and all of the health issues that being obese can bring. If your doctor told you that you need to take any other kind of medication indefinitely, but it would keep you alive, you would not say “no.” Of course not — you need to look at weight loss medication the same way.
Now that you know a lot more about why semaglutide stopped working or may not be working, why not Contact Us and find out more about this remarkable weight loss therapy?
