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Why am I not losing weight on Ozempic

Robbie Puddick
Written by

Robbie Puddick

Medically reviewed by

Fiona Moncrieff

5 min read
Last updated June 2024
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Jump to: How do you maximise weight loss on Ozempic? | 1 – You’re not in a calorie deficit | 2 – You’re in a weight-loss plateau | 3 – Your current dose isn’t high enough to promote lower hunger | Take home message

The main reasons you’re not losing weight on Ozempic might be that you’re not eating in a calorie deficit, you’ve hit a weight-loss plateau, or the current dose that you’re on isn’t high enough to lower your hunger to the point where you’re eating less.

Other factors may also contribute to this, such as other medications or health conditions impacting our ability to lose weight.

Not everyone responds the same way to semaglutide (the drug in Ozempic). A randomised controlled trial involving over 1,900 people living with obesity showed that 7% of participants discontinued their medication due to adverse events and side effects.

Ozempic is a powerful medication that significantly impacts the gastrointestinal tract and directly communicates with the appetite centre in the brain, the hypothalamus.

Unfortunately, these effects will result in negative responses for some people that aren’t tolerable to enable them to continue leading fulfilling lives.

Additionally, 86.4% of individuals in this study lost at least 5% of their body weight, an impressive amount. Still, that means 13.6% of participants lost less than 5%.

A weight loss intervention is typically considered successful if participants achieve more than 5-10% of weight loss. So, for some people, Ozempic doesn’t lead to clinically meaningful weight loss.

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How do you maximise the results of Ozempic?

To maximise the results of Ozempic, it’s essential to make positive changes to our diet and lifestyle.

Ozempic is only approved for type 2 diabetes in the UK but can be used for weight loss alongside lifestyle changes in the U.S.

There’s no evidence that Ozempic and other GLP-1 medications like Wegovy or Mounjaro can work sustainably in the long term without us also eating a healthy diet, getting active, and improving our emotional health.

At Second Nature, we’ve launched Wegovy and Mounjaro-supported programmes that combine our clinically proven weight-loss programme with weight-loss injections to maximise the results.

Wegovy and Mounjaro will help to kickstart your weight loss by lowering hunger and cravings. Our programme will then support you in developing healthy habits so you keep the weight off in the long term.

Ozempic isn’t available in the UK for weight loss and is only available for people living with type 2 diabetes, so Second Nature doesn’t provide Ozempic as an option on our weight-loss programmes.

Now, keep reading as we dig deeper into the three reasons you’re not losing weight on Ozempic.

1) You’re not in a calorie deficit

The evidence is clear: we must eat within a calorie deficit to lose excess body fat. When we eat below our energy balance, our body has to find the energy required to fuel our body’s primary functions by burning excess fat.

Ozempic works by interacting with the brain’s appetite control centre, the hypothalamus, to lower hunger and food-seeking behaviours.

Research suggests that semaglutide can reduce our energy intake by around 40% compared to individuals not taking semaglutide.

However, we eat for more reasons than physical hunger, and some people might continue to eat enough food that prevents them from achieving a calorie deficit due to psychological, environmental, or habitual reasons.

Additionally, suppose our baseline diet was rich in ultra-processed foods and refined sugars, and we continue to eat this way whilst on Ozempic. In that case, we may still eat more calories than we need to lose weight.

So, it’s essential we transition to a diet based on whole foods to maximise the results of Ozempic.

Head to our NHS-trusted meal plan for a free diet plan to help kickstart your weight-loss journey.

Key points:

  • We need to eat in a calorie deficit to lose weight
  • If our baseline diet is rich in ultra-processed foods and we continue to eat this way on Ozempic, we may still consume more calories than we need to lose weight
  • It’s essential to eat a diet based on whole foods to support sustainable weight loss

2) You’re in a weight-loss plateau

Suppose we’ve lost some weight on Ozempic, but then we hit a plateau, and we can’t budge the scales any more. In this case, we’re likely in a weight-loss plateau.

Weight-loss plateaus are extremely common, normal, and a necessary part of the weight-loss process. Being on Ozempic doesn’t prevent us from experiencing weight-loss plateaus.

We have a full guide explaining weight-loss plateaus. However, as a quick summary:

  • Our brain receives signals from many hormones, letting it know how much energy we’re eating and how much fat we have stored. We call this the brain’s ‘set point’.
  • Weight-loss plateaus occur when our brain senses that we’re consuming fewer calories than normal and our fat stores are decreasing it ‘slows down’ our metabolism
  • Evolutionarily, we’re wired to protect fat to ensure survival
  • So, weight-loss plateaus are a survival mechanism in the brain to try and protect us from starvation
  • Fortunately, we can gradually lower our brain’s set point by continuing to lead a healthy lifestyle and being consistent in our habits

Key points:

  • Weight-loss plateaus are a necessary and normal part of the weight-loss process. Ozempic doesn’t prevent weight-loss plateaus from occurring.
  • Weight-loss plateaus occur when our brain senses we’re losing fat and eating less, so it slows down our metabolism to protect our remaining fat stores
  • We can overcome weight-loss plateaus by being consistent with our healthy habits

3) Your current dose isn’t high enough to promote lower hunger

Ozempic reduces appetite and hunger, helping you eat fewer calories; this effect is almost immediate when you start Ozempic.

However, you might notice the effect of lower hunger wearing off after 4-5 days post-injection in the first month of taking Ozempic.

It can take 4-5 weeks for Ozempic to reach a level in the body we call a steady state. A steady state is when the drug’s levels in the body remain consistent rather than spiking and falling.

Interestingly, this initial weight loss is no different to other weight loss treatments or the impact of diet interventions on weight loss. The real effect of Ozempic is seen beyond three months.

Ozempic is a long-acting medication that’s started at a lower dose to reduce the number and severity of side effects as it’s built up to a higher maintenance dose.

Additionally, we might find that our body adapts to the lower doses, and hunger can increase. However, we might find this reverses when we move up a dose.

Key points:

  • The lower doses of Mounjaro can wear off after 4-5 days
  • It can take up to 4-5 weeks for the medication to reach a ‘steady state’ where its levels are consistent in the blood
  • Weight loss may be steady at the beginning but become more consistent as you increase your dose

Take home message

As we’ve covered in this article, there are many reasons why you might not be losing weight on Ozempic. For many of us, there’s likely a way of maximising our results on Ozempic to kickstart our weight loss.

However, a small percentage (~10-20%) of individuals are unlikely to respond well to the medication for various reasons.

If you’re currently on Ozempic and are unsure why the medication isn’t having the desired effect, we’d recommend speaking with your doctor or local healthcare team.

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