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Why am I not losing weight on Wegovy?

Medically reviewed by Kristianne Hannemann, PharmD. Last updated on Sep 8, 2025.

Official Answer by Drugs.com

Not losing weight on Wegovy can be frustrating, but it’s often due to a combination of factors such as needing time to reach the full effective dose, inconsistent use, lack of calorie reduction, or underlying medical or medication-related challenges. Most people see significant results after 12–16 weeks at the highest dose, and a poor response can have several common causes that should be discussed with a healthcare provider.

Below, we will discuss several reason why you might not be losing weight on Wegovy.

You Haven’t Reached the Full Dose Yet

Wegovy (semaglutide) is started at a low dose and is gradually increased over several months, typically from 0.25 mg up to the full 2.4 mg per week over 16–20 weeks. Initial doses are primarily for minimizing side effects, and meaningful weight loss usually begins once the full dose is reached, not in the earliest weeks.

You’re Not Using It Consistently

Missing or delaying injections can reduce Wegovy’s effectiveness. Adherence can be impacted by side effects, changes in schedule, or insurance issues, all of which may lead to inadequate medication exposure and reduced weight loss.

You’re Not in a Calorie Deficit

While Wegovy helps suppress appetite, this does not guarantee weight loss unless calorie intake is reduced. Weight loss still depends on maintaining a consistent calorie deficit, and poor dietary choices can blunt the medication’s benefits.

You’ve Hit a Weight Loss Plateau

It's common for weight loss to slow down or temporarily stop after initial progress, due to the body adapting metabolically. This plateau is normal and can often be overcome by reviewing diet and activity patterns or adjusting strategies with professional guidance.

You Have a Medical Condition Affecting Weight

Certain health conditions like hypothyroidism, PCOS, Cushing’s syndrome, or insulin resistance can make weight loss more difficult. Getting lab tests and consulting a healthcare provider can help identify and manage these factors.

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You’re Taking Medications That Cause Weight Gain

Some drugs, including antidepressants, antipsychotics, steroids, and beta blockers, are known to cause weight gain as a side effect. Reviewing all current medications with a doctor is recommended if weight isn’t budging.

You May Not Respond to Wegovy

A small percentage of individuals may not respond to GLP-1 therapies like Wegovy. A small cohort study showed that total body weight loss percentages in people with overweight or obesity were around 6% at 3 months and 11% at 6 months with semaglutide treatment. If less than 5% of body weight is lost after 16 weeks at the full 2.4 mg dose, discuss reasons why you might not be responding as well to Wegovy. Your healthcare provider can discuss strategies, including alternative medications such as Zepbound (tirzepatide) or Saxenda (liraglutide).

What to Do Next

If Wegovy isn’t working as expected, consult a healthcare provider to review dosing, adherence, possible health conditions, and medication side effects. They may suggest lab tests, discuss alternatives, or help troubleshoot barriers to weight loss. Personalized advice is key to overcoming plateaus and achieving healthy weight goals.

This is not all the information you need to know about Wegovy for safe and effective use and does not take the place of your doctor’s directions. Review the full patient medication guide and discuss this information and any questions you have with your doctor or other health care provider.

References
  1. Ghusn W, De la Rosa A, Sacoto D, et al. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Netw Open. 2022;5(9):e2231982. DOI: https://www.doi.org/10.1001/jamanetworkopen.2022.31982
  2. Wegovy [package insert]. Updated August 2025. Novo Nordisk. Accessed on September 8, 2025 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b

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