Why am I not losing weight on Zepbound?
If weight loss isn’t happening on Zepbound, several common factors may be affecting progress. These include medication timing, dosing, lifestyle choices, side effects, health conditions, or financial barriers.
In this article, we will review reasons you may not be losing weight while taking Zepbound (tirzepatide) and what to do about it.
Zepbound Takes Time to Work
Zepbound (tirzepatide) is an FDA-approved injectable medication for weight loss. In major clinical trials such as the SURMOUNT-1 study:
- Aaverage weight loss was about 5%–8% at 12 weeks
- 16%–22% at 72 weeks
Because the dose is increased slowly and the body needs time to respond, noticeable changes usually begin after several weeks or months. Not seeing immediate results does not mean the medication isn’t effective.
You May Not Be on a Therapeutic Dose Yet
Zepbound treatment starts with a low dose (2.5 mg weekly) that is increased slowly over several months, reaching a maximum of 15 mg. Significant weight loss often occurs only after hitting the therapeutic dose, so the early weeks are typically for tolerability rather than rapid results. For many patients, it may take up to three to five months before reaching the optimal dose where real weight loss begins.
Diet and Physical Activity Still Matter
Zepbound works best when combined with a reduced-calorie diet and increased physical activity. Clinical guidelines generally suggest 1,200–1,500 calories/day for women and 1,500–1,800 calories/day for men, though individual needs may vary. Tracking food intake and exercise with digital tools helps improve adherence and accountability, reinforcing the medication’s effects.
Side Effects May Limit Adherence or Dose Escalation
Gastrointestinal side effects, such as nausea, vomiting, and diarrhea, are common with Zepbound, especially during the beginning of treatment. This can sometimes lead to missed doses or slower titration.
These side effects are often manageable and may diminish over time, but it’s important to communicate with a healthcare provider and follow individualized recommendations to maintain progress. Contact your prescriber if side effects are interfering with your ability to take Zepbound regularly.
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Other Health Conditions or Medications Could Affect Weight Loss
Medical conditions like hypothyroidism, polycystic ovary syndrome (PCOS), or use of certain medications (e.g., antidepressants, insulin, beta-blockers) can slow weight loss even when using Zepbound. It’s important to review these possibilities with a provider, who can tailor treatment based on comorbidities and potential drug interactions.
Financial or Insurance Barriers May Interrupt Treatment
Cost and insurance coverage can make it difficult to maintain consistent access to Zepbound. Missed doses due to financial or logistical issues can limit therapeutic benefit. Checking insurance options and exploring manufacturer savings programs, such as those offered by Eli Lilly, may help sustain treatment.
When to Talk to a Doctor
Contact your healthcare provider if:
- No weight change is seen after 12–16 weeks on the maximum therapeutic dose
- Side effects are severe or if adherence becomes challenging
- You are having trouble paying for treatment
Your healthcare team can help you with options for adjusting treatment and managing side effects.
This is not all the information you need to know about Zepbound 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
- Drugs.com. (2025, January 21). How much weight can I lose on Zepbound? Drugs.com. https://www.drugs.com/medical-answers/how-weight-lose-zepbound-3575539/
- National Heart, Lung, and Blood Institute. (n.d.). Healthy eating plan. https://www.nhlbi.nih.gov/health/educational/lose_wt/eat/calories.htm
- Zepbound [package insert]. Updated July 2025. Eli Lilly and Company. Accessed on September 09, 2025 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
Read next
How much is Zepbound with or without insurance?
Zepbound may cost $25 if you have insurance, or without insurance, Zepbound can cost $349 for a 2.5mg vial and $499 for a 5mg vial
Continue reading
How long does it take for Zepbound to work?
Many people lose weight during the first 4 weeks of taking Zepbound (tirzepatide). How quickly you lose weight depends on various factors, including your starting weight, the dose you’re taking, diet, and physical activity level.
Continue reading
Can you get tirzepatide from a compounding pharmacy?
Tirzepatide cannot be legally compounded in a U.S. pharmacy at this time. It has been removed from the FDA drug shortage list as of October 2, 2024. When drugs are in short supply, the FDA may allow temporary compounding of some medicines to allow patients to continue to access their treatments. Tirzepatide is now widely available as a prescription medicine made by Eli Lilly under the brands names Mounjaro (for type 2 diabetes) and Zepbound (for weight loss and sleep apnea).
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Drug information
- Zepbound Information for Consumers
- Zepbound prescribing info & package insert (for Health Professionals)
- Side Effects of Zepbound (detailed)
- Zepbound user reviews (434)
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