What to Do When Weight Loss Drugs Stop Working

Clinical trials have shown that patients taking weekly injections of weight loss medications, such as Ozempic, Wegovy, Zepbound, or other GLP-1 drugs, can achieve an average weight loss of 15% of their body weight.

However, not everyone taking these drugs will undergo such weight loss, and some may not experience any significant weight reduction at all. Some patients who take these medications may eventually reach a plateau, during which the body resists further weight loss despite continued efforts.

Why Does My Weight Loss Drug Stop Working?

When you maintain consistent dietary habits or exercise routines for a month without experiencing any weight loss, you have reached a weight loss plateau.

Hormonal Adaptation

Weight loss medications, such as Wegovy and Zepbound, work by mimicking GLP-1, a hormone found in the gut that regulates feelings of hunger and appetite. However, it's important to know that GLP-1 is one out of eight hormones responsible for controlling hunger and weight. Typically, within about a year, the remaining hormones will adjust accordingly, signaling the body to initiate changes to prevent further weight loss. Weight loss medications may become less effective over time as the body adapts to their effects. This adaptation can lead to less appetite-suppressing effects and a plateau in weight loss despite continued medication use.

The plateau effect can also be caused by your body's regulation of hunger hormones known as ghrelin. Ghrelin stimulates appetite and promotes food intake. When you initially start losing weight, your body may respond by increasing ghrelin production. This is a natural survival mechanism designed to prevent excessive weight loss and help maintain energy balance.

As you continue to lose weight, the increased levels of ghrelin signal to your brain that your body needs more food, leading to increased hunger and cravings. This can make it harder to adhere to your weight loss plan, may contribute to a plateau in weight loss, and you may even notice changes in how your body is responding.

Efficacy of Weight Loss Medications

In some clinical trials, over 13% of participants using Wegovy and 9% on Zepbound and Mounjaro were classified as "non-responders" to the medications. This means that they did not achieve a weight loss of 5% or more of their body weight within the first 3 months of treatment.

Long-Term Outcomes

A two-year study on obesity treatments with drugs like semaglutide (found in Wegovy and Ozempic) showed an average weight loss of 15%, which then plateaued over the following year. This indicates that while some patients, dubbed "super responders," see substantial weight loss, others may see less dramatic results.

Scientists are currently researching why certain patients can tolerate and respond to GLP-1s more effectively than others.

Continued Use and Weight Regain

Discontinuing GLP-1 therapy can lead to weight regain, about 1% of body weight per month, illustrating the drug’s effectiveness during use, even if weight loss plateaus.

Strategies to Consider When You Hit A Weight Loss Plateau

Adjusting Dosage

Sometimes, the effectiveness of a weight loss medication can be enhanced by adjusting its dosage. This might involve increasing the dose within safe limits or altering the frequency of administration. If your current regimen isn't yielding results, your doctor might suggest these changes.

Switching Medications

If you find that your progress has stalled with your current medication, your doctor may recommend switching to a different weight loss drug that operates differently. This strategy can sometimes reactivate weight loss if your body has adapted to the current medication.

Lifestyle Modifications

Weight loss medications are most effective when combined with lifestyle modifications. Despite the assistance these medications provide in managing hunger, they are not standalone solutions. Clinical trials often include dietary and exercise advice, underscoring the importance of these elements in overall weight management.

• Diet: Review and possibly overhaul your diet to ensure it aligns with your weight loss goals. Working with a registered dietitian or nutritionist can be particularly beneficial in optimizing your eating plan.
• Exercise: Enhancing your exercise regimen can boost calorie burn and improve overall fitness. Consider incorporating a variety of physical activities that you enjoy, as this can help maintain motivation and effectiveness.

Speak With Your Doctor

If you've hit a plateau in weight loss while taking any weight loss medication, the first step is to consult with your healthcare provider. They can evaluate your progress, assess whether adjustments to your medication regimen are necessary, and provide guidance based on your specific situation.