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Ozempic Plateau: Did Your Weight Loss Drug Stop Working?

Ozempic Plateau is an expected phenomenon. You can not lose weight indefinitely. Your body tries to adapt to the new situations.

A person who has accumulated extra fat can lose weight by restricting his diet and following an exercise routine. Or, once you reach a plateau and you don’t lose weight, you can take weight loss pills such as Qsymia, Contrave, and Xenical.

With all these weight loss pills, you can lose another 5% to 10% of your body weight. But again you reach a plateau and no matter how hard you try, you may not lose more weight.

With GLP-1 medications such as Saxenda (or Victoza) and Semaglutide (Ozempic, Wegovy, and Rybelsus) or with Mounjaro (Tirzepatide), you may lose 15% to 21% of your body weight.

However, some people reach their plateau weight earlier than others. This means, that depending on your body’s response to these medications, you may lose as little as 5% of your body weight. You may not lose even a single pound, or you may lose up to one-fourth of your body weight.

Once you reach the Ozempic Plateau or your weight remains constant or you start regaining weight, you may be left with only one option, bariatric surgery (Gastric Sleeve or Gastric Bypass).

People who have had gastric sleeve or gastric bypass lost significant weight within the first 6 months to two years.

After 2 to 10 years, half of the patients regained weight while some continued to have a slow weight loss, others reached their optimal weight plateau.

ozempic plateau
The Ozempic Plateau: Body weight remains static or patients start gaining weight despite increasing the Ozempic dose



Ozempic Plateau: People who may not lose the weight they desire with Semaglutide or Mounjaro:

If you have lost significant weight and reached the Ozempic plateau, that is good for you as you haven’t wasted your money and time.

However, some people may reach their weight loss plateau earlier than expected. After losing only a pound or so, people stop losing weight. For them, it’s very frustrating.

Our doctors at ‘Dibesity Clinic” have been prescribing Ozempic (Semaglutide) for diabetes and weight loss over the last 2 years or so. 

We have identified high-risk groups who may not lose significant weight with GLP-1 including Ozempic and Mounjaro. These include:

  • Individuals who have genetic obesity and metabolic syndrome:

Genetic obesity and metabolic syndrome are interrelated. However,  not all obese individuals have metabolic syndrome, and not all individuals with metabolic syndrome are overweight.

However, those who are obese and have metabolic syndrome are usually those who have multiple medical conditions such as high cholesterol and hypertension.

It is not clear if Ozempic or other GLP-1 can influence body weight at the genetic level or not. It was thought initially that Ozempic may lower the “set point” and patients may not regain the weight.

As experience with Ozempic and other GLP-1 increased, it was seen that this was not the case. Ozempic probably does not lower the “setpoint” and patients will regain weight when they stop ozempic.

In our experience, people with genetic obesity and those with metabolic syndrome are hard to treat. They rapidly achieve the Ozempic plateau and rapidly regain their lost weight.

  • Individuals who are not keen to follow a low-calorie diet or exercise:

When planning to lose weight, one of the basic rules is to follow a low-calorie diet and exercise regularly.

Following a simple rule of a 500-calorie deficit diet, one can easily lose one pound weekly. Similarly, you can lose one pound weekly if you walk 10,000 steps daily.

When you start Ozempic treatment (or any other GLP-1), you will not feel like eating. You will feel full and may have gastrointestinal side effects too.

Thus, your calorie intake is markedly reduced. However, some individuals get used to Ozempic really fast and hence start eating better again.

Thus, they reach their weight plateau very early during the treatment phase. For such patients, Ozempic and Mounjaro meal plans with calculated calories are the best.

  • Individuals who have underlying hormonal disorders such as hypothyroidism:

Acromegaly, Hypothyroidism, and Polycystic ovarian syndrome are some of the common hormonal problems associated with weight gain.

Ozempic may help these patients lose some pounds, however, as long as the underlying hormonal problems are not corrected, weight loss may only become a dream.

Hypothyroidism requires treatment with levothyroxine. Acromegaly is treated with pituitary surgery, somatostatin analogs, or growth hormone receptor inhibitors.

There is no definite treatment for PCOS. Weight loss can correct hormonal imbalances in women with PCOS 50% of the time.

However, some individuals, despite taking thyroxine, do not lose significant weight with Ozmepic. They achieve the Ozempic Plateau earlier during their treatment.

Similarly, women with PCOS respond slowly to Ozempic. They reach the Ozempic Plateau earlier during their treatment.

  • People on multiple medications:

Individuals who are taking multiple medications may develop weight gain either as a side effect of those medicines or may not be able to tolerate Ozempic at all.

Insulin, antidepressants, sleep medications, gabapentin and pregabalin, and hormonal contraceptives are all commonly used medications that may cause weight gain or may not let you lose weight while using Ozempic.

Such patients reach the Ozempic Plateau earlier during their treatment period.

  • Individuals who develop severe side effects:

Lastly, people who do not tolerate Ozempic, may not be able to inject higher doses. Hence, they may not achieve significant weight loss using Ozempic.

For such individuals, the dose may be more slowly titrated upwards than recommended.

weight regain after stopping mounjaro zepbound Ozempic Plateau: Not Losing Weight
Ozempic Plateau: Not Losing Weight



What to do to delay the Ozempic Plateau Phase?

If you are one of those who have reached the Ozempic Plateau Phase earlier during the treatment period, you may need to first look into the factors that may not be letting you lose weight.

Important factors, as discussed above, are:

  • Lack of exercise
  • Not following a low-calorie Ozempic meal plan
  • Have hormonal problems
  • Using medications that cause weight gain, and
  • not tolerating Ozempic

If you have corrected the above issues but are still not losing weight, check if you are injecting Ozempic correctly.

Also, there are counterfeit Ozempic injections in the market, check if you are using the counterfeit injections.

If your injection technique is good and you are not using counterfeit Ozempic injections but not losing weight, you may try adding another FDA-approved weight loss drug to your current weight loss regimen.

Weight loss drugs which are considered acceptable and can be used in combination with Ozempic include:

  • Ozempic + Topiramate
  • Ozempic + Contrave
  • Ozempic + Qsymia
  • Ozempic + Xenical
  • Ozempic + Jardiance
  • Ozempic + Farxiga

Lastly, if you are regaining weight and you are considering quitting Ozempic or Mounjaro injections (or other weight loss medicines), it is best to slowly taper them rather than abruptly stop them.

This is especially important for obese diabetic individuals who may develop rebound hyperglycemia.

One approach in such situations is to titrate the dose downwards similar to when you were titrating the dose up.

Another approach is to increase the interval between the two injections from weekly to every second week.


In conclusion:

Ozempic plateau is a state when your body stops responding to Ozempic. You may not lose more weight despite increasing the dose. In fact, some people may start regaining weight.

Always look into the reasons why your body is not responding. Consult your doctor. Your doctor may prescribe another weight loss pill or may change your depression tablets.

Continue exercise and follow a low-calorie weight loss meal plan even if you are not losing weight. Believe me you will feel more energetic even if you are overweight.

What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

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