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6 Reasons Why Ozempic May NOT be Working For You?

Ozempic not working

Ozempic (Semaglutide) is one of the blockbuster medicines in the management of Diabetes and Obesity. However, for some of us, Ozempic may not be working up to our expectations.

After its approval in 2020 but the FDA, Novo Novartis, the manufacturer, claims that it is one of the strongest antidiabetic drugs and the best among all the weight loss drugs.

Most guidelines now consider it as a first-line drug along with metformin in the treatment of diabetes mellitus type 2.

Having said that, some people will not get the desired results no matter how hard they try. Why do some people get the best results while others struggle to control their diabetes, lower their A1C and starve to lose a single pound?

It is also not explainable why some people have to wait for months to get some benefits while others lose more than 10 pounds in one week.



Ozempic Not Working For Me?

For those who achieved their A1C targets and desired weight loss targets, Awesome! You have spent your money wisely.

For those who believe they have wasted several weeks or months trying another Big Pharma product, there might be some questions you need to ask yourself about why Ozempic is not yielding the expected results for you.

  1. You were not the right candidate for Ozempic!

  2. You Relied on Ozempic

  3. Ozempic effects were blunted by the other medicines

  4. Wrong injection technique

  5. It’s too early

  6. The Ozempic dose is not sufficient



Ozempic Not Working for You Because You Are NOT the Right Candidate:

If you are young, feeling active and healthy, and a little chubby, avoid medications! Medicines are for people who are sick.

Ozempic is only recommended for the following people [Ref]:

  • People with diabetes who are already on a low-calorie diet and exercise and still have their blood glucose out of the normal ranges
  • People with diabetes who have heart diseases to reduce their risk of subsequent cardiac and cerebrovascular events

When used primarily for weight loss, Semaglutide is indicated only if [Ref]:

  • Your BMI (body mass index) exceeds 30 kg/m², or
  • Your BMI exceeds 27 kg/m² in the presence of other obesity-associated medical conditions such as diabetes, hypertension, and high blood lipid levels.

You are not a candidate for Ozempic, if:

  • You have Type 1 diabetes mellitus
  • If you have contraindications to its use such as a history of medullary thyroid cancer (including a family history of MTC)
  • You are allergic to Ozempic
  • You have pancreatitis, especially recurrent pancreatitis
  • Worsening vision due to diabetic retinopathy
  • Advanced kidney disease

Apart from the above contraindications, if you are thinking about starting a weight loss medicine without first improving your diet or going out for a workout, you are going to get more side effects and fewer positive results.

“Weight loss” should not be the goal, a “Healthy weight loss” should be the goal. For a “healthy weight loss”, you need to reduce your calories first. Avoid junk, carbs, and carbonated drinks, and try to take a balanced and healthy diet.

Start going out for a workout. It is best to exercise for at least 30 minutes daily.

You can start Ozempic if you have diabetes or obesity and despite a low-calorie diet and exercise, you are not losing weight and have high blood glucose levels and A1C off the targets.



Ozempic Not Working for You Because You Relied Totally on Ozempic: What else should you do?

The first and most important step in treating diabetes or obesity is lifestyle intervention. If you are eating a lot and especially have cravings for foods with a high glycemic index, eating lots of carbs, fast foods, and liquid beverages, you are just wasting your money on Ozempic.

If you love fast foods, you should select the ones with the least amount of calories.

Likewise, you need to start a workout, go to a gym, or for a Hike, or else you are not going to achieve much with Ozempic.

You can combine intermittent fasting but I am not a Pro-Keto fan especially when you are on Ozmepic. The Keto diet may increase your bloating, fullness, and other Ozempic-related side effects.



Ozempic Not Working for You Because Your Medical Conditions and Medications are a Barrier to Your Weight Loss and Diabetes Control:

Obesity is linked with multiple disorders. All of us know about diabetes. But diabetes is not the only condition that is associated with obesity.

Another most common condition is “Depression“. Depression is more common than diabetes.

Other conditions linked with obesity are:

  • Metabolic syndrome:

    • It is a constellation of symptoms that include diabetes, hypertension, obesity, and hyperlipidemia.
  • Insulin resistance:

    • Insulin resistance can manifest as diabetes. It can also manifest as skin conditions like acanthosis nigricans (hyperpigmented skin), PCOS (polycystic ovarian syndrome), and others.
  • Hypothyroidism:

    • Another endocrine disease that makes you gain weight despite very low-calorie intake. It slows your metabolism.
  • Genetic disorders:

    • These medical conditions can make you gain weight no matter what you do. Children with extreme obesity usually have one of these genetic disorders:
      • Prader Willi Syndrome
      • Lawrence Moon Bardet-Beidel Syndrome
      • Turner syndrome
      • Others

In addition, not only do these medical conditions make you gain weight, but some of the drugs that are used to treat these conditions also make you fat.

Important Medications that make you fat include:

Medical Conditions


Diabetes MellitusInsulin

  • Gliclazide,
  • Glipizide
  • Glimepiride, and
  • Glyburide

  • Repaglinide and
  • Nateglinide

  • Pioglitazone
  • Rosiglitaozne
DepressionExcept for Bupropion (Wellbutrin) and Fluoxetine (Prozac), all antidepressants cause weight gain.

Paroxetine is associated with much more weight gain compared to other antidepressants.

Other mental disorders (Psychosis, Schizophrenia, etc)
  • Olanzapine (Zyprexa)
  • Clozapine (Clozaril)
  • Quetiapine (Seroquel)
  • Aripiprazole (Abilify)
  • Risperidone (Risperdal)
  • Ziprasidone (Geodon)
  • Pimozide (Orap)
  • Valproic acid (Epival)

Among all the antipsychotics, Olanzapine and Clozapine are associated with much more weight gain than the others

HormonesCorticosteroids cause significant weight gain. The weight gain is usually disproportionate with more weight gain in the torso and very less in the limbs (lemon on a matchstick appearance)

Oral contraceptive pills are also associated with significant weight gain and water retention

Antithyroid drugs like propylthiouracil and carbimazole

Growth hormones (Norditropin and Humatropin) also cause significant weight gain

Cardiac medicinesBeta-blockers (Metoprolol and Atenolol) cause weight gain (about 2 – 3 pounds)
Pain medicationsNSAIDs cause fluid retention

Opioids like methadone have been linked with weight gain because of an increased appetite.

Asthma medicationsCorticosteroids can cause weight gain.

Inhalers are rarely associated with weight gain, especially when used very frequently and in very high doses.

Dupixent (Dupilumab) has also been linked in post-marketing reports with weight gain and diabetes.

Chemotherapy and cancer drugsAlthough one of the cardinal symptoms of cancer is weight loss, some cancer drugs can cause weight gain.

Important in this category are hormones that treat breast cancer, cisplatin, and docetaxel

If you are on any of the above medications or have any medical condition that is linked with obesity and weight gain, you are going to poorly respond to Ozempic treatment.

You may still be doing much better than those patients who have similar medical problems as yours and are not using Ozempic. However, compared to the general population, you may feel like you are not losing weight.

For example. If you are on Olanzapine or paroxetine plus Ozempic and not gaining weight, you are still doing great.

Some of the genetic disorders associated with binge-eating disorders may also respond very well to Ozempic as it suppresses your satiety and the craving to eat more.

In conclusion, if you think Ozempic is not working, always check your medications and associated medical conditions that may be a hindrance to your weight loss journey.



Ozempic Not Working? Know How to Inject Semaglutide (Ozempic):

Some of the factors that can be associated with a loss of Ozempic efficacy are:

  • Injecting Ozempic at the wrong site:

    • The recommended sites for Ozempic injections are the stomach (Tummy) slightly away from the navel, front or sides of the mid-thighs, and the upper arms.
    • Injecting elsewhere may be associated with erratic absorption and Ozempic may not be working properly.
  • Injecting an inadequate dose:

    • The usual maintenance dose for diabetes is 0.5 mg, 1 mg, or 2 mg maximum which is administered once a week.
    • The recommended maintenance dose of Semaglutide for weight loss is 2.4 mg once weekly.
  • Frequent missed doses:

    • If you are missing doses frequently, you may not achieve the results you expect.
  • Other injection issues such as improper storage, handling, and heating issues:

    • Ozempic should be stored in a refrigerator at 2C to 8C (36F to 46F). It can be kept at room temperature (15C to 30C) for a maximum of 56 days.
    • After 56 days, the injection should be discarded. Six weeks or at most 56 days is the maximum shelf-life of Ozempic injection. It is not recommended to use it after 56 days.
    • In addition, before injecting Ozempic keep it at room temperature for about 30 minutes. Do not heat it with an external device or a microwave. Do not keep it in hot water.
    • All these steps should be followed for Ozempic to work efficiently.


Ozempic Not Working Because It’s Too Early. How Long Does It Take For Ozempic To Work?

It depends on your blood glucose levels and baseline weight, motivation, exercise, and compliance with the diet.

It may take about a week or two to kick in. In some patients and may take up to three months. The maximum time after which you may be thinking of switching to Victoza or Saxenda, or another drug is three months.

During these three months, you should increase your dose by 0.25 mg at monthly intervals (after four doses) until the maximum effective and tolerable dose.

I have written a detailed article on “How long does it take to lose weight on Ozempic“. In this article, I collected data from real-life users of Ozempic and studied the time after which they started responding to Ozempic.


Don’t Lose Hope! Continue Ozempic for a minimum of three months. Increase your dose gradually until you reach the maximum dose or you develop significant intolerable side effects.



What is the right dose of Ozempic for Weight Loss and Diabetes?

The dose of Ozempic to treat Diabetes vs obesity is different. If you are on a low dose that is used to treat diabetes you may not lose significant weight.

What is the dose that is used to treat diabetes vs obesity is covered in the article: Ozempic Dosing for Weight Loss and Diabetes Mellitus.

ozempic dosing for weight loss and diabetes
Ozempic and Wegovy dosing for weight loss and diabetes

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

Here is a link to My Facebook Page. You can also contact me by email at or at My Twitter Account
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