Why Am I Not Losing Weight on Ozempic?

November 29, 2023
Fact-checked by Dr. Avidon Appel

Ozempic, also known as semaglutide, is an effective weight loss treatment that can help patients lose weight and keep it off long-term, especially when combined with diet and exercise.

Weight loss is a challenging process that doctors continue to learn about. While the foundation of losing weight is burning more calories than you take in, many factors influence body composition.

The best way to successfully use Ozempic to lose weight is by understanding the drug and how it works. Learning about factors that inhibit weight loss while taking Ozempic will help you decide if the medication is the right option for you.

What is Ozempic and How Does it Work?

Ozempic is an FDA-approved type 2 diabetes medication that doctors prescribe off-label as a weight loss treatment. The drug is a glucagon-like peptide-1 (GLP-1) agonist. These medications mimic the effects of naturally produced hormones to support pancreatic function and help patients with diabetes control their blood sugar.

The medication also affects digestion, slowing how quickly the body breaks food down. This deceleration, which delays gastric emptying, leaves you feeling sated for longer. Feeling full depresses your appetite, thereby lowering the number of calories you consume. When you take in fewer calories, your body burns stored fat for energy, leading to weight loss. 

Ozempic also affects the area of the brain that influences appetite and cravings. This action further reduces appetite to help establish the caloric deficit needed for weight loss.

What Makes a Good Candidate for Ozempic?

Good candidates for semaglutide have body mass indexes (BMIs) above 27 and a weight-related condition, such as high cholesterol or hypertension, or a BMI above 30. Those with a history of pancreatic, renal, or gallbladder conditions may not be good candidates. Your doctor will ask about your medical history to rule out possible contraindications.

Patients with a family or personal history of medullary thyroid cancer or multiple endocrine neoplasia syndrome (MENS) type 2 cannot use Ozempic.

Why Aren’t You Losing Weight on Ozempic?

Genetics, lifestyle, and environment all influence body composition and weight loss. However, the underlying principle of weight loss is burning more calories than you consume. In many cases, patients who do not lose weight while taking Ozempic have not achieved the necessary caloric deficit.

One possibility is that a lack of physical activity is limiting how many calories you burn. Everyone has a base metabolic rate of calories their body burns at rest, but it’s vital to increase that number through regular exercise.

On the other hand, you may be consuming more calories than you burn, even if you are exercising often. While Ozempic suppresses appetite to reduce portion size, consuming high-caloric foods can counteract this reduction in meal size and frequency.

Some individuals’ biochemistry may make them less sensitive to the hormone-simulating effects of Ozempic, making the medication less likely to facilitate weight loss for them. In other cases, your dose may be too small to affect your body.

Hormone levels and thyroid function can also impact Ozempic's effect on your weight. This is why it's essential to disclose your complete medical history to your doctor during your weight loss consultation.

Non-compliance with your doctor’s instructions can also compromise the drug’s effectiveness. Taking the injection consistently with those instructions and at the same time each week is essential for weight loss. Proper dosing will optimize the level of the medication in your system.

Finally, some patients may skip or miss doses due to the extent or severity of their side effects, which can detract from its effectiveness. Be sure to discuss your response to the medication with your doctor so as to avoid such issues.

Is it Possible Not to Lose Weight on Ozempic?

Yes. While Ozempic is highly effective in most cases, differences in hormones, biochemistry, and underlying health can influence how patients respond to the medication. Some don’t experience much of a response at all.

The best way to use Ozempic is by participating in a medical weight loss program. When you enroll in one such program, your doctor will monitor your progress through follow-up exams and guide you through the weight-loss process by advising you on how to use Ozempic safely and effectively.

How to Maximize Weight Loss on Ozempic

Eat a Healthy Diet

Nutrition is critical for patients using Ozempic due to the medication's effect on digestion. A balanced diet featuring high-quality lean proteins, nutrient-rich fruits and vegetables, and complex carbohydrates is best. These foods deliver necessary vitamins and minerals while fueling muscle development.

Minimizing or eliminating processed foods, simple sugars, and high-fat foods will help broaden your caloric deficit and bolster your overall health.

Exercise Regularly

Routine exercise is vital for cardiovascular health and overall wellness. Following an exercise plan will increase the number of calories you burn per day and widen the caloric deficit that fuels weight loss.

Regular exercise also promotes muscle growth, which will raise your base metabolic rate and ensure you lose weight from fat instead of muscle.

Consult Your Doctor

Ozempic carries a chance of side effects, like all drugs. That said, doctors who prescribe it follow a tiered dosing plan designed to minimize the extent of the injections’ side effects and help the body adapt to them.

Talking to your doctor about your progress and side effects is essential to maximizing your weight loss. They can offer advice on side effect management, modify your dose if necessary, and share guidance on diet and exercise choices.


See results on your first visit.

90% of the time ED can be treated and treated effectively.


November 29, 2023

Written By
Dr. Avidon Appel

Fact-checked By
Dr. Avidon Appel

Editorial Process
Our Editorial Process


About Author

Dr. Avidon Appel is the founder of Iron Mountain Men’s Health. He is an Internal Medicine Specialist based in Willow Grove, PA who specializes in men’s sexual health and hormone optimization and has over 19 years of experience in the medical field. He is a graduate of Philadelphia College of Osteopathic Medicine, as well as Saint Joseph’s University.

Previous
Previous

Victoza vs. Ozempic

Next
Next

Ozempic and Alcohol