Wondering why semaglutide isn’t working for you?
Semaglutide has helped many people lose weight. But not everyone sees results right away. If you’re feeling stuck, frustrated, or wondering what’s going on, you’re not alone.
There are real reasons why the scale might not be moving yet. In this guide, we’ll walk through what might be slowing things down and how you can start seeing progress again, with the right support and strategy.
What Is Semaglutide?
Semaglutide was first created to help people manage type 2 diabetes. Today, it’s also FDA-approved for weight loss under the brand name Wegovy, while Ozempic and Rybelsus are approved for treating type 2 diabetes but are sometimes prescribed off-label for weight management.
It works by mimicking a hormone in your body called GLP-1. This hormone plays a big role in regulating appetite, digestion, and blood sugar. By acting like GLP-1, semaglutide helps you feel full sooner, stay full longer, and reduce how much you eat throughout the day.
One of the ways it supports weight loss is by slowing down digestion. Delays in digestion can make a big difference in helping you cut back on calories naturally without feeling deprived.
You can explore more about how semaglutide is used for weight management and type 2 diabetes in the FDA’s official safety guide for semaglutide-based medications.
The FDA has also approved the first oral GLP-1 treatment, giving patients more options for how they use this type of medication.
How Does Semaglutide Work for Weight Loss?
Semaglutide helps you lose weight by working with your body’s natural hunger signals. It:
- makes you feel full sooner
- keeps you satisfied longer
- helps curb cravings that often lead to overeating
It also improves how your body uses insulin, which supports better blood sugar balance and can make it easier to burn fat instead of storing it.At the heart of it all is a hormone called GLP-1. Semaglutide mimics this hormone to regulate appetite in the brain’s hunger center. The role of GLP-1 in appetite control helps explain why semaglutide is so effective in reducing food intake and supporting long-term weight loss.
Why Am I Not Losing Weight on Semaglutide? 9 Common Reasons
1. Your dose may be too low
In the beginning, semaglutide is typically prescribed at a lower dose to help your body adjust and reduce side effects. This slow and steady approach is important, but it also means you might not see much weight loss early on.
In fact, research shows that people on lower doses may not lose weight at all. Some even gain weight in the early stages.
Over time, increasing the dose under medical guidance is what usually leads to meaningful results. According to clinical data on semaglutide dosing and weight trends, around 25 percent of patients on lower doses experienced weight gain, while higher doses were linked to greater weight loss.
2. You’re not pairing it with lifestyle changes
Semaglutide can definitely help reduce hunger, but it’s not meant to do all the work on its own. For most people, it works best as part of a bigger plan, which includes:
- eating balanced meals
- moving your body
- creating steady, sustainable habits
Research shows that semaglutide was most effective when combined with healthy lifestyle changes. When the medication is used alongside real behavior change, the results are not only stronger, they’re more likely to last.
3. Your physical activity level is low
Semaglutide helps reduce appetite, but movement is what allows your body to use energy more efficiently. If you’re not moving much throughout the week, that could be slowing your progress.
Regular movement doesn’t have to mean hours at the gym. Even simple things like walking, swimming, or dancing count. It all adds up.
In fact, exercise improves metabolic health and supports the effectiveness of medications like semaglutide.
The American Heart Association recommends at least 150 minutes of moderate activity or 75 minutes of vigorous activity each week. Building that into your routine can make a big difference in how your body responds.
4. Poor sleep habits
If you’re not sleeping well, your body has a harder time staying in balance. Hunger hormones like ghrelin and leptin can get thrown off, your metabolism may slow down, and you might find yourself craving high-sugar or high-carb foods.
Even with medication, these shifts can make it harder to see progress.
Research shows that sleep deprivation affects hunger hormones and slows metabolism, which may prevent weight loss even with semaglutide. Getting consistent, quality rest is one of the most underrated tools in any weight loss plan.
5. Chronic stress is getting in the way
Even if you’re eating well and staying active, stress can work against your progress. When your body is under pressure, it releases more cortisol, a hormone that can increase fat storage and trigger emotional eating.
There’s a strong connection between obesity and chronic stress, especially when that stress goes unmanaged for long periods of time.
It also helps explain why stress often leads to overeating, even when you’re doing everything else right. Finding ways to manage your mental load is just as important as managing your meals.
6. You may have an undiagnosed medical condition
Sometimes the issue isn’t your effort. It’s something happening under the surface. Conditions like hypothyroidism can slow down your metabolism, making it harder to lose weight even with the support of semaglutide.
If you’re doing all the right things but not seeing results, it might be time to run some lab work and rule out anything that could be interfering with your progress.
7. You’re comparing yourself to others
It’s easy to scroll through social media or hear stories from friends and start wondering why your progress doesn’t look the same. However, weight loss timelines are different for everyone.
In reality, people taking 1.0 mg of semaglutide lost around 13 pounds over 56 weeks. That’s over a year, not a few weeks.
Comparing your journey to someone else’s can add pressure that isn’t helpful. The most important thing is staying consistent and working at a pace that’s right for your body.
8. You’re experiencing a plateau
Weight loss rarely follows a straight line. It’s completely normal to hit a stretch where the scale doesn’t move, even if you’re doing everything right.
Plateaus are part of the process. They don’t mean the medication has stopped working. In fact, your body might just be adjusting to a new set point before continuing to lose.
This is a good time to check in with your provider, review your habits, and stay patient. Progress often picks back up with a few small adjustments.
9. You have diabetes or insulin resistance
Semaglutide is effective for people with and without diabetes, but the outcomes can look different.
On average, those without diabetes tend to lose more weight, possibly because their bodies respond differently to the medication’s effects on insulin and glucose.
That doesn’t mean it won’t work for you. It might take a little longer or require a more personalized approach. The same pattern was seen in the clinical review comparing weight loss in diabetic and non-diabetic patients, which showed consistent benefits for both groups, even if the results varied.
How to Maximize Weight Loss on Semaglutide
If you’re not seeing the results you hoped for, a few small shifts can make a big difference. Here’s how to help semaglutide work even better for your body and your goals:
- Stick to your injection schedule and follow your provider’s dose adjustments. Consistency matters.
- Choose whole, nutrient-rich meals with a focus on fiber, lean protein, and healthy fats. These foods help you feel full and energized.
- Keep your body moving in ways that feel good to you. Walking, stretching, strength training, dancing, it all counts.
- Prioritize rest, manage stress, and stay hydrated. These often-overlooked basics play a big role in how your body responds.
- Partner with a provider who understands your full health picture. Regular check-ins can help fine-tune your plan and troubleshoot anything that’s getting in the way.
You don’t have to figure this out on your own. A thoughtful, personalized approach makes all the difference.
Frequently Asked Questions
Can semaglutide cause weight gain?
Not directly. The medication is designed to support weight loss. However, some people feel bloated or retain water in the first few weeks, which can temporarily mask early progress.
Why is semaglutide not working?
It could be related to your dosage, lifestyle habits, or an underlying health condition. Regular follow-ups with your provider can help identify what’s holding you back and guide the right next steps.
How much does semaglutide cost?
Brand-name prescriptions typically cost between $1,000 and $1,200 per month without insurance. Compounded versions may be more affordable, ranging from $300 to $500 per month, depending on the pharmacy.
What happens if you don’t lose weight on semaglutide?
That’s a sign to reassess. Your provider may want to review lab work, adjust your dose, or explore how nutrition, activity, sleep, and stress are playing a role.
How to speed up weight loss on semaglutide?
Stay consistent with your injections, eat whole foods, limit ultra-processed snacks, and keep your body moving. Working with a provider who can personalize your plan makes a big difference.
Why would semaglutide not work for me?
Your metabolism, medical history, or certain medications could be influencing how your body responds. That’s why individualized care is key to long-term success.
How long does it take to lose 20 pounds on semaglutide?
If you’re losing one to two pounds per week, you could reach that goal in about 10 to 20 weeks. Everyone progresses at their own pace, but steady, sustainable loss is the goal.
Struggling with Results? Let’s Find the Missing Piece
If semaglutide hasn’t worked the way you hoped, don’t give up. At Functional Wellness in Salem, Oregon, we take a personalized, whole-person approach to weight loss.
We’ll help you get clarity on what’s stalling progress and guide you toward sustainable results that last.
Rick & Jennifer Meyers | FNP, LE & MA
Functional Wellness & Aesthetics
Phone: 503-991-8549
