What Is an Ozempic Plateau?

Ozempic and other glucagon-like peptide 1 (GLP-1) agonists are being hailed for the rapid weight loss they can help people achieve. But for anyone who's losing weight , including people taking these medications, weight loss can plateau - that is, slow down or stop - before they've reached their goal weight.

"The early rapid weight loss seems too good to be true. We become accustomed to the weight loss and expect it to continue uninterrupted, but this is not the case. Over time, many users experience a plateau, and it seems to catch us off guard," says Angela Haynes-Ferere, MPH , an associate clinical professor at the Nell Hodgson Woodruff School of Nursing at Emory University in Atlanta, who has been taking a GLP-1 drug herself.

What Is an Ozempic Plateau?

An Ozempic plateau is when someone's weight loss slows or stops, even though they're still taking the medication.

Just about everybody hits a plateau eventually when they're trying to lose weight. It can happen with weight loss medications, with surgical weight loss, and when people adjust their eating and exercise habits to shed excess pounds.

Part of this is because people can initially lose some water weight, and then lose some muscle that helps burn calories. Metabolism declines as muscle mass is lost, slowing down how many calories people burn. There is also the effect of a process called adaptive thermogenesis, in which the drop in metabolism is greater than expected based on the amount of weight loss.

But once the body adjusts to the effects of a GLP-1 drug, a person can hit a plateau: Weight loss slows down and then stops, Haynes-Ferere says. The exact timing is different for everyone, but it's a common experience, she notes.

Since GLP-1 drugs are relatively new, there isn't a lot of long-term data to pinpoint exactly when this happens or when people usually overcome it. Studies of both semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) suggest that weight loss tends to plateau after about a year, but more research is needed to confirm how many people will experience this.

"We question why the medication has stopped working," Haynes-Ferere says - when, in fact, the body is acclimating to the new weight.

How Common Is It for Ozempic to Stop Working?

Again, it's totally normal - even expected - for weight loss to eventually slow or stop when taking a drug like Ozempic. Weight loss plateaus can happen with all weight loss methods, even for Ozempic and other GLP-1 drugs like Wegovy and dual receptor agonists (Zepbound) that can produce dramatic weight loss, says Amanda Velazquez, MD , an assistant professor and director of obesity medicine in the Department of Surgery at Cedars-Sinai in Los Angeles.

"Weight loss plateaus are very common for patients taking medication for weight management," Dr. Velazquez says.

What Causes an Ozempic Plateau?

While there are many factors that can contribute to an Ozempic plateau, part of the problem is that the metabolism slows down as people shed excess pounds, making it harder to lose weight after the initial success, Velazquez says.

In addition, she explains, hormones that help regulate weight can respond to weight loss by signaling the body to eat more and reducing feelings of satiety.

"So essentially your body is working against you and making it harder for you to lose weight as you continue the process," Velazquez says. "These hormone signals get stronger with time and the more weight you try to lose."

How to Overcome an Ozempic Plateau

When people switch up their eating and exercise habits to lose weight, the best way out of a plateau is to decrease calories or increase physical activity, according to the Mayo Clinic.

The best way to overcome an Ozempic plateau starts with seeing your doctor, Velazquez says. Depending on your exact circumstances, they might adjust your medication dose or recommend that you make lifestyle changes like focusing on getting more sleep, managing your stress better, or increasing the number or intensity of your workouts.

One thing people shouldn't do is stop taking Ozempic, Haynes-Ferere says.

"There are many different views about the long-term use of these medications, but we do not ask the patient with hypertension or diabetes to discontinue their medications when they become controlled," she explains. "The very mechanisms of the medication that are so effective in weight loss are key for continued management of obesity."

Beyond this, there are lots of other things people can try to help them overcome an Ozempic plateau, Haynes-Ferere says. These include:

• Eating more protein: Protein helps build more muscle mass, which helps you burn more calories.

• Drinking more water. Water can help suppress your appetite and boost your ability to exercise.

• Setting a regular sleep schedule. Getting more sleep helps you consume fewer calories.

• Changing your exercise routine. Devoting more time each week to exercise, switching up your workouts, and adding weight lifting to build muscle can all help you overcome a plateau.

• Changing your eating habits. Cutting more calories can also help jump-start weight loss, but you shouldn't consume fewer than 1,200 calories a day.

Making small adjustments, rather than massive changes, may be easier to handle and more sustainable over time, Haynes-Ferere says.

"I had to stop stepping on the scale every day, and instead rely on how my clothes fit. I also had to remind myself frequently that strength training was adding muscle tone, and the scale might not be my best friend," Haynes-Ferere says. "I have experienced several plateaus in my weight loss journey, and I chose to focus on making small adjustments and reminding myself that this is not a race."

When you try everything you can to overcome a weight loss plateau and the numbers on the scale still won't budge after several weeks of effort, you have several options.

Your healthcare provider might be able to help you assess whether there's still room for changes to your eating or exercise habits, for example. You may also need to reassess your weight loss goals, and determine whether you need to revise your target weight to make it more realistic - especially if you're already pretty close to your goal and have already achieved numerous health benefits from weight loss, according to the Mayo Clinic.

The one thing you absolutely don't want to do is get so discouraged that you stop trying to lose weight at all, and revert to your old eating and exercise habits.

This can result in regaining weight and reversing improvements to your health.

Why Overcoming an Ozempic Plateau Is Worth It

There's no one answer to this question, because a lot of this depends on how much weight somebody still has to lose to achieve optimal health benefits, Velazquez says. Somebody with weight-related health complications like type 2 diabetes might need to lose more weight than somebody who is generally healthy.

Losing 10 percent, or even 5 percent, of your starting body weight can help improve blood pressure, blood sugar levels, obstructive sleep apnea, and other weight-related medical issues, Velazquez notes.

"If you still need to lose a significant amount of weight, moving through the plateau is necessary to keep progressing," Haynes-Ferere says. "Staying in the state of not losing over time is disheartening and disappointing, and may lead to discontinuation of the weight loss journey."

One thing people should not do is blame themselves for hitting an Ozempic plateau, Haynes-Ferere stresses.

"The biggest misconception about weight loss is the messaging about lack of willpower," she says. "Obesity is not about lack of willpower, but about lack of access to reliable tools to manage illness, and Ozempic is just such a tool."

The Takeaway

It's normal for anyone to hit a plateau when they're trying to lose weight. If you've hit an Ozempic plateau, the first thing you should do is talk to your doctor, whom you should be seeing regularly already. They can suggest different ways for you to switch up your routine that can help you resume shedding pounds.

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Sources

1. Getting Past a Weight-Loss Plateau. Mayo Clinic . April 9, 2024.
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3. Hudson J et al. Protein Intake Greater than the RDA Differentially Influences Whole-Body Lean Mass Responses to Purposeful Catabolic and Anabolic Stressors: A Systematic Review and Meta-Analysis. Nutrients . May 20, 2020.
4. Shmerling RH. Does Drinking Water Before Meals Really Help You Lose Weight? Harvard Medical School . February 20, 2024.
5. Caldwell A. Getting More Sleep Reduces Caloric Intake, a Game Changer for Weight Loss Programs. The University of Chicago Medicine . February 7, 2022.