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Five Reasons Why You Are Not Losing Weight on Wegovy

While Wegovy is effective for many, some people find their progress disappointingly stagnant. Here are five possible reasons why your weight loss remains static despite being on Wegovy:

Flawed Administration

Drug absorption is affected by administration. Although Wegovy can be administered any time of day, consistency is advisable to maintain steady drug levels and to remember when to take the drug. 

The administration technique is also important. As a subcutaneous (under the skin) injection, the wrong technique can affect drug effectiveness and absorption. 

Site rotation is essential to avoid reactions at the injection site. For example, itchy, red skin or swelling may affect absorption.

Solution: 

Commonly advised injection sites include the thigh, upper arm, and abdomen (these areas have more fat). Rotate the site after each injection. If you keep forgetting to take the drug, set weekly reminders on your phone.

Adverse Reactions and Side Effects

All medicines including Wegovy have the potential to cause side effects. The most common side effects are gastrointestinal (relating to the gut) such as nausea, vomiting, and diarrhea. 

This explains why the dose is increased over several weeks - to reduce these side effects. If you are experiencing these side effects, it can affect your adherence i.e. reluctance to take the drug on time due to potential side effects. This can influence your weight loss journey.

Solution: 

For severe side effects, speak to your pharmacist or doctor. They will be able to provide solutions such as temporarily reducing the dose, maintaining the same dose for longer, or advising to take Wegovy with food/changing administration times.

Inadequate Dose

When you initially start Wegovy treatment, the doses are gradually increased over 16 weeks. Though a slow increase can help with side effects, increasing the dose too slowly over a long period means that Wegovy could be less effective. 

In the landmark clinical trial to evaluate its efficacy, 2.4mg once weekly was found to be the ‘optimal’ dose to reduce body weight. The starting dose, 0.25mg, is considerably lower.

Solution: 

If you are using Wegovy without any side effects, the advised dose increase is every 4 weeks until the maintenance dose of 2.4mg. Work in conjunction with your doctor to discuss progress if you feel ready to increase the dose.

Lack Of Lifestyle Interventions

Treatment with medicine is only one key factor to losing weight, the other being lifestyle changes – specifically diet and exercise. The evidence behind many currently licensed weight loss drugs reiterates the need to incorporate lifestyle interventions. 

The same applies to Wegovy. In the STEP 1 trial, a double-blinded trial comparing semaglutide and placebo, participants also had to follow dietary and exercise plans such as reduced-calorie diets or increasing physical activity. 

Other trials evaluating other weight-loss drugs often all involve some form of diet and exercise plan. This stresses the idea that weight loss requires a multifactorial approach.

Moreover, dieting can be misleading. Often, you end up over-consuming calories even if portion sizes ‘look small’. The type of food eaten is also important. Wegovy slows gastric emptying and high-fat meals can also have a similar effect leading to stomach discomfort.

Solution: 

Lifestyle interventions should be incorporated day to day. Regarding diet, keeping a food diary can be helpful to identify trends. Food scales and measuring cups help maintain a consistent portion size. 

High-fat foods are best avoided at the same time as Wegovy administration. Regarding exercise, 150 minutes per week is advised but the exercise chosen should be tailored to how realistic you can achieve. Swimming is a great exercise but if not possible, walking and jogging are suitable alternatives.

You Need To Give More Time

The final reason is not related to Wegovy, but you as the patient! Many patients start complaining about weight loss drugs after one month. This is an unrealistic expectation. 

Weight loss treatments are not a miracle cure, instead require consistent administration over a steady period to achieve results. It can take weeks or months to reach the ‘optimal’ dose. However, by doing so gradually, it ensures you lose weight effectively and safely.

Solution: 

Be patient! Persist with treatment, take doses on time and discuss treatment plans with your clinician. Keep track of your progress as results are unlikely to be significant within the first month. Simply taking Wegovy for a longer time can be the key to success.

Conclusion

If you are doing all the steps above but weight loss progress continues to stall, Wegovy may not be for you. 

You should speak to your doctor and discuss future treatment plans if you have been taking Wegovy for 6 months and your weight has not decreased by at least 5%. This could simply be down to individual variability in response – each person reacts to drugs differently due to differences in their bodies.

In some cases, other treatments may be a better option. At Prescription Doctor, we also offer a comprehensive portfolio of other weight loss treatments (e.g. Mounjaro, Mysimba) to help you achieve your ideal body weight goals.

Authored & Reviewed By

Mohamed Imran Lakhi

MPharm - Lead Pharmacist
Imran Lakhi is the superintendent pharmacist and founder at Prescription Doctor. He has been at the core of our team.

Published on: 04/07/2024 Reviewed on: 04/07/2024
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