Semaglutide is part of a newer cohort of medications for weight loss that are incredibly effective and safer compared to older weight loss medications.

Semaglutide, commonly known as Ozempic or Wegovy, generally leads to weight loss of about 15 to 20 percent of your initial body weight. If you’re not losing weight, here are a couple of common reasons why that might be happening:

Dosage Issues

A common reason for not losing weight on semaglutide is not being on a high enough dosage. Many patients start on a low dosage and gradually increase it. However, sometimes the dosage increases stop prematurely, even though the patient can tolerate the medication well. In such cases, it’s essential to continue increasing the dosage to achieve the desired weight loss.

Tolerability Issues

Another reason could be tolerability issues. The most common side effects of semaglutide are gastrointestinal, including abdominal discomfort and nausea. These side effects can make it difficult to increase the dosage, which is necessary for effective weight loss.

Semaglutide works by acting on a receptor called GLP-1, which helps regulate appetite and blood glucose metabolism. Another medication, Tirzepatide, works on both the GLP-1 and GIP receptors. Tirzepatide tends to have fewer gastrointestinal side effects and can be a suitable alternative for those who do not tolerate semaglutide well. Switching to tirzepatide can help you achieve your weight loss goals if you can tolerate higher dosages of this medication.


In summary, it’s rare for semaglutide not to lead to significant weight loss. If you’re not seeing results, it’s typically because you’re not on a high enough dosage due to tolerability issues or because the dosage hasn’t been increased adequately. Adjusting the dosage or switching to a medication like Tirzepatide can help you reach your weight loss goals.

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