GLP-1 medications are widely used for weight loss, but many people notice that progress can eventually slow down.
Drugs such as Ozempic, Wegovy and Mounjaro were originally developed to help people with type 2 diabetes manage blood sugar, though they are now also commonly used as part of weight-loss treatment.
As treatment continues, some patients find that their results begin to level off rather than continue at the same pace. This is often called a weight-loss plateau, and it is a common part of long-term weight management rather than a sign that the medicine has stopped working.
“Most people reach a plateau in the middle of their journey on GLP-1s, as the body adjusts and finds ways to become more efficient,” Dr Grace Lim, a triple board-certified obesity medicine specialist told the Daily Mail.
Dr Lim, who says she has administered
‘more than 30,000 weight-loss shots in the past year,’
explained that this is often the point where people start asking about increasing their dose. In some cases, she said, patients may even try taking additional injections on their own.
She warned against doing so, saying it can trigger harmful complications.
‘led to serious side effects’
‘nausea, vomiting, abdominal pain, low blood sugar, dizziness and dehydration’.
Dr Lim also said some people who took that approach have ended up in hospital.
According to Dr Lim, weight-loss plateaus are partly driven by the body’s response to changes in energy intake and body composition. As people lose weight, they typically burn fewer calories at rest and may also feel hungrier than they did at the start of treatment.
‘the body’s natural instinct is to preserve fat,’
She said the body therefore
‘adapts to to limit further weight loss,’
and may even treat reduced calorie intake as a
‘threat,’
which can lead to a slower metabolism and increased hunger.
Experts in obesity medicine say this is one reason plateaus are so common: the body needs fewer calories at a lower weight, so the same eating and exercise habits that once produced steady loss may no longer create as large a deficit.
There is also another important point for patients taking GLP-1s: these medicines are usually intended to work alongside ongoing lifestyle changes, not instead of them. Wegovy, for example, is prescribed with a reduced-calorie diet and increased physical activity, and dose increases are meant to happen only under medical supervision.
Some patients who hit a plateau may be tempted to change their dose on their own or add extra injections, but clinicians generally advise against this. Adjusting the schedule without medical guidance can raise the risk of side effects and does not guarantee faster or better fat loss.
Other experts have made similar observations about why weight loss can stall over time.
“The plateaus tend to happen after the patient loses a significant amount of weight and is getting closer to a healthy weight,” Dr. Ali told Medical News Today. “The body is tending to hold on to calories to preserve itself.”
Dr. Jason Ng told the publication that the flatline happens when
‘your body’s energy burn equals energy being added through food’.
Dr. Ali said he often sees this happen at around the 60-week point.
Doctors say one of the most effective responses is to
‘significantly alter energy balance,’
which can include increasing physical activity.
Strength-based exercise may be especially useful during this stage.
‘as it helps preserve lean muscle mass and maintain metabolic rate,’
Bolt Pharmacy suggests resistance training, including weights, because maintaining lean muscle can support ongoing fat loss.
Dr Lim likewise said that losing muscle mass may reduce metabolic rate, which can make further progress harder.
She also recommends
‘consuming around 1.2g of protein per kilogram of body weight each day,’
alongside exercise.
That advice can differ from person to person, however, so speaking with a dietician may be important, particularly for anyone with kidney disease.
Maintaining healthy routines such as staying hydrated and getting good-quality sleep may also play a role, partly because poor sleep can make appetite and cravings harder to manage.
If weight loss has stalled, doctors may also review whether the person is still taking the medication correctly, whether the dose is appropriate, whether other medications could be affecting weight, and whether the person’s calorie intake has crept up over time. In some cases, a clinician may decide to extend the time spent on a dose, move to a higher maintenance dose when appropriate, or consider a different treatment plan.
For many people, the best next step is not to panic but to reassess the basics: food intake, protein, exercise, sleep and overall adherence. A plateau does not always mean failure. It often means the treatment plan needs to be adjusted to match a smaller, lighter body.
Anyone with questions about treatment, side effects or dose changes should speak to their doctor.