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Drugs including Ozempic have a reputation for helping people who’ve struggled to drop pounds lose weight and keep it off. One study, for example, showed that when people with obesity took injectable semaglutide, a GLP-1 receptor agonist, once weekly, they lost an average of 14.9 percent of their body weight over 68 weeks. For these participants, this was an average of 11.7 kilograms, or about 25.8 pounds.
But recent reports suggest this isn’t always the case: A so-called “Ozempic plateau” is possible. “This is when a person stops losing weight with the use of the Ozempic (or other semaglutide), healthy eating, and exercise,” says Su-Nui Escobar, RDN, a doctor of clinical nutrition and founder of Nutrition for Weight Loss Meds in Miami. Weight loss plateaus are also normal, regardless of whether someone is taking a weight loss drug or losing weight through other means. Research indicates that plateaus often represent your body’s evolutionary response to weight loss by attempting to maintain its energy stores.
That said, an Ozempic plateau isn’t always problematic. “Just because a person is not losing weight actively does not mean the body has not stopped changing for the positive,” says Amy Beney, RD, CDCES, owner of Nutrition Insights in Lockport, New York. “It is important to check into non-scale victories. Are they gaining muscle mass? Are they losing visceral fat and subcutaneous fat?” If you’ve reached a weight that’s brought about desired health improvements, an Ozempic plateau might feel like an okay landing place.
For some people, though, an Ozempic plateau can be a frustrating and mystifying experience. So what can you do when Ozempic isn’t working anymore? Try taking up these seven habits.
1. Practice Mindful Eating
Mindful eating is a good idea any time, but especially when you’re taking a weight loss drug. “The medication is wonderful at reducing hunger and appetite, but listening to the body is still essential to maximize the effects of the medication,” says Dr. Escobar. Because semaglutide can seriously alter your appetite, eating mindfully may be more important than ever while on these meds.
Try removing distractions (like watching TV, reading, and using your phone) during mealtimes to give food your full attention. Take time to savor each bite. And check in frequently with your level of hunger and fullness throughout the day. These strategies can help you eat when your body needs food — and hold off when you’re not really hungry.
2. Prioritize Protein
Of the three macronutrients (protein, fat, and carbohydrates), protein is the most satiating, per one study. Building your plate around a protein source like lean meat, beans, seafood, or tofu can help you feel fuller longer, reducing cravings that may be undermining weight loss.
Escobar notes that protein also helps maintain muscle mass. Because research shows rapid weight loss on semaglutide could potentially mean losing muscle as well as fat, getting enough protein may help you hang onto more lean tissue.
3. Focus on Fiber
Another nutrient to focus on: fiber. This indigestible carb is key to minimizing constipation. “Constipation can be a side effect [of semaglutide] that may affect weight loss or cause a plateau,” says Beney. “Incorporate fibrous foods that include insoluble and soluble fiber, plus plenty of fluids.” Some sources of insoluble fiber include whole grains, nuts, seeds, beans, potatoes, and leafy greens. You’ll find soluble fiber in oats, lentils, oranges, wheat bran, and apples.
4. Drink Plenty of Water
Not getting enough water could be another culprit behind an Ozempic plateau, Escobar says. Whereas semaglutide slows digestion, water can help keep things flowing, preventing constipation. Plus, according to a report from Johns Hopkins University, the more hydrated you are, the more efficiently your body works at burning fat.
You don’t have to overdo it on water, but strive to hit recommended amounts for healthy hydration. “According to the U.S. National Academies of Science, Engineering, and Medicine, women need 11.5 cups a day and men need 15.5 cups a day of water per day,” Beney points out. Try keeping a favorite water bottle handy and sipping throughout the day.
5. Switch Up Your Workout
Losing weight almost always involves not just diet, but exercise, too. Physical activity burns calories, contributing to the energy-in, energy-out balance of weight loss. If you’ve stopped losing weight on semaglutide, Beney encourages trying a new workout routine, such as strength training. “If you are not using resistance (or strength) training, now may be the time to do so. If you are using resistance training, maybe increase the weight on your workout.”
On the other hand, she says, it’s possible your workout might be too strenuous. “Sometimes an intense workout can put more stress on the body than you realize and prevent further weight loss,” Beney adds. A check-in with a sports medicine doctor or personal trainer could help you get on the best path for physical activity.
6. Stick to a Healthy Sleep Schedule
Could the solution to a weight plateau lie in your bed? The connection between sleep and weight is well established, with research suggesting that poor sleep leads to increased calorie intake. Other studies also indicate it lowers fat metabolism.
The Centers for Disease Control and Prevention (CDC) recommends that adults ages 18–60 get seven or more hours of sleep per night. Prioritize your nighttime rest with healthy habits like keeping a consistent sleep schedule, powering down screen devices an hour or two before bed, and maintaining a dark, uncluttered bedroom.
7. Stay in Touch With Your Healthcare Team
If you find the number on the scale has stopped moving while on Ozempic, let your doctor know. You may simply need to adjust your dose. “Increasing the dose can help break the plateau,” says Escobar. “Ozempic is FDA-approved for the treatment of diabetes [rather than weight loss], and the dose might be lower than the dose necessary for weight loss.”
Talking with a nutrition expert can also identify diet choices that are holding you back from weight loss. “Meeting with a dietitian to help with diet modifications and accountability can be key to overcoming weight loss plateaus,” Beney says.
The Wrap-Up
Ozempic may be a powerful weight loss aid, but taking it and similar drugs doesn’t necessarily mean you’ll reach your goal weight without bumps in the road. “They are not guaranteed weight loss. Diet and lifestyle modifications need to be a part of the plan in addition to the medications,” says Beney.
When your weight loss has stalled on Ozempic, try any of the healthy habits above. They may help you push through an Ozempic plateau — or simply help you become healthier in general.
