Why Am I Not Losing Weight on Semaglutide?

Health and Wellness | Health Tips | Nutrition | Weight Loss and Management

“Why am I not losing weight on Semaglutide?” is a question I hear frequently in my private practice. Semaglutide, a weight loss drug marketed under brand names like Ozempic, Wegovy, and Rybelsus has quickly gained popularity as one of the latest “du jour” drugs to lose weight. 

Its ability to suppress appetite and regulate blood sugar levels has made it a go-to for those struggling with weight loss. However, despite its initial success, many people find themselves not losing weight or hitting a weight loss plateau after some time on the weight loss medication.

As a registered dietitian with years of experience helping clients who struggle to lose weight, I receive countless questions about weight loss drugs like Semaglutide. 

While it can be an effective tool for jumpstarting weight loss, relying solely on this medication without addressing underlying body weight issues and making lifestyle changes can lead to disappointing results. 

In this blog post, you’ll learn why weight loss drugs, including Semaglutide might not be working as expected and why long-term success requires more than just a prescription.

semaglutide ozempic injection pen

Semaglutide: A Jumpstart, Not a Long-Term Solution

Semaglutide can be a powerful weight loss medication for kick-starting weight loss, providing a much-needed boost for those who have struggled to see any weight loss results through diet and exercise alone. 

Its appetite-suppressing properties can help individuals quickly shed initial pounds, making it an attractive option when it comes to weight loss medications for short-term use.

However, it’s important to understand that Semaglutide is not a long-term solution. 

Relying solely on this (or any) weight loss medication without addressing the underlying factors contributing to excess body weight can lead to a plateau or even weight regain once the weight loss medication is stopped. 

Sustainable weight loss requires a comprehensive approach that includes changes to your dietary habits, physical activity, and behavioral modifications. These lifestyle changes are essential for maintaining weight loss and improving overall health in the long run.

Using Semaglutide as a jumpstart can be beneficial, but it’s only one piece of the puzzle.

Long-term success depends on adopting healthy habits and making lasting changes to your lifestyle.

high cost of weight loss medication like semaglutide

High Cost and Accessibility Issues

One of the significant drawbacks of Semaglutide is its high cost. As a boutique drug, Semaglutide comes with a hefty price tag that can be prohibitive for many people. The expense can add up quickly, making it a financial burden, especially for those who need to take it long-term.

Moreover, insurance coverage for Semaglutide is often limited. Many insurance plans do not cover the medication unless the patient is diabetic, leaving non-diabetic individuals to shoulder the full cost. This lack of coverage can push people to seek alternative markets, such as Canadian pharmacies, to find more affordable options.

The high cost and limited insurance coverage make Semaglutide inaccessible for many, underscoring the importance of finding sustainable and affordable weight loss solutions. Investing in long-term lifestyle changes promotes lasting health benefits and healthy body weight and can be more cost-effective in the long run.

Dependency and Long-Term Use

A major issue with Semaglutide is the necessity of taking it for life to maintain its weight loss effects. While it can help shed the weight, the benefits are often only sustained as long as you continue the medication. This creates a dependency, where stopping the drug can lead to regaining the lost weight.

Relying on Semaglutide without addressing the root causes of weight gain poses significant risks. 

It can become a crutch, preventing individuals from learning and adopting healthier habits that are crucial for long-term success. Without understanding and tackling the underlying issues—such as emotional eating, poor dietary choices, and a sedentary lifestyle—the weight is likely to return once the medication is discontinued.

True, sustainable weight loss requires a holistic approach that includes dietary modifications, increased physical activity, and behavioral changes. 

The Dangers of Ignoring the Root Causes of Weight Gain

Using Semaglutide to lose weight is similar to undergoing gastric bypass surgery: both can provide significant initial weight loss, but neither addresses the root causes of weight gain. 

Just as gastric bypass patients need to adopt new eating habits and behaviors post-surgery, those taking Semaglutide need to understand and modify the factors that led to their weight gain in the first place.

Failing to address these root causes can lead to a cycle of weight loss and regain. It’s essential to recognize that weight gain often stems from complex, multifaceted issues, including emotional eating, poor dietary choices, and a lack of physical activity. 

Without identifying and addressing these underlying factors, any weight lost through Semaglutide is likely to be temporary. 

Understanding and implementing lifestyle and behavior changes are vital for long-term success.

loss of appetite and hunger cues on semaglutide

Disrupted Hunger and Satiety Cues

One of the primary ways Semaglutide helps people lose weight is by significantly suppressing appetite. While this can be beneficial for short-term weight loss, it can also disrupt your body’s natural hunger and satiety cues. These cues are vital for maintaining a healthy relationship with food and understanding your body’s needs.

When Semaglutide curbs your appetite to the point where you rarely feel hungry, it can lead to eating becoming a mechanical process rather than a response to genuine hunger. 

Over time, this can cause you to lose touch with your body’s signals, making it difficult to recognize when you are truly hungry or full. This disconnection can have long-term consequences, as you may struggle to regulate your food intake once you stop taking the medication.

Bottom line? You’ll need to relearn and respect your body’s hunger and satiety cues. 

This involves mindful eating practices, such as paying attention to your body’s signals, eating slowly, and savoring your food. By reconnecting with these natural cues, you can develop a healthier, more intuitive approach to eating that supports long-term weight management and overall well-being.

balanced meal plan for long term weight loss

A Registered Dietitian’s Perspective on Semaglutide to Lose Weight

As a registered dietitian, I see the appeal of Semaglutide as a tool for initiating weight loss. For many individuals, the initial boost provided by this medication can be motivating and can help them see early results that spur them on to further efforts. 

However, it’s important to recognize the difference between using Semaglutide as a temporary aid and relying on it as a long-term solution.

Weight loss and maintenance are lifelong journeys that require ongoing effort and commitment.

Healthy mindful eating habits are foundational to any successful weight management plan. They help you nourish your body, regulate your energy levels, and maintain a healthy weight without relying on medication. By focusing on developing these habits, you can create a sustainable lifestyle that supports your health and well-being for the long haul.

Ultimately, Semaglutide should be seen as a stepping stone rather than a crutch. 

It can help you start your weight loss journey, but the real work involves making lasting changes to your diet and lifestyle. With dedication and the right guidance, you can achieve your weight loss goals and maintain them in the long term.

woman preparing a healthy snack for long term weight loss without semaglutide

Real Client Weight Loss Journey: Transitioning from Semaglutide to Healthy Habits

Let me share the experience of one of my clients. She initially started taking Semaglutide and saw impressive results, losing 25-30 pounds in just four to six months. However, despite the significant weight loss, she faced a huge issue: she never felt hungry. 

Eating became a mechanical process, without natural hunger and fullness cues that are essential for a healthy relationship with food.

Recognizing that this wasn’t a sustainable way to live, she decided to stop taking Semaglutide. She understood that to maintain her weight loss and improve her overall well-being, she needed to focus on making lasting lifestyle changes. 

This transition involved learning to listen to her body’s hunger and satiety signals using mindfulness tools. She also learned which food choices and combinations worked for her and with consistent meal planning, avoided late night snacking and overeating. Incorporating regular physical activity into her routine each week also was a big plus. This not only helped with her weight loss, but played a significant role in improving her overall mental well-being.

While Semaglutide provided a valuable initial kickstart to her weight loss journey, it was not a long-term solution. By committing to behavior and lifestyle changes, she was able to maintain her weight loss and develop a more balanced approach to eating and self-care. 

walking on a treadmill long term weight loss

Risks and Side Effects of Semaglutide

While Semaglutide can be effective for weight loss, it’s important to be aware of the potential risks and side effects associated with its use. 

Some of the common side effects include gastrointestinal issues such as:

  • Nausea
  • Abdominal pain
  • Indigestion
  • Vomiting
  • Bloating
  • Diarrhea
  • Flatulence
  • Belching
  • Constipation

Another serious concern is the potential for psychological side effects such as depression and anxiety. 

Some users have reported experiencing suicidal thoughts while on Semaglutide. This is a significant risk that must be carefully monitored, especially for individuals with a history of mental health issues.

semaglutide side effects abdominal pain bloating

Other potential side effects include: 

  • Tachycardia (high pulse rate)
  • Headache
  • Dysphagia (difficulty swallowing)
  • Fever
  • Gallstones
  • Allergic reactions
  • Cold-like symptoms
  • Cough
  • Fatigue
  • Dizziness
  • Blurred vision
  • Darkened urine
  • Cold sweats

These symptoms can range from mild to severe and may persist as long as the medication is being taken.

Beyond these immediate side effects, there are also considerations for the long-term health impacts of using Semaglutide. 

The drug’s effects on appetite suppression can lead to a disconnection from natural hunger and satiety cues, potentially resulting in unhealthy eating behaviors once the medication is stopped. 

Additionally, long-term dependency on medication for weight management is not ideal, as it can prevent you from developing sustainable, healthy habits that are important for lifelong well-being.

When considering Semaglutide for weight loss, weigh these risks against the potential benefits and discuss them thoroughly with your healthcare provider. 

dietary changes for long term weight loss without ozempic semaglutide

The Real Weight Loss Solution: Long-Term Dietary and Lifestyle Changes

Sustainable lifestyle changes are the solution to lasting weight loss and overall well-being. The foundation of successful weight management is built on healthy habits and addressing the root causes of excess weight.

Sustainable Lifestyle and Dietary Changes

Adopting a sustainable approach to weight loss involves making gradual, manageable changes to your daily routine. This includes:

  • Balanced Nutrition: Focus on a well-rounded, whole food diet that includes a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats. Avoid processed and high-sugar foods. Stay clear of overly restrictive diets that are hard to maintain in the long term.
  • Regular Physical Activity: Incorporate physical activity that you enjoy into your routine. This can include activities like walking, swimming, cycling, or strength training. Consistency is key, so find exercises that you look forward to doing.
  • Mindful Eating: Practice mindful eating by paying attention to your hunger and fullness cues, eating slowly, and savoring your food. This helps you develop a healthier relationship with food and avoid overeating.
  • Identify Triggers and Emotions: Identify and address emotional and behavioral triggers that lead to unhealthy eating habits. This might involve stress management techniques, seeking support from a therapist, or finding healthier ways to cope with emotions.

2 women taking a break from a walk - healthy physical activity for weight loss

Benefits of Addressing the Root Causes of Weight Issues

By focusing on the root causes of a weight loss plateau or slow weight loss, you can achieve more than just a number on the scale. 

Benefits of this approach include:

  • Improved Physical Health: Sustainable weight loss through healthy lifestyle changes can lead to better overall health, including improved blood pressure, cholesterol levels, and blood sugar control.
  • Enhanced Mental Well-being: Developing healthy habits and a positive relationship with food can boost your self-esteem, reduce stress, and improve your mental health.
  • Long-Term Success: Unlike temporary solutions, sustainable lifestyle changes are more likely to result in long-term success from your weight loss efforts. You’ll be better equipped to manage your weight and health throughout your life.
  • Increased Energy and Vitality: A balanced diet and regular physical activity can enhance your energy levels, making you feel more vibrant and capable of enjoying daily activities.

While Semaglutide and similar medications can provide an initial boost, the real solution for long-term weight loss and health lies in making sustainable lifestyle changes. 

mindful eating concept - woman writing in a food journal

Sustainable Weight Loss: Moving Beyond Semaglutide

At the end of the day, Semaglutide is not a sustainable long-term solution on its own for weight loss. Addressing the root causes of weight gain and committing to lasting lifestyle changes are essential for achieving and maintaining weight loss success. 

The moral of the story: weight loss and getting to a healthy state of mind and body takes some work. 

Anything worth having is going to take some effort. There’s no magic bullet. 

Try not to use weight loss drugs as a long-term crutch. Real success lies in adopting healthy habits, such as balanced nutrition, regular physical activity, and mindful eating. These changes not only support weight loss but also enhance your overall health and quality of life.

By focusing on more mindful and holistic approaches, you can improve your physical and mental well-being, achieve long-term success, and enhance your overall quality of life. 

healthy eating lifestyle concept - couple dancing in the kitchen

Remember, the journey to better health is not about quick fixes but about making meaningful changes that you can maintain for a lifetime.

eating journal mockupTo support you on this journey, I invite you to download my free “Mindful Eating: Journal & Prompts” PDF. This resource is designed to help you develop a healthier relationship with food and better understand your body’s hunger and satiety cues.

Additionally, if you’re looking for personalized guidance and support, I offer complimentary calls to discuss how we can work together to achieve your weight loss and health goals. Click here to contact me. 

Let’s take the first step towards a healthier, happier you!

Voula Manousos’ writing is featured in the “Winchester Living Magazine” and “The Winchester Star” of Wicked Local.

Newsletter Signup

Sign up for my newsletter to get notified of updates, recipes, tip and tricks, and you’ll automatically receive the download link to my recipe book: “Five Days of Easy Cool Dinners”.

"*" indicates required fields


Check out my video resources!

View videos focusing on meal planning, cooking demos, and nutrition education.

Let’s Connect!


Start your weight management journey today!

You CAN balance work and eating well. Stop putting yourself last.

Invest in your health and happiness. A healthy, informed you means more energy and time for everything else in your life.