Hit a Weight Loss Plateau on Your GLP-1? Here's What to Do Next
You've been making great progress on your GLP-1 medication—semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound), or another GLP-1 agonist. The pounds were coming off steadily, you were feeling great, and then... nothing. The scale hasn't budged in weeks.
Sound familiar? Weight loss plateaus are incredibly common, even on GLP-1 medications. But here's the good news: a plateau doesn't mean your medication has stopped working or that you've failed. It's often a sign that it's time to reassess and adjust your approach.
Here are the key areas to evaluate when you hit a weight loss plateau:
1. Reassess Your Caloric Intake
This might be the most important factor: you are a smaller person now. Your body doesn't need as many calories as it did when you started your weight loss journey. Your basal metabolic rate—the calories your body burns just existing—has decreased as you've lost weight.
What worked at the beginning may no longer create the caloric deficit needed to continue losing weight. It might be time to recalculate your daily caloric needs based on your current weight and adjust accordingly. Remember, your goals may need to evolve as your body changes.
2. Check Your Macronutrient Intake
It's not just about calories—what you're eating matters enormously, especially for long-term success and preserving your health during weight loss.
Protein: Are you getting enough? Most patients should aim for at least 100 grams of protein per day. Adequate protein intake is crucial for:
Preserving muscle mass during weight loss
Maintaining your metabolism
Keeping you feeling satisfied
Supporting overall health
Fiber: Target at least 25 grams of fiber daily. Fiber helps with satiety, digestive health, and blood sugar regulation—all important factors in successful weight management.
Carbohydrates: Are you consuming too many? Most patients do best in the 100-150 gram range per day, though this can vary depending on your height, weight, activity level, and individual metabolism. If you're consistently exceeding this range, it may be time to dial it back.
Track your food for a few days to get an honest picture of where you stand. You might be surprised.
3. Evaluate Your Exercise Routine
Here's a hard truth: you can't out-exercise a poor diet, but you also can't maintain a healthy metabolism without movement—especially strength training.
Strength training is vital for:
Preserving muscle mass as you lose weight
Maintaining your metabolic rate
Improving body composition
Building bone density
Enhancing insulin sensitivity
If you're not already incorporating resistance training at least 2-3 times per week, now is the time to start. Muscle is metabolically active tissue—the more you preserve (or build), the better your metabolism functions.
Cardiovascular exercise is great too, but don't skip the weights.
4. Consider Medication Adjustments
Sometimes, despite doing everything right with diet and exercise, you need a pharmaceutical boost to break through a plateau.
Options include:
Dose adjustment: You may benefit from increasing your GLP-1 agonist dose if you haven't reached the maximum recommended dose yet.
Combination therapy: Adding another medication can provide synergistic effects:
Phentermine: An appetite suppressant that can complement GLP-1s
Contrave (naltrexone/bupropion): Works on different pathways in the brain to reduce cravings and appetite
Metformin: Particularly helpful if you have insulin resistance or prediabetes
Each patient responds differently to medications, and what works for someone else may not work for you. This is where individualized medical care makes all the difference.
5. Rule Out Other Health Factors
Sometimes a plateau isn't about calories, macros, or medications—it's about something else going on in your body.
A comprehensive health evaluation can identify factors that might be stalling your progress:
Thyroid dysfunction: Hypothyroidism can significantly slow metabolism
Sleep issues: Poor sleep disrupts hunger hormones and metabolism
Stress and cortisol: Chronic stress can promote weight retention
Hormonal imbalances: PCOS, menopause, or other conditions affecting hormones
Medications: Some prescriptions can promote weight gain or make loss harder
Fluid retention: Sometimes the scale reflects water weight, not fat
A thorough medical evaluation can uncover these hidden obstacles and address them appropriately.
The Bottom Line
Weight loss plateaus on GLP-1 medications are frustrating but normal. They're not a sign of failure—they're a signal that your body has adapted and it's time to reassess your strategy.
The most successful patients are those who:
Stay flexible and willing to adjust their approach
Focus on sustainable habits, not just the number on the scale
Work closely with their healthcare provider to optimize all aspects of their weight loss plan
Remember that health improvements extend far beyond weight alone
If you've hit a plateau, don't get discouraged. Schedule an appointment so we can evaluate what's happening and create a personalized plan to get you moving forward again. Weight loss is rarely a straight line—but with the right adjustments, you can continue making progress toward your goals.
Ready to break through your plateau? Contact our office today to schedule a comprehensive weight loss evaluation.