Why am I not losing weight on GLP-1?

Medically reviewed

Clinical trial data shows roughly 86% of people on semaglutide and 91% on tirzepatide lose at least 5% of body weight by week 68 (STEP-1, SURMOUNT-1). When loss stalls, the most common explanations are mechanical, not pharmacological.

Check four things in order: (1) you've reached an effective maintenance dose, not still on titration steps; (2) your calorie intake is genuinely in a deficit — appetite suppression is not a guarantee of one; (3) you're hitting a protein floor (1.2–1.6 g/kg) to preserve lean mass; (4) you've held the current dose for at least 6–8 weeks.

Related questions

How long should I wait before assuming the medication isn't working?

At least 8–12 weeks at a maintenance dose. Earlier weeks reflect titration, not full effect.

Should I escalate the dose if loss has stalled?

Discuss with your prescriber. Sometimes the answer is dose escalation, sometimes it's holding longer at the current dose with protein and resistance training.

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