GLP-1 Weight Plateau: Why It Happens & What to Do
Has your weight loss stalled on Ozempic, Wegovy, or Mounjaro? Plateaus are a normal part of the weight loss journey. This guide explains why they happen, how long they typically last, and evidence-based strategies to break through.
Normal
Plateaus are expected on any weight loss journey
2-8 weeks
Typical plateau duration before weight loss resumes
12-18 mo
When most people reach stable weight on GLP-1s
Is It Really a Plateau?
Before assuming you've hit a plateau, rule out normal weight fluctuations:
- 1-2kg day-to-day variation is normal
- Water retention from sodium, carbs, exercise
- Menstrual cycle fluctuations (up to 2kg)
- Constipation from GLP-1 side effects
- Weight stable for 4+ consecutive weeks
- No downward trend on weekly averages
- Measurements also unchanged
- Clothes not fitting any differently
Tip: Track your weight weekly at the same time (morning, after bathroom, before eating) and look at 4-week trends rather than daily changes. Apps that show weekly averages can help smooth out fluctuations.
Why Weight Loss Plateaus Happen
Plateaus are your body's natural response to weight loss. Here's what's happening biologically:
Metabolic Adaptation
Your body burns fewer calories at a lower weight. A 15kg loss can reduce daily calorie needs by 200-300+ calories.
Muscle Loss
Weight loss often includes some muscle, which burns more calories at rest than fat. This slows metabolism.
Hormonal Changes
Leptin levels drop with weight loss, increasing hunger signals. Ghrelin may increase, promoting appetite.
Medication Tolerance
While not common, some people may develop reduced sensitivity to GLP-1 effects over time.
Lifestyle Drift
Eating and activity habits often gradually shift over months of treatment, even without awareness.
Set Point Theory
Your body may defend a new lower weight as its set point, requiring time to adjust further.
Typical Weight Loss Timeline on GLP-1s
Understanding the normal pattern can help set realistic expectations:
Weight loss is typically fastest during dose escalation. Many people lose 5-10% of body weight. The medication effects are novel and appetite suppression is strong.
Weight loss continues but often slows. You may experience short plateaus that resolve. Most of your total weight loss occurs during this period. Lifestyle habits become more important.
Most people reach a stable weight plateau. This doesn't mean the medication has stopped working - it's still suppressing appetite and providing metabolic benefits. This weight becomes your new stable point while on treatment.
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Strategies to Break Through a Plateau
Here are evidence-based approaches, organised by category:
Discuss dose increase
If not at maximum dose, your prescriber may increase it
Consider switching medications
Some people respond better to different GLP-1 drugs
Review injection technique
Ensure proper administration for maximum absorption
Increase protein intake
Aim for 1.6g per kg body weight to preserve muscle
Track food honestly
Calorie creep is common - logging helps identify it
Reduce ultra-processed foods
These can promote overconsumption even with GLP-1
Consider meal timing
Some find time-restricted eating helps
Add resistance training
Builds muscle, increases metabolism, essential during weight loss
Increase daily movement
Non-exercise activity (NEAT) often drops with weight loss
Try different cardio
HIIT or new activities can challenge your body differently
Prioritise sleep
Poor sleep increases hunger hormones and reduces willpower
Manage stress
Cortisol promotes fat storage and comfort eating
Stay hydrated
Dehydration can be mistaken for hunger
Dose Considerations
If lifestyle adjustments don't help, medication adjustments may be appropriate:
Increasing Your Dose
If you're not at the maximum dose, increasing may restart weight loss. Discuss with your prescriber about:
- Whether you're at your maximum tolerated dose
- If side effects are manageable enough to increase
- The appropriate next step in the escalation schedule
Maximum Dose Options
| Medication | Maximum Dose |
|---|---|
| Wegovy (semaglutide) | 2.4mg weekly |
| Ozempic (semaglutide) | 1mg weekly (2mg in some countries) |
| Mounjaro (tirzepatide) | 15mg weekly |
| Saxenda (liraglutide) | 3mg daily |
When to Consider Switching Medications
If you've tried optimising your current treatment and plateau persists, switching medications may help:
- On maximum tolerated dose for 3+ months
- Lifestyle factors have been optimised
- Weight loss goals not achieved
- Intolerable side effects limiting dose
- Switching isn't guaranteed to work
- May need to restart dose escalation
- Side effects may return initially
- Cost/availability may differ
Accepting a New Stable Weight
Sometimes a plateau represents your new stable weight. This is worth considering if:
- You've lost a significant amount of weight (10%+ of starting weight)
- You're on the maximum tolerated dose
- Weight-related health markers have improved (blood pressure, blood sugar, etc.)
- Further restriction would require unsustainable lifestyle changes
- You're eating a healthy, balanced diet
Important: A 10-15% weight loss, even if not your original goal, provides significant health benefits and is considered clinically meaningful. Not everyone will achieve the average trial results.
Frequently Asked Questions
Related Guides
References & Sources
- Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). NEJM 2021.
- Hall KD, et al. Quantification of the effect of energy imbalance on bodyweight. Lancet 2011.
- Rosenbaum M, et al. Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight. Am J Clin Nutr 2008.
- NICE Clinical Guideline: Obesity: identification, assessment and management (CG189).
Medical Disclaimer
This information is provided for educational purposes only and is not intended as medical advice. Any changes to your medication regimen should be discussed with your prescriber. If you're concerned about your weight loss progress, consult with your healthcare provider.
Last updated: December 2025
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