Wegovy not working at all is an uncommon occurrence; we have rarely seen total Wegovy failure at any of our weight loss clinics, and when we do, there is almost always a reason it can be solved. Basically, the reasons why Wegovy won’t work fall into one of two categories: there is something about the patient’s body that is preventing the drug from working as it normally would, or the patient is failing to use the drug correctly or is not combining it with the right kind of diet and lifestyle changes for Wegovy to be effective.
In the first case, there is little that can be done other than perhaps reworking your dose to overcome the issues that could be making you Wegovy resistant. But more often than not, if Wegovy isn’t working, it’s because of something you are not doing right that can be corrected.
How Long Does it Usually Take for Wegovy to Work?
Before you jump to the conclusion that your Wegovy injections “aren’t working,” please understand that it takes time for Wegovy to start working. Wegovy has been found to be quite effective in helping people lose significant amounts of weight.
In clinical trials, participants lost an average of 15% -16% of their body weight by week 68 on the maximum 2.4 mg once-a-week dose of Wegovy. Generally speaking, our patients tend to start seeing results much sooner than that; however, do keep in mind that in many patients, it can take several weeks or months until they start to see substantial weight loss on Wegovy.
The aforementioned trials concluded that patients could lose weight on Wegovy up to and through the 68th week of using the drug, but we have seen our patients continue to lose weight beyond that mark. Continued weight loss on Wegovy past week 68 is especially possible when combined with the kind of exercise, diet, and lifestyle counseling we give all of our Wegovy patients.
One study found that among obese adults who were simultaneously encouraged to eat appropriately and be physically active, two years of Wegovy treatment led to an average of 15% weight loss vs. only about 2-3% in the placebo group.
Five Reasons Why You May Not Be Losing Weight on Wegovy
The reasons why a person may not be losing weight on Wegovy can vary. Several things factor into your ability to lose weight with or without a weight loss drug like Wegovy. Your unique genetics, age, the amount you eat, and how much exercise you get all play a role in how well Wegov does or does not work for you.
Here are the five most common reasons why we see patients who fail to lose the amount of weight they want to on Wegovy.
Side Effects
The most common reason we see patients failing on Wegovy is because they stop taking it due to unwanted side effects. However, severe side effects on Wegovy are rare, and most of the common ones can be dealt with.
Like waiting for it to work, the best thing you can do about Wegovy side effects is to be patient. The most common side effects of Wegovy, such as nausea, diarrhea, and other gastrointestinal distress, usually fade out in time. If they do not, there are ways we can help you to mitigate them.
It is quite unusual in our practice to have to take a patient off of Wegovy due to side effects. The key is to discuss any side effects with us, and we can work to solve them.
Dosage Issues
Maybe the reason Wegovy is not working for you is you are not taking a high enough dose – yet. Wegovy is purposely “titrated,” meaning you are started out at the least effective dose, 0.25 mg injected once weekly for the first month so that your body is given a chance to get used to the medication.
Then, over the next several weeks, we slowly build up to the maximum dose of 2.4 mg after about the 17th week. So, if it seems like Wegovy is not working, especially early on, it may not kick in till you reach your maximum dose.
You May Be a Non-Responder
There are some people who simply do not respond to Wegovy. No drug is 100% effective. That does not prevent them from being FDA-approved. Every drug class has to work for a certain amount of people per set guidelines to be certified as “effective” in treating the given condition for which it is prescribed. For weight loss drugs like Wegovy, the guideline is if a patient loses more than 5% of their body weight within 3 months.
If it turns out you are a non-responder as close to 13% in the Wegovy clinical trials were, you may need to try another weight loss medication or a custom compounded version of semeglutide.
Medical Conditions
There are several medical conditions that can affect how well Wegovy works for you. For example, people with type 2 diabetes do not respond as well to Wegovy as those who are non-diabetic. A 2022 study published in JAMA found that people with diabetes only lost about 7% of their body weight after 6 months on Wegovy, as opposed to those without diabetes who lost nearly 12% of their body weight in the same time period.
Sometimes, it’s not the condition itself but the medications used to treat them that can negatively impact Wegovy’s effectiveness. Drugs to treat hypertension and some emotional disorders, for example, have been found to slow down weight loss on Wegovy.
If you have any of these conditions, it does not mean that you cannot and should not take Wegovy to lose weight, but you must keep in mind that it may not work as well for you as it might for someone who does not suffer from such ailments.
Not Adhering to Diet and Lifestyle Changes
Another quite common reason for Wegovy not working the way you expect is that you are failing to follow our advice on diet, exercise, and other lifestyle changes. We have seen too many patients who think Wegovy is some kind of magic drug that means once you are on it, you can just eat whatever you want, whenever you want.
They also make the mistake of thinking they do not have to worry about working out either. We are afraid to tell you that Wegovy simply does not work that way.
Maybe you could lose a few pounds on Wegovy if you take it weekly and do absolutely nothing else. But if you want to maximize your weight loss results, you must also make adjustments to your diet and physical activity.
One of the largest trials studying Wegovy found that the drug was most effective in participants who dropped their caloric intake by at least 500 calories daily and increased their physical activity to 150 minutes of moderate-intensity exercise (like walking) per week.
Can Wegovy stop working?
As we said earlier, in the clinical trials of Wegovy, patients continued to lose weight for up to 68 weeks, and there were those who continued to do so for two years and beyond. Wegovy has been designed for long-term use. As long as you are continuing to lose weight and not being troubled by side effects, there is little research to suggest that you will reach a point where Wegovy will stop working or that you must stop taking it.
In fact, the opposite is true; if you have been effectively losing weight on Wegovy and you do choose to stop, there is a good chance that the weight you lost will come back. So, as long as Wegovy is working for you, there is no reason to stop Wegovy.
If the idea of being on a weight loss drug potentially for the rest of life seems daunting, just think of the alternatives and all of the health issues that being obese can bring. If your doctor told you that you need to take any other kind of medication indefinitely, but it would keep you alive, you would not say “no.” You need to look at Wegovy the same way.
