If you've been on Wegovy for several months and aren't seeing the results you expected, you're not alone. Here are the most common reasons and what to do about them.
Are you at the full dose?
The dose escalation takes 16 weeks. Most significant weight loss happens at the maintenance dose (2.4mg). If you're still escalating, give it time.
Common reasons for slow progress
- Not enough time: Average weight loss of 15% takes 68 weeks. If you're only 3 months in, you're early.
- Liquid calories: Wegovy reduces food appetite but doesn't stop you drinking calories (alcohol, sugary drinks, coffee drinks).
- Medication interactions: Some medications (steroids, certain antidepressants, insulin) can promote weight gain.
- Underlying conditions: Hypothyroidism, Cushing's, or undiagnosed insulin resistance can slow weight loss.
When to talk to your doctor
If you haven't lost at least 5% of body weight after 6 months at the 2.4mg dose, your doctor may recommend switching to Mounjaro or adjusting your treatment plan.
Dealing with a weight loss plateau →
The 5% rule
Clinical guidelines define "adequate response" as losing at least 5% of body weight after 6 months at the full therapeutic dose (2.4mg for Wegovy). If you haven't reached this threshold, the medication may not be the right fit — but several factors should be checked first:
- Are you actually at the full dose? The 16-week escalation means you don't reach the therapeutic dose until month 5. Judging results before this is premature.
- Are you taking it consistently? Missed doses significantly reduce effectiveness. Set a weekly reminder.
- What's your dietary intake? Track for one week — you may be consuming more than you realise, especially from liquids.
- Are other medications interfering? Corticosteroids, some antidepressants, insulin, and beta-blockers can promote weight gain.
Next steps if Wegovy truly isn't working
If you've been at 2.4mg for 6+ months with less than 5% loss despite consistent use:
- Switch to Mounjaro: The dual mechanism works differently and may succeed where semaglutide doesn't. Some non-responders to semaglutide respond well to tirzepatide.
- Add complementary treatment: Your doctor may consider adding a second medication (e.g., bupropion) or referring to a specialist.
- Investigate underlying causes: Thyroid function, Cushing's syndrome, or other metabolic conditions should be checked.