All about GLP-1 Plateau

These expert-based tips can help the scales start moving again.

If you are taking Ozempic or Wegovy, you may already know that semaglutide injection belongs to a class of drugs called GLP-1 receptor agonists. They help with weight loss by mimicking the glucagon-like peptide-1 (GLP-1) hormone, which regulates blood sugar levels and suppresses appetite. Once a closely guarded secret among celebrities and the super-rich, these drugs have become increasingly common in recent years, with a surge in popularity among those who want to lose weight.

While GLP-1 does make losing weight easier, that doesn’t mean there won’t be any bumps along the way to reaching your goal weight. Even with a prescription, it’s common to experience a plateau. This can be frustrating – especially if you’re used to seeing results week after week. But it’s also common, and procrastination never means you’re doing something wrong.

“It’s rare that someone sees a completely stable, linear decrease in weight over time,” says Michael L. Glickman, M.D., M.D., Obesity M.D. revolution Medicine, health and fitness. In other words, it’s all part of the process, and thankfully, there are steps you can take to get back on your feet, according to Dr. Glickman and another weight loss expert we spoke with. Here’s why GLP-1 weight loss plateaus occur and how to overcome them.

Recognizing the signs of weight loss plateau

If you keep stepping on the scale and find the same number staring back at you, you’re probably going through a plateau, says Amy Shapiro, founder of Manhattan nutrition practice Real Nutrition. “A weight loss plateau is when your weight stops changing or changes very little despite continuing the same diet, physical activity, or medications,” she says.

Dr. Glickman noted that a true plateau occurs when a person maintains the same weight for several months. “Start by ruling out normal weight fluctuations caused by water retention, hormonal changes, waste removal and disrupted sleep,” he explains.

To determine if you’re truly plateauing (i.e. not just stuck with your period), log your weight every day. “To get the most accurate reading, check your weight first thing in the morning after emptying your bowel and bladder,” advises Dr. Glickman. If your weight has stayed the same for more than a month, you may need to make some adjustments to get the scale moving again.

What causes your weight loss plateau?

There are countless reasons for weight plateauing while taking drugs like Ozempic or Wegovy, but Dr. Glickman and Dr. Shapiro say these are the culprits.

Your hunger hormones have risen

The GLP-1 hormone is one of eight hormones that play a role in hunger and weight regulation. Specifically, GLP-1 helps regulate blood sugar, slows gastric emptying, and increases feelings of fullness. GLP-1 agonist drugs mimic these effects to promote weight loss.

While Dr. Glickman points out that this approach can last for a while (a little over a year on average), the fact is that seven other hormones also play a role in hunger and weight regulation, and they are designed to prevent hunger. “Even though GLP-1 reduces some hunger signals, other hormones and mechanisms can still promote appetite and energy conservation,” Shapiro explains. So, at some point, they wake up, realize you’re consuming fewer calories, and signal your body to make biological changes to help you avoid weight loss.

In other words, your metabolism adapts. Unfortunately, this can happen even if you haven’t reached your goal weight or the optimal weight for your health.

Your lifestyle does not support weight loss

Relying solely on medications to lose weight does not support sustained weight loss. Shapiro noted that plateaus are more likely to occur in people who don’t make lifestyle changes, the most important of which is muscle-building physical activity. This is because the more muscle you have, the more calories your body burns at rest. On the other hand, when you lose muscle (which is more likely to happen when losing weight quickly), your metabolism may drop dramatically, hindering your progress. “People who lose fat while retaining skeletal muscle (or better yet, gaining muscle) will have less of a decrease in basal metabolic rate than those who lose muscle,” says Dr. Glickman.

Poor sleep quality, high stress, and regular alcohol consumption are other lifestyle factors that can affect hunger hormones like ghrelin and leptin, thereby hindering your progress. Alcohol can also exacerbate the gastrointestinal side effects of GLP-1 drugs, including nausea and acid reflux. Dr. Glickman says that regularly managing these symptoms may delay dose increases, which in turn can lead to plateauing of the medication.

Overcoming GLP-1 Weight Loss Platform

Now that you understand why you can’t lose weight, you may be wondering what you can do about it. Both Shapiro and Dr. Glickman say a good place to start is by changing lifestyle factors such as sleep, nutrition and physical activity. “It’s a common misconception that you can just take a medication and see results. While this may work for a while, it won’t lead to long-term success. This is where lifestyle changes come in,” Shapiro says. From that point on, if you still don’t see changes, it may be worth checking your medications with your doctor – including your GLP-1 and any other medications you may be taking.

Challenge and nourish your muscles regularly

Participating in GLP-1 does not mean you can skip going to the gym. Doing so will only hinder your progress. Studies show that people who take GLP-1 and sweat regularly lose more weight than people who don’t sweat regularly, and tend to lose weight more effectively. This is because exercise helps strengthen muscles, which will help your body burn more calories throughout the day.

While any type of physical activity is beneficial, when it comes to protecting and strengthening muscles, resistance training is king. “It helps maintain lean body mass during weight loss, which helps keep your metabolism high and allows for further fat loss without losing muscle mass,” explains Shapiro. Both Dr. Glickman and Shapiro recommend doing full-body heavy training 2 to 3 times per week for best results.

Shapiro points out that fueling your muscles is equally important. “Building muscle through regular strength training can help maintain metabolism as you lose weight, while prioritizing adequate protein intake can help with lean body mass and feelings of satiety,” she says. Both Dr. Glickman and Dr. Shapiro recommend consuming 1.2 to 1.5 grams per kilogram of body weight per day, spread throughout meals and snacks. “This will help you feel full and support healthy blood sugar levels,” explains Dr. Glickman.

In practical terms, this means that a 150-pound person should consume 82 to 102 grams of protein per day from whole foods such as meat, seafood, eggs, dairy, tofu, and beans. If you’re finding it difficult to meet your daily goals, protein powders like HUM Core Strength can help. (Contains 20 grams of plant protein per serving.)

Also focus on fiber and moisture

Protein often gets all the attention when it comes to weight loss, but Shapiro stresses that staying hydrated and getting enough daily fiber is just as important. She explains that these habits contribute to sustainable fat loss and help shorten the duration of the plateau.

Dr. Glickman and Dr. Shapiro explain that drinking water throughout the day aids digestion, gives you energy for exercise, and eliminates other beverages that may make it harder for you to overcome your plateau, such as alcohol and sugary drinks. The Academy of Nutrition and Dietetics recommends that women drink about nine glasses of water per day. However, you may benefit more if you’re particularly active or thirsty easily, so be sure to listen to your body.

When it comes to fiber, both Dr. Glickman and Dr. Shapiro recommend consuming at least 25 grams of fiber per day, primarily from the following whole foods.

• raspberry: 1 cup, 8 grams
• Apple, skin on: 1 medium, 4.5 g
• broccoli: 1 cup, 5 g
• Potatoes, skin on: 1 medium, 4 g
• Whole wheat pasta: 1 cup, 6 g
• brown rice: 1 cup, 3.5 g
• almond: 1 ounce (about 23 nuts), 3.5 grams

If you find it difficult to reach your daily fiber goals through whole foods alone, consider a supplement like HUM’S Flatter Me Fiber GLP1 Booster. Contains 9 grams of fiber per 4 teaspoons.

Don’t forget sleep and stress management

“Poor sleep quality and excessive stress can limit the body’s ability to lose weight,” Shapiro says. “Lack of rest often leads to an imbalance of ghrelin, which stimulates appetite and promotes fat storage. Additionally, if you’re tired, you won’t have the energy to perform the exercise you want.”

That’s why she stresses the importance of mind-body practices like meditation, yoga and breathing that can help relax and improve sleep quality, and get at least seven hours of sleep each night.

If you have trouble falling and staying asleep, supplements like HUM Beauty zzZz can help. It combines melatonin, vitamin B6 and calcium to enhance sleep quality, regulate circadian rhythm and promote restful sleep.

Ask your doctor if your medication should be changed

If you go to the gym several times a week, eat a fiber- and protein-rich salad for lunch every afternoon, and get enough sleep every night, but still aren’t losing weight, it’s time to talk to your doctor. “The next step might be to increase the dose of GLP-1,” Dr. Glickman said. They may also consider switching you to a stronger medicine, such as tilsiparatide. While GLP-1 agonists only mimic one hormone, tilsiparatide (such as Zepbound and Mounjaro) mimics two hormones: GLP-1 and gastric inhibitory polypeptide (GIP), which can help overcome the plateau.

Your doctor can also review any other medications you are currently taking to consider whether they may be slowing your progress. “For example, many common medications have side effects that promote weight gain. If one of your regular medications causes weight gain or slows down your weight loss efforts, your doctor may switch you to a different medication,” says Dr. Glickman.

Scale-related wins are only part of the story

It’s easy to get caught up in the weight loss successes that show up on the scale and ignore the weight loss successes that don’t show up. But when dealing with a plateau, a change of mindset may be just what you need. “It can help to focus on other markers of health to maintain a positive attitude,” Dr. Glickman notes. For example, if important biomarkers like waist circumference, blood pressure and heart rate are improving, that’s proof your GLP-1 journey is working, he says. “Keep in mind that losing just 5 to 10 percent of your body weight can significantly improve many aspects of your health.”

It can also be encouraging to look at other “non-scale wins,” as Shapiro puts it, like your clothes fitting better or being able to climb stairs more easily. “Even if the numbers on the scale don’t change much, these things can provide insight into the positive cardiovascular and body composition benefits,” Dr. Glickman said.

Shapiro emphasized that reaching a steady state is a normal physiological response, regardless of whether GLP-1 is taken or not, and does not prove that the treatment has stopped working. So your best bet is to stay the course—and don’t throw in the towel or stop taking your medication without talking to your doctor first—even if you’re just maintaining your current weight. Remember: If you’re seeing improvements in your overall health, it’s better to experience some weight loss than none.