Semaglutide Not Working? The Checklist, in Order
Results vary a lot by person. In STEP 1, the average loss on semaglutide 2.4 mg weekly was 14.9% over 68 weeks, against 2.4% on placebo. If you have lost little after several months on your full dose, talk to your prescriber.
- Average loss, top dose
- 14.9%
- On placebo
- 2.4%
- Trial length
- 68 weeks
- Trial
- STEP 1
Wegovy in brief
Its half-life is about 1 week: after 7 d half is gone, and after five half-lives (35 d) about 3% is left.
In STEP 1 over 68 weeks, the figure was 14.9% of body weight, compared with 2.4% for placebo.
Monthly price points in US dollars cover the list price, plus self-pay offers. Each one is read from the price page the maker posts.
Sources: FDA label (DailyMed), healthsystemtracker.org, prnewswire.com 1 2.
Semaglutide not working: the numbers first
| Trial | Dose group | Average weight lost | Placebo or comparison | Weeks | Who was in it |
|---|---|---|---|---|---|
| STEP 1 | Semaglutide 2.4 mg weekly | 14.9% | 2.4% | 68 | Adults with obesity or overweight, without diabetes |
| OASIS 4 | Wegovy pill 25 mg daily | 13.6% | 2.4% | 64 | Adults with obesity or overweight, without diabetes |
| SURMOUNT-5 | Semaglutide 1.7 or 2.4 mg weekly (Wegovy) | 13.7% | semaglutide (Wegovy) | 72 | Adults with obesity, without type 2 diabetes |
| STEP 2 | Semaglutide 2.4 mg weekly | 9.6% | 3.4% | 68 | Adults with type 2 diabetes and either obesity or overweight |
Sources for the studies: STEP 1 (FDA label (DailyMed)), SURMOUNT-5 (PubMed), STEP 2 (PubMed).
What causes a stall, and what helps
- See where you are in the dose steps. Across every trial listed above, the lower doses produced less weight loss.
- Look back over the past month and count the doses you took late or missed entirely.
- Record a few days of food and drinks. As portions get smaller, liquid calories and grazing add up.
- Get protein with each meal and continue strength exercise so that fat makes up most of your weight loss.
- Take a look at sleep and stress, since they change appetite.
- Ask your pharmacist whether any of the other medicines you take can lead to weight gain.
- If your progress has stalled for months, talk with your prescriber about switching medicines. Also ask about a thyroid test or a blood sugar check.
How many people in the trials stopped
Sources: STEP 1 (FDA label (DailyMed)), STEP 1 (PubMed).