HealthMen's Health

Yes, you can hit a weight loss plateau — even on drugs like Wegovy

It’s inevitable. Eventually, with a weight loss goal of more than a few pounds, the dieter hits a plateau. The body seems to balk at more weight loss. It even happens with GLP-1 drugs, like semaglutide (Wegovy) and tirzepatide (Zepbound). That doesn’t mean treatment is a failure. You can work with your doctor to get past your plateau. It may take patience and persistence, but you can do it. There are millions of success stories, and you can star in your own story.

Plateaus are your body’s natural, response to weight loss – calorie restriction will lead to your body responding with hunger hormones. Simultaneously, your slower metabolism and lighter body burn fewer calories. Expecting the plateau will limit disappointment. Be encouraged that, eventually, a healthy diet will lead to lasting change. Let’s look at a few ways you can improve your weight loss journey:

Embracing lifestyle changes

If you’ve tried weight loss many times, you’ve probably tried fad diets and learned that they are unsustainable. The same can be said for any weight loss you may have managed on those fad diets. You introduced chaos into your metabolism. Give yourself the gift of an appointment with a registered dietitian. You don’t need a doctor’s order. It doesn’t hurt to have another health professional on your cheering squad.

GLP-1s are only FDA-approved for weight loss when used with behavior modification. A dietitian can help you handle side-effects and prevent malnutrition while on the drugs. You may need to increase protein intake to help prevent muscle loss. A dietitian can suggest certain eating times and nutrients (like increasing fiber) that can help you break through your weight loss plateau.

A health coach or trainer can teach exercises and routines personalized for you, as well as provide encouragement. Studies show that moderate exercise for 150 minutes per week when on a GLP-1 results in greater fat loss and more successful weight loss maintenance than when taking the drugs alone.

Try different drug combinations

There are many alternatives to GLP-1s that work as anti-obesity medications on distinct parts of the brain. While GLP-1s stimulate insulin secretion and delay gastric emptying to reduce appetite, phentermine (Lomaira) stimulates the release of norepinephrine to reduce appetite. Topiramate (Topamax), used to manage epilepsy and migraines, also suppresses appetite and prolongs a feeling of fullness.

Metformin (Fortamet), bupropion/naltrexone (Contrave), and zonisamide (Zonegran) target different hormones and brain receptors to induce weight loss.

If you reach a plateau on one drug and you are still on your way to meeting your health or weight loss goals, switching to a different type of drug, drugs that target different areas of the brain, may be effective. Discuss it with your physician.

A woman showing the weight she loss with her oversize pants and holding pills.

Treat underlying mental health conditions

Obesity and depression are common companions. Studies show that people with obesity have a 55-percent greater risk of developing depression. People with depression have a 58-percent higher risk of developing obesity. Other mental health conditions like anxiety and disordered eating can also contribute to overweight and obesity.

Depression is linked to both a sedentary lifestyle and emotional eating. These can make it harder to conquer weight loss plateaus. GLP-1s may lift depression in some people, but it gets worse for others. Cognitive behavioral therapy (CBT) is designed to change negative thought patterns, contribute structure, and set priorities. It can increase your sense of control and independence.

GLP-1s may trigger disordered eating. Mental health support, while you’re transforming your body, can carry you through a plateau without the cost of developing anorexia or another harmful eating disorder.

Remember – obesity is a chronic condition

Obesity is a chronic condition. For more than 10 years, the American Medical Association has recognized obesity as a disease with “multiple pathophysiological aspects.” So, many people face resistance to weight loss, regardless of the method or methods they use to support their efforts. You may reach an especially stubborn plateau. That doesn’t mean that the GLP-1 quit working.

It’s now known that GLP-1s are beneficial to your kidneys’ health. That’s especially a plus in people with diabetes because they are prone to chronic kidney disease. Even without weight loss, the drugs can improve your overall health.

Although weight loss plateaus can feel discouraging, you can weather those plateaus because you expect them, have backup approaches to weight loss, and focus on overall health.

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