Help, I’m Not Losing Weight On My GLP-1 Medication!
GLP-1 medications like tirzepatide and semaglutide, otherwise known by the brand names Ozempic, Wegovy, or Mounjaro, have had a huge surge in popularity because of their effectiveness at appetite suppression and weight loss.
Like any weight loss tool, however, the medications do have their limitations and patients should keep in mind that though they may be helpful, a well rounded lifestyle change is the only way to maintain a healthy weight in the long term.
For many people, the change in appetite when taking GLP-1 medications helps them lose weight quickly in the first couple of weeks or months. However, you may find that as time goes on, weight loss slows and even plateaus.
It is important to note that this is a normal and even expected outcome of weight loss, no matter the method you are using. Read on to gain a better understanding of why plateaus happen and how to overcome them.
What Causes the Weight Loss Plateau?
So why is it that no matter how you are losing weight, whether you are using GLP-1 medications to assist you or not, after an initial period of rapid weight loss you almost always hit a plateau? To put it plainly, your body tends to want to maintain the status quo.
Losing weight requires you to override your body’s natural inclination to hold on to weight. This function dates back to our hunter-gatherer ancestors who struggled to maintain adequate caloric intake and every calorie counted towards staying alive.
In the modern day, when resources are plentiful and many of us are struggling to maintain a healthy weight, here’s how it works:
A strong Start
When you are first losing weight through a calorie deficit, your body starts to look for energy sources other than calories from food.
It finds this energy from glycogen, a carbohydrate stored in the muscles and liver. When glycogen in burned, it releases water, which is why you typically hear that this initial weight loss is mostly water weight.
Next, your body starts burning off the energy it has stored in the form of fat and muscle tissue. As your body begins to burn through these stores, the initial rapid weight loss continues.
However, both of these functions of weight loss eventually lead your body to take counteractive measures, instead trying to hold onto or even gain weight back to reach its previous homeostasis.
What happens next
Studies show that no matter what diet or exercise routine you choose to lose weight, people experience a similar degree of weight loss within that first 8-12 week period. However, only about 10-20% of people maintain this weight loss beyond 24 weeks.
Your muscles burn more calories than any other tissue at rest, so as you lose both muscle and fat tissue, your metabolism actually starts to decline. It declines even more because a smaller body requires fewer calories than a larger one to perform the same daily functions.
In addition, as your body loses weight it actually begins to secrete higher levels of the hormone ghrelin which increases hunger. Ghrelin also increases fatigue and causes your body to conserve fat because it falsely believes you are starving.
How Your GLP-1 Medication Works
Glucagon-like peptide-1, or GLP-1 medications, are an analog for a hormone that is naturally secreted by your body during digestion. They are called tirzepatide or semaglutide and were originally prescribed to help people manage their type 2 diabetes.
GLP-1 medications work by cueing your body to release satiety hormones, making you feel fuller. They also regulate blood sugar and slow stomach emptying, making the patient feel fuller for longer.
Other than weight loss and diabetes care, the medications have been found to help lower blood pressure and cholesterol.
Although these medications are extremely effective at helping to decrease your appetite and feel fuller longer, they do not counteract the functions of weight loss we discussed in the previous sections.
What this means is that while GLP-1 medications are a powerful tool that can help you reach your goals, you still need to make adjustments throughout your weight loss journey which will help you to maintain weight loss while your body goes through these physical changes.
So, How Do You Get Back on Track with Weight Loss?
The simplest and most straightforward way to understand weight loss is to understand that your body converts calories from food into energy. When you eat an excess of calories, your body stores them as fat for later, and when you eat a deficit of calories, your body begins to burn those fat stores to make up the difference.
Cut Calories
As you lose weight, your caloric needs change. Like we mentioned earlier, a smaller body requires fewer calories than a larger one to perform the same functions.
What this means is that while your calorie intake at the start of your weight loss might have been adequate, you will need to make adjustments as you get closer to your goal weight.
Use a calorie calculator with your current weight and activity level to get a more accurate picture of how your caloric needs have changed. We recommend this one because it takes into account your age and activity level as well as gives a helpful macronutrient breakdown.
Generally, a good calorie deficit is about 500 calories below your maintenance calories, but because everyone’s bodies are different, you may need to adjust.
If you find that you feel too hungry or fatigued, increase your calories by about 100 at a time. If you are still not breaking through that plateau however, you might need to try eating fewer calories.
It might take time to find that sweet spot where you both feel satiated and are still losing weight.
Increase Exercise
The second thing to look at when you aren’t losing weight is the amount and quality of your exercise. We discussed in a previous blog post the new research that suggests that you can’t increase your calorie deficit with exercise. However, exercise is still an essential aspect of weight management that shouldn’t be overlooked.
Remember when we talked about your muscle’s connection to metabolism? Well, maintaining or growing your muscles is an extremely important aspect of maintaining weight loss over time.
If you are experiencing a plateau, examine your relationship with exercise at the moment. Does exercise still feel challenging to you or have you slipped into a routine where you aren’t progressing? Are you focusing too much on cardio and not spending enough time in the weights room?
In order to gain muscle you need to be continually challenging those muscles. You can do this either by increasing the time you are spending on strength training or increasing the intensity of your routine through higher weights.
Add More Protein
At TeleHealthNP, we don’t believe in a magical diet that will unlock weight loss. Instead, we advocate that you strive for the balance that works best for your unique tastes and lifestyle.
That being said, there is one diet adjustment that we believe would serve just about everyone, and that is increasing your protein intake. There are many benefits to increasing protein, and you can read about it in depth in this post.
To put it more simply in the interest of brevity, protein is an amazing nutrient that helps you feel more satiated after a meal and helps your body to build more muscle.
This means that by consuming higher protein content meals, you will feel fuller and more satisfied while eating fewer calories. In addition, a high protein diet will make your strength workouts more effective, helping you to build muscle and increase your metabolism in the process.
The Bottom Line
Managing your weight can feel complicated, especially when you hit a plateau. Plateaus can feel frustrating and discouraging when you feel like you’re doing everything right.
Hopefully this post has helped you to see weight loss in more simple terms and empowered you to make decisions that will get you back on track.
As always, we at TeleHealthNP are here to help you become the most confident, healthiest version of you. Reach out to our nurse practitioner and weight loss expert for support and guidance on your journey.
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