What to do if you aren’t losing weight while on weight loss medication

by | Dec 3, 2023

While on weight loss medication you will likely notice some ebbs and flows with losing weight.  This month’s newsletter discusses what to do when this occurs..  The easiest solution is to increase the dose of your medication.  After you have been on the medication for a few months, side effects with dose increases tend to occur less frequently.  Please contact your clinician if you have any questions or are not sure what the maximum dose is for your medication.  Semaglutide comes in different concentrations so the maximum dose and dose increases can be confusing.  If you can’t increase your dose due to side effects, we can discuss switching to another weight loss drug.  Since both Semaglutide and Tirzepatide are FDA approved for weight loss we now have more options to find the right medication and dose for you.  Tirzepatide price does increase per dose but we do offer discounts for multi-month orders.
At some point, everyone will reach the maximum weight loss for the medication they are taking.  However, further weight loss can be increased with  lifestyle interventions.  These interventions are key if you wish to stop taking the medication and keep the weight off. Here are several ideas:
Intermittent fasting – This is a catch-all term for a variety of options to limit calories by decreasing the total time you are eating during the day.  The best method is to go one step at a time.  First, eat a protein-rich dinner and do not snack after dinner.  After you are comfortable with that, try delaying when you eat breakfast.  Start with 30 minutes after your normal time.  Then try an hour.  Keep on moving the time back.  The commonly accepted ideal schedule is 16 hrs fasting, 8 hours eating food.  Try moving to two main meals and fruits for snacks.  Learn more here.
Increasing protein – Protein will make you feel more full and requires more energy to digest.  Aim for one gram of protein per pound of ideal body weight.  This is a challenge but you will be amazed how full you feel once you cut back on carbohydrates and fats!  The easiest way to start is to eliminate carboyhydrate-rich/junk foods from your house. If you only have healthy options at home, you will be eat healthily a good percentage of the day. Protein rich meals.
Strength training – This is a common topic we discuss because it is so important!  Start with walking 30 minutes.  If you aren’t active, make a goal to go twice a week.  Once you start moving your body it can be hard to stop.  Add in some resistance training. Find something you like. The long term dividends to your health are endless.  Options to start here.
Strength training is especially important when using weight loss medication because muscle mass can be lost along with fat. Resistance training will ensure that more of the weight you lose is unwanted fat rather than the healthy muscle tissue you want to maintain.
Adequate sleep – Your body needs to rest time to work in its best state.  Without good sleep, your body enters a stress state.  This “fight or flight” state will work against weight loss. Also, your inhibitions will be lower and you are more likely to reach for junk food and carbohydrates that simply add weight without any benefit to your body. Tips on sleep.
Additional medication
Metformin, traditionally used for managing type 2 diabetes, also has weight loss properties that can complement the effects of GLP-1 medications. When used together, these medications can potentially enhance weight loss more than when either is used alone. Metformin works by improving insulin sensitivity and reducing glucose production in the liver, which not only helps in managing blood sugar levels but also aids in controlling hunger and reducing food intake. Meanwhile, GLP-1 medications increase insulin secretion and create a feeling of fullness after eating, which helps reduce overall calorie intake. This dual approach can be particularly effective for patients who are struggling to achieve significant weight loss with GLP-1 therapy alone. Learn more here.

This blog post is intended for educational purposes only and should not be considered a substitute for professional medical advice.