Why doesn’t semaglutide work for me?
Since the 2021 FDA approval of semaglutide for weight loss through the branded medication Wegovy, many people have been able to utilize this powerful medication to aid in their weight loss goals.
If you are on your weight loss journey with the help of semaglutide but not losing the amount of weight you desire you’re probably wondering “why doesn’t semaglutide work for me?”.
What is semaglutide?
Semaglutide is a medication that has been used to treat type II diabetes for many years under the brand name Ozempic. Wegovy has recently been added to the cohort of drugs for weight management as the FDA approved version of semaglutide specifically for weight loss.
Semaglutide belongs to a class of medications called GLP-1 that mimics a peptide our body naturally produces which helps to decrease hunger and improve insulin sensitivity, leading to weight loss.
Who is semaglutide for?
Semaglutide as Ozempic is for people with type II diabetes or who have an A1C that is considered pre-diabetic if other weight-related conditions are present such as high blood pressure, cardiovascular disease, or obstructive sleep apnea.
Semaglutide as Wegovy is for people with a BMI over 30 or a BMI over 27 with an existing weight-related condition such as high blood pressure, cardiovascular disease, or obstructive sleep apnea.
Insurance approval of either medication can be tricky, but the main differentiation between getting Wegovy versus Ozempic has to do with the absence or presence of an elevated A1C that will either lead to diabetes or has already resulted in diabetes.
What is the difference between Ozempic and Wegovy?
The primary difference between Ozempic and Wegovy is the available dosages.
Ozempic has 3 dosages available – 0.25 mg, 0.5 mg, and 1.0 mg.
Wegovy is approved for 5 dosages – 0.25 mg, 0.5 mg, 1.0 mg, 1.7 mg, and 2.4 mg.
The extended dosages available for Wegovy is what promotes the weight reduction possible with this medication. Ozempic is approved for diabetes management only, which can be achieved at lower doses.
I’ve been taking semaglutide but haven’t lost any weight – why?
At Rivas it is exceptionally rare for one of our patients to fail to lose weight while taking semaglutide. We have hundreds of patients using semaglutide for medically supervised weight loss and nearly 100% of our patients achieve at least some weight loss. If someone is taking semaglutide but not seeing weight loss it could be due to one of the following reasons.
• The dose is too low.
Though some of our patients will see therapeutic benefit at lower doses such as 0.5 mg or 1.0 mg of semaglutide, many find it necessary to use either a 1.7 mg or 2.4 mg dose to sustain consistent weight loss.
If have maxed the dose available for Ozempic and are not seeing weight loss, it is possible that your body will respond better to a higher dose and Ozempic may not be the proper solution for your weight loss goals.
If you are taking Wegovy and have not yet been increased beyond these lower doses, discuss your concerns with your prescriber and they may be willing to increase your dose if you are tolerating side effects well.
• Lack of medical support and counseling
The importance of accountability, support, and weight loss counseling cannot be overlooked.
Many patients receive Ozempic or Wegovy from their primary care provider or other medical specialist. These providers are unfortunately not often able to provide in-depth or thoughtful counseling on lifestyle modifications that lead to healthy weight loss.
There are numerous myths about weight loss and even more ways to successfully lose weight that may or may not be sustainable long term for many people. The available information through the media can make weight loss overwhelming, with people encouraged to adopt one fad after another.
At Rivas, we supply simple and sustainable lifestyle modifications that, if continued beyond treatment, can often yield lifelong weight maintenance with minimal impact on daily life.
Seeing your provider more than once a month or once every 3 months is necessary to review questions and recommendations about the medication that, if addressed, can easily return someone with stalled weight loss to the consistent loss they were previously experiencing.
What should I do?
If your dose is too low, have a conversation with your prescriber about your concerns. Perhaps increasing your dose will allow you to resume weight loss.
If you’re on an appropriate dose with either Wegovy or Ozempic but not losing consistent weight, you may benefit from the kind of individualized counseling we offer at Rivas.
Rivas uses generic semaglutide rather than offering branded prescriptions. Thanks to this we are able to utilize the full range of the FDA-approved doses for weight loss (0.25 mg – 2.4 mg). Seeing patients every week allows us to increase your dose at a pace that works for your weight loss and your body rather than what the manufacturer prepackages.
Generic semaglutide is not as costly as branded Wegovy and at Rivas we pass the cost-savings along to our patients. We even have patients successfully receive partial coverage from their insurance by submitting a receipt. Though not every insurance covers part of the cost, some do, and we encourage our patients to utilize any cost savings possible.
Generic semaglutide may not be as inexpensive as your coverage for branded Ozempic, but the care we provide at Rivas is yielding consistent results for our patients that allows many to reach their weight loss goal whether it is 20 pounds, 70 pounds, or more.
Ready to get started?
If you have been taking Wegovy or Ozempic and are not seeing the results you desire, call us to schedule a consultation. Our providers will tailor your semaglutide therapy to meet your personal goals while providing support and nutritional counseling. Call your nearest Rivas office for the next available appointment.
Written by:Kristin Perry, PA-C
Rivas Medical Weight Loss, Frederick, MD