Plateaus to Overeating: The Reasons You Might Be Gaining Weight on Ozempic

For decades, doctors have doled out the same weight management advice: To see those pounds fall, you need to watch what you eat and exercise.

But in recent years, semaglutide medications, including Ozempic and Wegovy, have offered a more efficient and effective solution — especially for individuals who have difficulty losing weight or a history of yo-yo dieting.

Studies back their effectiveness with an 80% or higher success rate. But one concern has emerged: Patients who don’t lose weight or end up gaining weight on Ozempic or Wegovy. Below, we break down the reasons why this might be happening and offer strategies to finally see the results you want.

First, What Is Ozempic?

According to the Centers for Disease Control and Prevention, over 40% of American adults are obese. Many of these individuals have developed chronic health conditions as a result, including type 2 diabetes.

Ozempic initially entered the market as a type 2 diabetes medication intended to control blood sugar by encouraging the body to produce more insulin, and lower the risk of cardiovascular events. Doctors, however, noticed an additional benefit: Along with better diabetes management, this injectable medication produced significant, rapid weight loss.

Behind this effect, Ozempic suppressed patients’ appetites by mimicking GLP-1, a hormone the body releases to control appetite. As a result, Ozempic helps patients feel fuller longer, slows digestion and reduces feelings of hunger — all of which can lead to consuming fewer calories overall. 

As doctors and researchers observe more patients prescribed semaglutides, they’ve noticed that Ozempic and Wegovy have an effect similar to bariatric surgery, a far more invasive procedure. This observation encompasses the 86% people who’ve lost weight while using a semaglutide.

What about the remaining 14%? These individuals report either no change, a plateau after early progress, or weight gain after stopping Ozempic.

For a distinction here, Ozempic has yet to be approved for weight loss. Wegovy, a once-per-week injectable that contains a higher dose of the same active ingredient, was approved by the Food and Drug Administration in 2021 for weight management.

Why Am I Gaining Weight On Ozempic?

Gaining weight on Ozempic or Wegovy often comes down to two side effects. Your body has gotten used to the medication and your weight plateaus in response. Or you stopped taking the semaglutide and the weight returned.

Other possible scenarios are:

1. Your doctor hasn’t prescribed you the right dosage: Generally, doctors start patients on a lower dose of a semaglutide (for example, 0.25mg per week for four weeks) and increase it in response to pounds lost and side effects. At each stage, your body adjusts to the medication — a process that might take a few weeks. As a note, consistent doses yield more consistent results.
2. You haven’t evaluated your lifestyle: There’s one misconception about semaglutides: You just get injected and go on with your life. Yet, just as with bariatric surgery, you benefit from — and see more visible results in response to — lifestyle changes. These include eating a diet full of nutritious fruits, vegetables, whole grains and lean protein and getting in about 30 minutes of physical activity each day.
3. You’re not consuming enough protein: As the secret to staying full, protein takes longer to break down. This effect also improves your energy levels, helps you consume less per day and allows your body to build lean muscle mass.
4. You’re not drinking enough water: Staying hydrated better helps your body eliminate waste and additionally supports your metabolism.
5. You’re living with an underlying health condition: If untreated, certain conditions like polycystic ovarian syndrome and hypothyroidism can cause your body to hold onto unwanted pounds.
6. You don’t sleep seven to eight hours per night: “Beauty rest” takes on an entirely different meaning for weight loss. Getting under seven hours each night makes you feel drowsy the next day, a factor that can lead to poor eating choices and reduce your motivation to work out.

Can Ozempic Cause Weight Gain?

"Can I gain weight on Ozempic?" The answer is, maybe, especially in response to the following:

• You stopped Ozempic or lowered your dosage after hitting your goal weight.
• Your doctor hasn’t prescribed you a higher, more effective dosage.
• Your body hit a weight loss plateau after some early success, and you might benefit from lifestyle changes, like adding more lean protein to your diet or exercising more.
• Your body has developed insulin resistance and therefore holds onto fat and causes your blood sugar to spike.
• You might be experiencing water retention or edema — a potential side effect if you live with heart or kidney disease or use a corticosteroid.

What Not to Eat on a Semaglutide

Whether you use Ozempic or Wegovy, certain foods trigger side effects like nausea, bloating or an upset stomach. Or they cause your blood sugar to spike and limit how well your medication controls your body’s insulin.

In addition to overeating on Ozempic, Common culprits here include:

• Foods that are high in fat — known to result in an upset stomach for semaglutide patients.
• Sugary foods and drinks and anything with a high glycemic index.
• Refined or ultra-processed carbohydrates, which have less fiber and vitamins.
• Starchy vegetables, which typically have a high glycemic index and contribute to blood sugar increases.
• Alcohol, which may sit in the stomach for longer when a patient uses a semaglutide.

How to Address Post-Ozempic Weight Gain

As a starting spot, view your health beyond pounds gained and lost, and instead, think about how you can provide your body with the fuel it needs to function. To get started:

• Work with your doctor and a dietician to set up a personalized diet plan that centers around lean proteins, vegetables, fruits, whole grains and other low-glycemic foods.
• Monitor how much protein you get in and from which sources, and consider adding a meal replacement shake like Biocare to your diet.
• Make a fitness plan that focuses on a mix of strength training and aerobic exercises.
• Limit, if not avoid, fried, high-sugar and other high-calorie foods.
• Manage stress with mindfulness activities or hobbies.
• Seek encouragement from friends, family and support groups.
• Embrace progress, not perfection!
• Address any post-Ozempic weight gain with your doctor to discuss dosages, lifestyle, underlying health conditions and other factors.

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