Four Key Factors Why Weight Loss Medications May Be Ineffective for You

The majority of persons going for GLP-1 receptor agonist medications, including Wegovy and Zepbound, in most cases show very remarkable weight loss. Their health markers also improve greatly. However, this is not so in all cases. This can be very frustrating to some people using these drugs and ending up adding zero or a few pounds to their weight, especially after several months of medication. In clinical trials, more than 13% of the patients taking Wegovy and almost 9% taking Zepbound and Mounjaro were unequivocally “non-responders” to these medications.

This means they lost less than 5% of their body weight in the first three months. No drug is perfect for everyone, and no such thing exists, also, with this new class of weight management and diabetes drugs, said Dr. David Lau, an emeritus professor and director of the Julia McFarlane Diabetes Research Centre at the University of Calgary. While researchers are still investigating all the reasons for individual variability in response to GLP-1 medications, several lifestyle factors are well within your control. Here are some questions you should ask yourself if you aren’t seeing the weight loss results you want with a GLP-1 drug. Aren’t You Having a Good Diet, Exercises, and Enough Sleeping? GLP-1 medications can control appetite and hunger, but they do not work alone.

Whether or not such drugs work effectively also depends on the attention you give to other aspects of your health. Indeed, in clinical trials, participants received diet and exercise counseling together with their medication. “Lifestyle intervention and lifestyle modification remain the foundation of therapy for people living with overweight and obesity,” says Dr. Lau. Many GLP-1 drug users reported reduced amounts of “food noise” or fewer cravings for fatty, sugary foods. However, if you continue to reach for those high-calorie foods instead of getting in nutrient-dense food, you may sabotage weight loss. Importance of Protein and Exercise “Protein intake is really one of the principle components of maintaining weight within a healthy range,” said Moreno, an obesity medicine specialist and assistant professor at Yale School of Medicine. “Adequate protein consumption allows a decrease in hunger post-meal, this in turn suppresses snacking, and it also allows for the preservation of lean muscle mass”. “Number one with a bullet to help keep the weight off is exercise,” says Dr. Moreno. In addition to building muscle mass, metabolic rate, bone strength, and blood sugar control, strength training also offers a host of other health payoffs.

Aerobic exercise is good for the heart and the head. When added to a GLP-1 drug, frequent exercisers lost not only more weight than their less-active counterparts did but also maintained those losses over time. Poor Sleep and Stress Management Poor sleep and high stress levels are yet others. When one is not able to get enough rest, it can alter hunger hormones, leading to feelings of increased hunger while also promoting the storage of fat. Stress causes stimulation on hormone releases, making one feel hungrier or conserve energy by storing calories. “When you don’t sleep well, you may be hungrier the next day. You may be tired, so you don’t have as much energy to exercise as much as you want to. You’re not able to focus on all the things that you want to do, like eat better. Some people who are super swamped may not be consistent with taking the medication,” says Dr. Moreno. “All of these things matter, and every little bit adds up.” If you’re eating well, exercising, sleeping enough, and yet the GLP-1 medications don’t seem to work for you, it might be that your body isn’t responding to these drugs correctly. Are You on the Right Dosage? If you’ve started on a GLP-1 only recently, then you need to give it some time. For most people, the weight starts to come off after three weeks of the drug itself. “It’s only after a trial of taking the medication that we can identify who responds and who doesn’t respond,” says Dr. Lau.

Sometimes, just changing the dose is a game changer. In clinical trials of a 5 milligram dose of tirzepatide — its brand names are Zepbound and Mounjaro — 85% of people had meaningful weight loss; 91% of people taking a 15 milligram dose did. Dr. Lau says that other people might require a higher dose of GLP-1 medication for them to respond adequately. Studies underway are testing whether tripling the current dose of semaglutide, found in Wegovy, to 7.2 milligrams might enable more people to respond. “If you overload the system with more GLP-1, you’re more likely to have the receptors open and bind to the GLP-1. Therefore, you would elicit a response that you otherwise might not have at a lower dose of the drug,” Dr. Lau explains. “This is still a subject of tremendous research.” Overcoming Plateau in Weight Loss If Weight Loss with a GLP-1 Medicine Slows After an Initial Step Down, That Doesn’t Mean the Medicine Isn’t Working. It’s always good to keep in mind that whatever way people go after weight loss, eventually, it will slow down or hit a plateau.

If that plateau occurs before you’ve been able to achieve your health goals, your doctor may be able to help you think through next steps. He or she might switch you to a different medicine, for example, add another that isn’t a GLP-1 to work in tandem with a GLP-1, or even bariatric surgery if warranted by your situation, or other lifestyle changes. Consistency in the Use of GLP-1 Adequacy and efficacy of a GLP-t medication demand consistency in its use. Discontinuation of the medication and usage in intermittent phases will result in regaining the bodyweight and bad control of glycemia. To prove my point: In fact, a trial among persons who interrupted the use of tirzepatide resulted in regaining about 15% of body weight in 4 months. “This treatment is meant for a lifetime unless you are willing to return to your original weight,” Dr. Steven Heymsfield explains in paraphrase, who is the acting professor of metabolism and body composition at Louisiana State University. “Compliance is the number one issue, and lack of compliance has many causes.” Side Effects and Financial Barriers A headache and gastrointestinal side effects are manageable for some but for others stop the GLP-1 medications. Subsequently, if the medications are not covered, the cost of these medications is very high for nearly anyone. Regrettably, too many pay the over $1,000 per month necessary for these medications. It’s also important to make sure you’re getting the pure form of medication prescribed.

Compounded drugs may contain semaglutide sodium or other inactive ingredients that have not been shown to work and could even cause safety problems. Thinking About Other Health Problems It can, moreover, be affected by other health conditions. For example, people with type 2 diabetes may tend to lose less weight when placed on GLP-1 medication compared to patients who only have the condition of obesity but no diabetes. Taking insulin further complicates weight loss. Some psychiatric medications can cause weight gain. If a person needs to take such medications for another condition, their doctor may prescribe a more appropriate older GLP-1 drug.

For example, Contrave (bupropion/naltrexone) can help people with depression and anxiety see both mental benefits and weight loss from its use.\ The average weight loss shown in clinical trials is just that—an average. Not everyone will lose 15% or 20% of their body weight. Patients who cannot tolerate the highest doses of semaglutide or tirzepatide may also run into problems trying to match the impressive weight loss noted in studies with these drugs alone. At the other extreme were what got labeled as “super responders,” those who lost so much more weight than others. Much of this dynamic variation can be guided by some genetic and other biological mechanisms that research is continuing to unravel. For example, the way humans will metabolize or process drugs is one of the things that varies between individuals; people can have different sensitivities to hormones. Researchers are still investigating a slew of determinants that influence the success of body weight management. Most likely, their findings will enable clinicians to personalize treatment plans to offer a health solution that best fits each patient and his potential for weight loss and health improvement.