Why the scale stopped

Is it actually a plateau?

Daily weight swings of one to two kilos are normal and mean almost nothing. Hydration, sodium, glycogen, the menstrual cycle and what time you weighed all move the number more than a week of fat loss does.

The unit that carries signal is a seven-day average against the previous seven-day average. On that basis:

The checklist, in the order worth checking

Work down this list before concluding the medication stopped working. In almost every case the answer is somewhere in the first four.

1. Is the dose still escalating? If you are mid-titration, you have not reached the dose the results are built on. A stall at week ten on 1 mg is often just week ten. The titration schedule shows where you are.
2. Has protein dropped? The first thing to slip when appetite falls, and the thing that protects lean tissue. Check it against a number rather than a feeling — the protein calculator gives you one.
3. Have portions drifted? Appetite suppression is not constant. As side effects settle, capacity returns, and portions grow back without any decision being made.
4. Has alcohol come back? Uncounted calories, disinhibited eating afterwards, disrupted sleep. See GLP-1 and alcohol.
5. Has sleep collapsed? Short sleep moves appetite regulation measurably, and it is the variable people never connect to the scale.
6. Has movement dropped? Not exercise — movement. Less weight to carry means fewer calories burned doing the same day.
7. Is food noise back? If the mental chatter about food has returned, that is information about dose adequacy and the single most useful thing to report.

Your curve was always going to flatten

Weight loss on these medications is not linear, and nobody's trial data says it is. The steepest part is early, and the curve bends as you approach whatever your new equilibrium turns out to be.

Two things follow. Comparing month nine to month two compares against the fastest stretch you will ever have. And the point where the curve genuinely flattens is not failure — it is the treatment arriving at maintenance, which is the phase the drug is licensed for.

The weight loss projection tool plots the published trial averages so you can see the shape rather than assume it should be a straight line.

Better metrics than the scale

People stall on the scale while continuing to improve on everything the scale cannot see. Worth tracking alongside:

• Waist measurement. Moves when the scale does not, particularly if resistance training is in the picture.
• Food noise. The earliest signal in either direction.
• Strength, or how many stairs before you notice.
• Blood pressure and glucose control, if either is why you are on treatment.
• Clothes. Unscientific, unarguable.

When it is worth raising

Four weeks of a flat seven-day average, at a stable dose, with intake genuinely unchanged. That combination is worth an appointment.

What makes that appointment useful is arriving with the checklist already worked through. "I've plateaued" invites a guess. "Seven-day average flat for five weeks on 1 mg since 3 July, protein averaging 95 g against a 130 g target, food noise back on days six and seven" produces a plan.

Common questions

Why has my weight loss stopped on Ozempic or Wegovy?

The most common causes, in order: the dose is still escalating and has not reached its full effect, protein and portion sizes have drifted, alcohol has returned, or sleep has dropped. Weight also naturally plateaus as you approach a new equilibrium — the trial curves flatten too.

How long is a normal GLP-1 plateau?

Under two weeks of a flat seven-day average is noise rather than a plateau. Four or more weeks at a stable dose with unchanged intake is worth raising with your prescriber.

Should I increase my dose if I plateau?

Not on your own. Titration schedules exist because escalating too quickly drives nausea, vomiting and dehydration. A plateau is a good reason to ask about a dose review, not a reason to change it yourself.

Does the medication stop working over time?

A flattening curve is expected as you approach a new equilibrium and is not the same as the drug losing effect. If the dose is stable, intake is genuinely unchanged, and the seven-day average has been flat for a month, that is the point to have it assessed properly.

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