You Hit the GLP-1 Weight Loss Plateau; What Now?

The rapid rise of GLP-1 receptor agonists, such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), has transformed the care of obesity and diabetes. Yet, as more people use these medications, a common experience emerges: the GLP-1 weight loss plateau.

If you ended up here because you don't understand what changed, I won't bury the lead—everyone taking a GLP-1 medication will eventually hit the plateau. It's what you do now and next that will define your experience.

Understanding the Plateau Phenomenon

A weight loss plateau refers to a period where weight loss slows or stops, even as a person continues their medication and previous lifestyle habits. This phenomenon is not unique to GLP-1s—plateaus happen in any regimen, including diets, exercise, and bariatric surgery.

In a recent tirzepatide (Zepbound) study, a weight loss plateau was defined as "a period when body weight remains relatively stable—defined as less than a 5% change over a 3-month period—after an initial phase of weight loss."

What that means is—you can do everything right and you'll still hit a GLP-1 weight loss plateau. In fact, our bodies are designed to do just that to prevent starvation and pool resources to sustain life.

The scientific term is homeostasis. As weight decreases, metabolism slows, and hunger hormones increase, making further weight loss progressively harder. GLP-1 medications counteract some of these adaptations by reducing appetite and improving satiety, but they do not eliminate the body’s underlying drive to resist weight loss.

The Hormones That Control Hunger and Weight

More than eight key hormones play central roles in regulating hunger, satiety, and body weight. These hormones interact in complex ways to influence appetite, metabolism, and fat storage.

One of those hormones is GLP-1, which is targeted by semaglutide and tirzepatide. They are GLP-1 agonists, essentially mimicking the hormone in a more potent and longer-lasting form. Tirzepatide is a dual agonist that targets glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1).

"Everyone hits a weight loss plateau at some point, no matter which weight loss intervention they use."

“Everyone hits a weight loss plateau at some point, no matter which weight loss intervention they use. GLP-1 and GIP are just two of eight hormones that control hunger and weight, and eventually, the other hormones signal the body’s protective mechanisms to make changes to prevent more weight loss" - Luca Busetto, MD, Lead Author of Tirzepatide Study

Hunger Hormone Details

Let's take a closer look at the other hormones that get involved.

Insulin, produced by the pancreas, allows cells to absorb glucose from the bloodstream for energy or storage. Chronically high insulin levels, often due to excessive carbohydrate intake, can lead to increased hunger, cravings, and fat storage.
Leptin is secreted by fat cells and signals the brain when you have enough energy stored, promoting feelings of fullness and suppressing appetite. Low leptin or leptin resistance (common in obesity) can increase hunger and lead to overeating.
Known as the "hunger hormone," ghrelin is released by the stomach when it is empty, stimulating appetite. Ghrelin levels decrease after eating, but certain foods, such as sugary drinks, may not suppress them effectively, leading to continued hunger.
Peptide YY (PYY) is produced in the gastrointestinal tract after eating and helps reduce appetite. Higher protein and fiber intake can increase PYY, enhancing satiety.
Cortisol, the "stress hormone," is released by the adrenal glands in response to stress. Chronic elevation of cortisol is linked to increased appetite, cravings (especially for high-calorie foods), and weight gain.
Cholecystokinin (CCK) is released in the gut and nervous system after eating, slowing stomach emptying and promoting feelings of fullness. Meals rich in protein, fiber, and healthy fats can boost CCK levels.
Neuropeptide Y (NPY) is produced in the brain and stimulates appetite, particularly for carbohydrate-rich foods. Stress and lack of sleep can increase NPY production, leading to overeating.

While not always listed among the “core eight,” GIP serves as a trigger for insulin secretion. Released by K cells in the small intestine—especially after eating fat—it also helps control fat storage and hunger signals throughout the body and brain.

The Role Dosing Plays in GLP-1 Weight Loss Plateaus

There’s no “perfect” GLP-1 dose that guarantees non-stop weight loss—it really is a balance. The dosing schedules for medications like Wegovy and Zepbound are designed to let your body gradually adjust, not just for safety but also to manage side effects like nausea or fatigue.

That said, if you’ve been on a lower or mid-range dose for a while and weight loss has stalled, a dose increase (aka "titrating up") might help—but it’s not a guarantee.

Some people do best with lower doses over the long term, while others don’t start responding until they reach the full dose. The key is working with your provider to find what’s both effective and sustainable for you, rather than assuming “more” is always better.

INSURANCE ALERT: Insurance often requires patients to follow the full GLP-1 dose escalation schedule, even if they feel fine on a lower dose or want to titrate up due to a GLP-1 weight loss plateau. The titration exists for a reason: it helps manage side effects and gives your body time to adjust. Talk to your provider about this.

New Research About the GLP-1 Weight Loss Plateau

A new three-year study on Zepbound (tirzepatide) shows that most people hit a weight loss plateau within the first six to 12 months.

However, the study also noted the type of person who is most likely to lose a lot of weight but then experience a later GLP-1 weight loss plateau.

"Not everyone responds to medication to the same degree, and we identified a greater chance of successful weight loss in a group with a higher proportion of females and those with no medical conditions linked to obesity,” Dr. Busetto added.

"We identified a greater chance of successful weight loss in a group with a higher proportion of females and those with no medical conditions linked to obesity."

The good doctor also pointed out that, regardless of when a GLP-1 weight loss plateau occurred, most participants maintained "clinically meaningful weight loss over 3 years, regardless of age, duration of obesity, and BMI."

You might also be happy to know that losing 15% of your body weight is the benchmark for reaping the most benefits from GLP-1 medications.

So if the scale has stalled, you're in good company—and it doesn't mean the medication stopped working. This plateau is part of the process, not the end of it.

woman standing on a plateau in a yoga pose

Is the Plateau Inevitable?

Most clinical experts agree that some form of plateau is virtually universal among people using GLP-1s for weight loss. The body establishes a new “settling point” or equilibrium after a period of weight loss, at which further reductions become much more difficult.

Dr. Andrew Kraftson of Michigan Medicine notes that “most people taking these medications will hit a plateau around the 18-month mark after starting treatment”. This timeline can vary, but the principle holds: the body adapts to the new, lower weight, and weight loss slows or stops.

Can You (or Should You) Break Through the GLP-1 Weight Loss Plateau?

Now that we know hitting the GLP-1 weight loss plateau is normal and to be expected, give yourself a pat on the back for lowering your weight and letting your body build a healthier, more efficient version.

So, should you push past it? That depends. If you haven’t yet met your health goals—whether that’s more weight loss, better blood sugar, or lower blood pressure—then it may make sense to keep going.

But if you’ve reached a stable, healthy weight and feel good, the plateau might just be your new set point. That’s not failure. That’s maintenance.

If your provider agrees that more weight loss is appropriate, strategies such as increasing protein intake, adding strength training, reassessing your calorie intake, improving sleep, and possibly adjusting your dose or medication can all help.

On the flip side, if the plateau comes with solid lab results, better energy, and improved quality of life, maintaining your current weight might be the win.

Bottom line: Breaking a GLP-1 weight loss plateau is possible, but whether you should depends on your goals, health, and what feels sustainable in the long term. GLP-1s were never meant to be a quick fix or magic bullet.

Are There Exceptions to the Weight Loss Plateau?

While the plateau is common, there are some nuances to it. The amount of weight lost before plateauing and the timing of the plateau differ among individuals, influenced by genetics, baseline weight, medication dose, and lifestyle factors.

A small subset of people may not lose significant weight at all on GLP-1s, which is a different issue from plateauing after initial loss.

Some may experience “mini plateaus” (short-term stalls) before resuming weight loss, while others reach a more permanent plateau.

Because the science is still evolving, doctors and researchers don’t fully understand why people respond so differently to these medications.

I've chatted with a lot of other GLP-1 users, and too many times I see the frustration after a few weeks without significant weight loss or a plateau hit just when they felt they found their stride. Don't give up the efforts to be the healthiest version of yourself.

Is the Plateau Permanent?

A plateau does not necessarily mean the end of progress. Strategies can sometimes help people break through:

Lifestyle Adjustments: Modifying diet, increasing physical activity (especially strength training), and improving sleep and stress management can help.
Medication Adjustments: Increasing the GLP-1 dose (if tolerated) or adding another medication that targets a different pathway may be effective for some.
Behavioral Interventions: Tracking food intake, varying exercise routines, and working with healthcare professionals can provide new momentum.

I started working with Ashley of Legg Day Fitness because I wanted one-on-one attention focused on better eating habits and fitness that evolves with my abilities and interests. I also didn't want to feel like workouts took over my personal time. Of all the programs out there that felt so cookie-cutter, the Legg Day Method was all about me and my specific needs and wants to change my life, not just lose weight.

Is It Really a GLP-1 Weight Loss Plateau?

It's also critical to realize when a "plateau" isn't a plateau. Sometimes the number on the scale stays the same because your body is changing in other ways, like gaining muscle, which weighs more than fat but takes up less space.

Hormonal shifts (like menopause), inflammation, or even a salty meal can cause temporary water retention that masks fat loss. That’s why it’s worth tracking progress beyond the scale—think measurements, energy, strength, or how your clothes fit.

Also, even if your main goal for taking Wegovy or Zepbound is to lose weight, there are other tests to consider. Get blood work done, check your heart, and explore your kidney filtration rates. Even modest weight loss (5–10%) can yield significant health improvements, so a plateau does not mean the medication “isn’t working”.

Enjoy the View from the Plateau

I always say, "Enjoy the view from the plateau." It’s a chance to pause, take in how far you’ve come, and appreciate the progress your body has made. For many, the toughest side effects are behind them, and the uncertainty of those early weeks has given way to a new rhythm.

This is your opportunity to reflect, reset, and talk to your doctor about what’s next—whether that means pushing forward or focusing on maintaining the health gains you’ve already earned. Either way, the view from here is well worth it.