Ozempic, Wegovy, Mounjaro, or Zepbound “stopped working”? Here is what I would do when the weight loss plateau hits, and why a flat scale does not mean failiure I’m a pathologist, and this is what the trials show, plus 4 questions to bring your prescriber.
Where I landed:
– The scale can stop while the drug is still working. In the 4-year semaglutide trial, weight held about 10% below the start while people stayed on it.
– The line goes flat where the drug’s effect meets a smaller body that burns less.
– Your fat cells mostly shrank. The number of cells stays about the same.
– There are 3 kinds of plateau: dose, drug, and life after the drug. Each one is a different conversation with your prescriber.
– Retatrutide’s “no weight loss plateau” headline: I went looking for where that sentence came from. It’s at 16:41.
– Resistance training cut the muscle share of weight lost to 17.5%. That part is yours to influence.
The GLP-1 Method (90 days of short daily videos on protein, muscle, sleep, and how you eat). Next cohort starts October 15. Free waitlist:
Watch next, long-term risks of Ozempic and Mounjaro, graded:
CHAPTERS
00:00 “I think it stopped working”
00:43 Three people, three scales
02:22 The graph: Ozempic, Zepbound, and the 4-year trial
03:41 Why your friend’s weight loss curve looks different
05:02 The bucket: why every weight loss plateau happens
07:42 Your metabolism after weight loss (adaptive thermogenesis)
09:32 Your fat cells under the microscope
11:42 5 things people try at a plateau, graded
14:18 Maria: Mounjaro or Zepbound dose and tolerability
15:29 James: top-dose Ozempic or Wegovy, is there a different drug
16:41 Retatrutide and the “no plateau” press release
18:56 Denise: weight regain after the drug stops
20:07 Muscle loss: what the weight you lose is made of
21:46 The hardest fact
22:33 What I’d do this week: 4 questions for your prescriber
23:37 Where I land
REFERENCES (checked on PubMed and the Lilly and FDA sites, September 2026)
1. Wilding JPH et al. STEP 1. N Engl J Med 2021;384:989-1002.
2. Wilding JPH et al. STEP 1 extension. Diabetes Obes Metab 2022;24:1553-1564.
3. Jastreboff AM et al. SURMOUNT-1. N Engl J Med 2022;387:205-216.
4. Ryan DH et al. SELECT weight outcomes. Nat Med 2024;30:2049-2057.
5. Aronne LJ et al. SURMOUNT-5. N Engl J Med 2025;393:26-36. Lilly funded, open-label.
6. Rubino D et al. STEP 4. JAMA 2021;325:1414-1425.
7. Hall KD. Physiology of the weight-loss plateau. Obesity 2024;32:1163-1168.
8. Leibel RL et al. N Engl J Med 1995;332:621-628.
9. Fothergill E et al. Obesity 2016;24:1612-1619 (n=14).
10. Spalding KL et al. Nature 2008;453:783-787.
11. Eisa N, Barood O. Diabetes Obes Metab 2026;28:4818-4827.
12. Lilly release, May 21, 2026, TRIUMPH-1 (company data):
13. Lilly release, March 19, 2026, TRANSCEND-T2D-1:
14. Bajaj HS et al. TRANSCEND-T2D-1. Lancet 2026;407:2402-2413.
15. FDA’s concerns with unapproved GLP-1 drugs:
16. Nauck MA et al. Diabetes 2011;60:1561-1565.
DISCLAIMER
This video is education, not medical advice, and it doesn’t create a physician-patient relationship. Don’t start, stop, or change any medication because of a video. Those decisions belong with you and your own physician. Maria, James, and Denise are composites to protect patient identity, not actual patients. I have no sponsor for this video and no financial relationship with any drug maker, compounding pharmacy, or peptide seller. Retatrutide is investigational and not FDA approved.
Dr. Amin Hedayat, MD | UNINFLAMED™ | New video every Saturday
#Ozempic #Mounjaro #WeightLossPlateau #Zepbound #GLP1
source
Which one are you: Maria, James, or Denise? Reply with the name and the month your scale went flat. I read these, and your answer may shape the next video.
Maria = stuck on a lower dose
James = stuck at the top dose
Denise = off the drug, and the weight is coming back
What I'd do this week (22:33):
1. Judge the trend over weeks. One morning's number tells you very little.
2. Write down your dose and the reason you're on that dose.
3. Bring your prescriber 4 questions: Is this a dose and tolerability issue? Is this the expected response to this drug? Is a different treatment appropriate for me now? Or is this a weight to maintain?
4. Count your protein for 5 days.
5. Do resistance training twice a week.
If someone you know is on Ozempic, Wegovy, Mounjaro, or Zepbound and thinks it "stopped working," send them this video. A flat scale and a failed drug are 2 different things.
This is education. I can't give individual medical advice in the comments.
The GLP-1 Method waitlist is free, and the next cohort start is listed at https://getuninflamed.com
I started a couple years ago at 308. Started in January and lost 45 on a semaglutide shot and flatlined in July. Kept taking it for a while but nothing was happening as you described. Paused for a while and picked a new provider. I started with Zepbound this year at the starter dose with 4 shots, increased dose , 4 shots, increase dose, etc. I'm at 15mg now and I've only lost around another 12 pounds. I've been on 15mg for 2 months now with no change. I've been basically hovering from 255-260 for quite a while now. So, I guess I'm James. But I'm also dealing with LowT – and low energy levels and the lack of motivation of a 57 year old. I'm staring at a fully equipped home gym that I can't spark the energy to use. I have all the desire throughout the day, but by the time I hit post work, I'm drained.
When I plateau my dr increases the dose by 2.5 mg
I lost 38lbs in 50 weeks
Will up my dose this week to 12.5mg I’m 66 5’5 225lbs
Can we give a 14 days gap on dose
Fasting for 36 hours ALWAYS fixes my weight loss stalls on GLP-1. Gotta each above maintenance on the day after. Fasting 36 hours is super easy on GLP-1 as I never get hungry.
wow this is fascinating. Thank you.
yes, but mounjaro never stops working for your sugar. It keeps controlling it and doing the best job of all of those drugs. I didnt take it for weightloss I took it for diabetes and my insurance stopped covering it. They want me to take the junk that never helped me I already went through that and why are they making me go backwards? :'(
Hello. I have been on Ozempic and currently on Mounjaro revised to a 12.5 after a year of no weight loss. I lost 10lbs only when I was off the drug on a trip in Europe. Unfortunately, when I stopped for the two months, my A1C went off the roof. I had to get back on Mounjaro. I have not lost a pound and I actually have gained four pounds back. My A1C dropped from 7.6 to 6.2, so I keep taking the drug. Would appreciate any advice you could provide. Thank you.
I went from 209 (March 2023) to 152 (December 2025) at the lowest and then regained back to 165. I'm dialed in again to get back down to 153 before the holidays, but the low 150's is hard to maintain. It's really easy to stay around 165. I can eat as much as I want and I don't go much above that thankfully. But to get down into the 150's I have to be very restrictive with calories. I had DEXA scans done before and after the weight loss and thankfully I only lost 10% of my weight from muscle, so I don't worry as much about losing muscle in those restrictive phases. Exercise helps my lab results, but it doesn't seem to move the needle in terms of weight loss.
I've learned a lot about my body, its set points and what it takes to maintain at every level so it feels good to really understand what I need to do even if I don't always feel up to the task of execution. The food noise is gone, but managing your weight can be all-consuming and sometimes I just want to enjoy things. I've always wanted to see what it might be like to be under 150lbs as an adult, but I can't imagine being able to stay there.
Stop the madness!! Its not living if i have to count anything. Just make a drug that loses weight without side effects. PERIOD!!
I still do not understand why we stop losing weight while on GLP-1. 2 mg is the last Ozempic strength, so should I change the medication? My endocrinologist said it's not about losing weight, but about lowering blood sugar. I lose weight, I lose sugar; when I gain weight, I gain sugar, period.
I found your video an absolute breath of fresh air, you have gained a subscriber, thank you. To answer your question, I think I am a James. I have lost 62lbs in 11 months but the last two weeks no weight loss. I am on the top dose of Wegovy. I have gone from 278lbs to 216lbs Which I am very pleased with but I still need to lose nearly as much weight again. I am only 5ft tall and would be very happy if I could get below 140lbs. My doctor would be happy if I was closer to 112lbs. Personally, I would like a white Christmas and to win the lottery, we all have some unobtainable goals in life. I exercise regularly, I walk a minimum of 10,000 steps at least twice a week and when not walking I cycle about 10 miles a night. Not a great deal I know, but compared to a year ago when getting out of bed was an exercise it's not too bad. I am 62 years old so Gym is not really an option, I think my knees and hips would totally give up on me. I would be interested if others like me have successfully lost over 160lbs on these injections or have beaten the plateau.
I lost 15% on Mounjaro in 16 weeks but felt a big loss in strength (golf Drives 10-15 yards shorter), upside was I dropped from Type 2 diabetes, through pre-diabetic all the way back to “normal”. Blood pressure and cholesterol great too. But it’s only now that I’m stable (6 months in, on .5 dose) that I have the energy to address my muscle loss. I couldn’t have worked out in the early weeks. I’m taking protein and creatine powders and working out 2-3 times weekly. In retrospect I could have started taking the protein shakes sooner and at least tried some gentle lifting but I’m feeling good doing this now. Wish me luck!
Plateau broke by holding 5mg six weeks instead of climbing. I get mine from Aureus Research LLC. COA every batch.
When you starve yourself, your body eventually puts a halt to the loss. This is why you don’t starve yourself 😂
STOP CUTTING CORNERS!
I’ve found I was taking way too many electrolytes. I was feeling weird and used my Apple Watch’s ecg feature and saw my heart beat pattern was approaching a sine wave. 😬
I stopped taking them and I started losing again right away. Now I think I’ll take them maybe once a week at most.
Here one for ya…down 40 lbs 🎉… when started I weighed 300lbs, unable to lose a pound for like 5 months now my A1c went from 6.1 to 5.3…i started on zepB lowest, now on 10mg…when I went up to 12.5 mg it made me fall asleep in my chair literally (NUTZ) so I backed off down to 10mg currently. I get my protein in barely and for sure dont eat like I used to bcuz I simply cant plus I no longer crave chocoate but def feel hunger pains if I havent eaten well or at times crave sugar every now and then..
Once I went off ZebB 2 wks I felt body changes and I ate more, and would think @ food more like I used to before I got on ZepB. I am living testimony this stuff does what it says but I hate the plateau….please help me!!! (Ozempic slowed my tummy down EVEN WORSE. almost died on that…ZepB is perfectly made for my issues)
Help.
Can’t fasting reach the same result ? 🤔
I'm Maria. Started Zep at 2.5 December 2025. 5.0 in March 2026 and have stayed there. 26 pounds lost. Started at 191, 5'4", 66 y.o., strength training 3x weekly, 120 g protein daily.
Graph went flat in July.
Thank you so much for the time stamps. That really helps absorb and remember all this.
Amazing video, Dr. Hedayat, thank you so much!
I started Mounjaro on the May 01st this year at 174.9kg (=386lbs), and was down 46.4kg (=102lbs) at September 14th; so -26.5% of my body weight, all on 2.5mg. For exactly two weeks I am stuck now, and I think a month ago it would have caused me to panic and spiral; but I take it fairly easy and relaxed.
For the last two weeks I had some health issues (flu), didn't move much, didn't work out or exercise at all, sat at my desk a lot, didn't drink enough water, and slept less than 4 hours most nights. But on the bright side: my caloric intake was decent (respecting my very low activity level), I still achieved my protein goals, and I will pick the workouts and weight training back up on Monday.
I still have quite a lot of weight to lose, but it doesn't upset me any more, because I see what I already did, and how much better my life has become. I'll keep working, and I am beyond grateful for the medication, to keep my food noise, constant hunger and the inflammation at bay, as I learn to eat like a healthy person, instead of the food-addicted human dustbin I was.
OK female 64 years old being taking mounjaro for a year and a have last 3 month at the 15 level no change in body weight can there be something different going on O by the way I'm prediabetic a1c at 5.8
Great info. Due to multiple health issues glps are not even an option for me. i find it frustrating and annoying when it is assumed automatically that weight gain is due to an uncontrolled appetite and unrestricted caloric intake. Weight gain (or weight loss) can be a symptom of a health issue or a side effect of medication and simply cannot be addressed just by eat less and move more.
I was 328 last May. Started Ozempic in June. I was 268 by June this year. Started Mounjaro. Im down to 219. I just added cag to my regimen. When the Mounjaro ceases its effectiveness I'll start on retatrutide.
I have been on ozempic for over 2 years. When I first started I was 440. I went down to 360 then stopped losing. In a month or so after I found out I had low testosterone and iron and hemoglobin was slightly low. I was very lethargic for months. 6 months after I plateaued I finally started taking iron daily and testisterone gel daily. It did not absorb nor did the iron and my weight stayed the same. It actually went up 20 pounds and stuck between 375 and 395 fpr 6 more months. Its now 2 on it and I am stuck still at 385. Now getting iron infusion 2 weeks in a row and testosterone needle half a milligram every 2 weeks. After having 2 infusions and 3 needles still bot losing. Have removed more food from my daily eating. Very upset.
Started mounjaro 19weeks ago with 2.5mg and after 4 weeks, moved up 5mg and have been on 5mg until now, reaching full this Friday. Lost about 9kg so far and weight has remain more or less the same for the last 2 week. Did intermittent fasting average 18hours a day, stop eating at around 3pm daily but sometimes if I am hungry, I will not starve myself and will eat by 7pm. Diet intake high protein (eggs, chicken, beef), some carbs (rice, bread), steam vegetables, fish, love my fruits and Greek yoghurt. Will eat dessert, ice cream on some days. Had some knee issues, so can’t do much walking or running but do some simple stretching exercises at home.
I lost 85 pounds in six months on mounjaro and managed to gain 3 pounds of muscle doing it. i'm a 6'4" tall man and I was 383.
A lot of people don't realize that just eating a lot of protein won't prevent muscle loss. You could eat a lot of protein and go to the gym and do resistance training and still lose muscles.
A lot of people do not realize that the human body can only mobilize so much fat per day, and Is based on the Alpert equation. Now not everybody's bodies going to behave to that equation. So I took it and reduced it by 25% and made sure I never went near that. Every 5 pounds I recalculated that equation.
Therefore, my body never needed to turn to my muscles for Energy
Most of my protein came from whey and casein protein which has leucine – which activates the mTOR pathways telling your body want to build muscle or at least keep it
people plateau for two reasons I figured out.. when you're in a weight loss and in a deficit, the body thinks it's starving so it reduces your BMR and becomes more efficient at exercise. So a lot of people aren't weighing and me measuring their food and tracking their calories and they don't where fitness tracker. So they have no idea what the input in the output is this makes it real easy to go in to too much of a deficit and burn your muscle or not really be in a deficit and plateau.
Yes, the drugs can lose their effectiveness or I should say in the body can adapt to them. Digestion can speed up and hunger can return because the body senses the threat of the weight loss.
That is a problem because now these people are getting hungry on these drugs again. My doctor solved it by stacking phentermine on top of the GLP/GIP drug, and that was actually able to get me to lose another 60 pounds. I'm now 238 pounds, and my A1c dropped from 7.2 to 4.8. I took an oral glucose tolerance test and stayed under 140. My doctor will slowly wean me off this drug over the next 6 to 12 months, and my type two diabetes is now cured – not remission – cured
20:28 so if i am exercising regularly and progressing, i should be fine because i am either gaining or maintaining muscle? for example i am doing weigjt exercise 3 times a week, cardio once a week (sorry i just hate cardio, i prefer walking), walking 6000+ steps every day and 10-15 minutes of yoga every day, i believe i should stop gaining fat at some point?
Edit: I am 35, female, i am currently only on diet and exercise. i gave birth 11 months ago. before that i was on and off using Mysimba and it cause a lot of issues with apetite, bowel movements, digestion, nausea… I was on metformin (siofor) 2022-2025 until i gave birth and that definitely helped to stop gaining fat. i dont measure the scale that much, i orefer to watch my waist and hips and hands measurements to know if i am losing fat. becaude ofc i dont want to lose muscle