Check for a real trend first
Your weight shifts with fluid, salt, bowel contents and hormones. Compare readings taken in the same conditions over several weeks. One morning's number tells you little. Constipation can hide a downward trend for a while without any gain in body fat.
A steady spell after large weight loss differs from a weak response all along. Note how long the plateau has lasted, your starting weight, your current dose and how regularly you have injected. This gives your prescriber a useful pattern to work with.
Why the early pace slows
As your body gets smaller, you need less energy. Some of the big early drop on the scales is fluid, and nobody expects the first rate of loss to last forever. Holding a lower weight steady is a real benefit in its own right.
In STEP 5, average weight loss levelled off after about week 60 and held through two years. This shows a flat line on the scales and an ongoing treatment effect go together. The trial does not set a week when you personally should expect to plateau.
Review the practical side without blame
Check your injection technique, missed doses and storage, and whether you take the medicine as prescribed. Think about changes to meals, alcohol, sleep, activity and other medicines. The aim is to find things you can change. A plateau is no sign of dishonesty or lack of effort.
Ask yourself whether a smaller appetite has led to skipped meals followed by bigger ones, or whether symptoms stop you being active. A dietitian can review what you eat without pushing you into ever stricter calorie cuts. Eating enough still matters while you decide what to change.
A higher dose is one option among several
If you are still stepping up the dose, stick to the planned reviews and do not skip stages. Some adults with obesity may be eligible for 7.2 mg after at least four weeks on 2.4 mg. The higher dose has limits on who can use it and its own side effects to weigh.
A plateau is no reason to double doses, shorten the gap between injections, combine medicines or switch to tablets on your own. Each of these can raise your exposure or mean taking two of the same drug. Ask your clinician to explain the likely benefit and the uncertainty of any change.
Measure the outcomes you care about
Look at your waist, mobility, blood pressure, glucose where relevant, sleep and how well you manage daily life. These sit alongside your weight and add context. If you take Wegovy to cut heart risk, the scales alone miss the point of treatment.
Agree when you will next review, which measures to record and what would count as too little response. Current UK product information sets a six-month point to judge weight response for weight management, with an individual weighing of benefits and risks. A clear review plan beats checking the scales daily and changing treatment after each reading.
Sources
Your own medicine leaflet and prescriber come first. A source from another country does not mean the same rule applies in the UK.
- Wegovy FlexTouch UK prescribing information medicines.org.uk
- STEP 5: two-year semaglutide trial pubmed.ncbi.nlm.nih.gov
- NICE TA875: semaglutide for weight management nice.org.uk
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