6 Reasons You’re Not Losing Weight on Semaglutide or Tirzepatide

You may ask yourself, “why am I not losing weight on semaglutide or tirzepatide?” You’re not alone. GLP-1 and GIP receptor agonists, like semaglutide and tirzepatide, work by slowing digestion, regulating blood sugar, and reducing appetite—but results can vary based on your body’s metabolism, lifestyle, and how long you've been on the medication.

Let’s explore a few common reasons weight loss might be slower than expected.

1. You Just Started Your Peptide Therapy

Semaglutide: In clinical trials for weight loss (like the STEP program), patients typically noticed reduced appetite within the first 2-4 weeks of treatment.  Full appetite suppression effects often become more noticeable by 4-8 weeks, as the body adjusts to the medication. Gradual dose escalation (starting low and increasing the dose) also helps minimize side effects.

Tirzepatide: As a dual agonist that targets both GLP-1 and GIP receptors, tirzepatide may begin suppressing appetite within the first 1 to 4 weeks. Some clients notice changes even faster than with semaglutide. Most experience consistent appetite control by 8 to 12 weeks.

2. You’re Experiencing Constipation

Constipation is a known side effect that can affect how you feel and your weight loss progress. The good news? It’s manageable. Staying hydrated, eating fiber-rich foods, and moving your body with light activity can make a substantial difference.

3. Your Dose Might Be Too Low

You and your Couture provider will discuss your treatment plan, which will likely include gradual dosage increases based on your weekly progress. This is a steady process, and it’s important to keep that in mind throughout your journey. If you're consistently losing weight, there may be no need to increase your dose—slow and steady progress is exactly what we aim for.

4. You’ve Hit a Weight Loss Plateau

Hitting a plateau is a normal part of every weight loss journey. Your provider will continue to check your dosing schedule and ensure you're taking your medication consistently. They will also discuss your diet and lifestyle habits. You may also want to use tools like reminders or a treatment journal to stay on track.

5. You’re Skipping Diet or Exercise 

If you are still hungry on semaglutide or tirzepatide, that is normal. Remember, you are human and still need to eat. It’s crucial to eat a high protein, high fiber diet to maintain muscle mass, regular bowel movements and feel full longer. 

You also want to maintain an active lifestyle and do at least 30 minutes of weight training 5 days a week. Although we all have our carb cravings, protein and fiber will help to alleviate the common side effects associated with peptides for weight loss. 

6. Your Metabolism May Be Slower

Individuals with faster metabolism may notice appetite-suppressing effects sooner. This is usually because they can process the medication faster. For people with slower rates, the full effects of semaglutide or tirzepatide may take longer to kick in. This can be especially true for changes like weight loss or sustained appetite reduction.

Be Patient with Yourself

Everyone's experience is different, and factors like diet, lifestyle, and individual health conditions can influence how quickly and effectively these drugs work.  In general, it is expected that patients will lose approximately 20% of their total body weight over one year and about 0.5 – 2lbs per week. That’s a significant achievement—and it’s absolutely within reach.

Most importantly, be patient with yourself and don’t hesitate to contact your Couture Med Spa provider. We’re here to listen, guide, and support you during your weight loss journey!