Semaglutide-based diabetes drugs like Ozempic and Wegovy have gained popularity among those struggling with weight loss. These medications have shown significant weight reduction, typically around 10% to 15% or more. However, there comes a point where the effectiveness of these drugs plateaus, usually after approximately 60 weeks of use. It is recommended to continue taking the medication for life to maintain the weight loss achieved.
Weight loss plateaus are common and can occur with various methods, including traditional diets and exercise routines. These plateaus often happen when the body reaches a healthy weight and begins conserving calories. The mechanics behind a weight loss plateau involve the body’s energy burn equaling the energy intake from food. As a person loses weight, their metabolism slows down to compensate, eventually reaching a point where the metabolism matches the energy intake, resulting in a plateau. To overcome a plateau, significant changes in energy balance, such as increased physical activity or further reduced food intake, are necessary.
It is important to note that weight loss should be viewed as an improvement in overall health rather than solely focusing on a specific number on the scale. Body composition, enhanced well-being, and better-fitting clothes are all signs of progress, even if the scale does not reflect it.
The dosing of semaglutide drugs should be tailored to each individual, starting at the lowest effective dose and gradually increasing as needed. However, there is a maximum dose beyond which further increases are not possible. If a plateau persists despite dietary changes, medication adjustments, or modified exercise programs, it may indicate that the drugs have reached their limit of effectiveness.
For individuals who have reached the limit of effectiveness with semaglutide drugs, there are more potent medications available. Tirzepatide, for example, mimics two hormones and has shown promising results in trials, achieving sustained weight loss of up to 20% in some participants. However, the long-term safety of tirzepatide is still unknown. Another medication under review is retatrutide, which mimics three hormones.
When considering a lifetime commitment to semaglutide or similar medications, it is crucial to weigh the long-term effects and risks. While reported adverse effects are generally temporary gastrointestinal discomfort, the long-term impact of these drugs on the body is not yet fully understood.
The decision to pursue weight loss through medication or surgery depends on various factors, including body mass index (BMI). Weight loss surgery is often recommended for individuals with a BMI of 40 or above. Those with a BMI between 35 and 40, along with other conditions like diabetes or high blood pressure, may also benefit from surgery. For individuals with a BMI between 30 and 35 who do not meet the criteria for surgery, newer medications like semaglutide can be effective. BMI serves as a guide for healthcare professionals to determine the appropriate therapeutic approach for weight loss.