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What Actually Happens During Weight Loss

When you start losing weight, whether through lifestyle changes or medication, your body follows a fairly predictable pattern. In the first few months, weight tends to come off more readily and progress feels steady.

But as you approach the one-year mark—and especially around 18 months—things often shift. Most people (though not all) will notice progress slowing down. The scale stalls, and it feels like the medication has stopped working.

In reality, that’s not what’s happening.

The Truth About Study Data

Large studies on GLP-1 medications often capture this plateau effect. They show that people maintain 14–20 percent weight loss or more, which is remarkable compared to what was possible before.

But remember, these studies only look at the medication in isolation. They don’t factor in additional medications, nutrition adjustments, exercise, stress management, or sleep optimization. So while the data shows a maintenance phase on medication alone, that doesn’t mean further progress isn’t possible. Think of the studies as inspiration, not a ceiling.

Why “Stopped Working” Is the Wrong Language

When people say their medication has stopped working, they’re misreading what’s happening. The medication is still suppressing appetite, regulating blood sugar, and supporting weight maintenance. What’s changed is that your body has reached a new equilibrium.

The fact that weight stays off is a success in itself. Before GLP-1s, maintaining significant weight loss was rare. These medications are doing heavy lifting—even if the effects don’t feel as dramatic as they did in the beginning.

A Quick Reality Check

Still think your medication isn’t working? With your doctor’s guidance, skip a week. You’ll quickly notice hunger and cravings return. That shift is proof the medication is doing more than you realize.

Reframing Progress

If you’ve lost 20 pounds, that’s not “just” 20 pounds. Imagine carrying a 20-pound backpack all day. You’d be desperate to take it off. That’s the difference the medication has already made for your body.

Progress isn’t about a total transformation overnight. It’s about sustainable changes that improve your health and quality of life.

What To Do When You Plateau

Hitting a plateau isn’t the end—it’s a signal to reassess. Options include:

• Adding or adjusting medications
  
  
• Tweaking nutrition or exercise routines
  
  
• Prioritizing sleep and stress management
  
  
• Working with experts who understand weight management
  

There are always tools available to support the next stage.

Beware of Social Media Myths

Be cautious of self-proclaimed coaches or influencers who insist your medication has stopped working and then pitch a supplement or program. Weight management is complex and personal and there’s no one-size-fits-all solution.

Your GLP-1 medication hasn’t stopped working. It’s still doing its job, and you still have plenty of options to support continued success. Don’t let study results or social media myths limit your mindset.

Your journey doesn’t end at a plateau, it’s simply a new chapter with new tools to explore.

Want to dive deeper into this topic? Tune in to the full episode of The Obesity Guide podcast, where I break down why GLP-1 medications don’t “stop working,” what plateaus really mean, and how to keep moving forward with your health goals.

TRANSCRIPT:

Disclaimer: The transcript below is provided for your convenience and may contain typos, errors, or grammatical inconsistencies, as it has not been professionally edited or proofread. Please enjoy it as-is and read at your own discretion.

Please note: The content shared in this podcast and blog post is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider for personalized medical guidance.  

 Welcome back to another episode of the podcast. I'm excited today to talk about that the medications do not stop working. I want to really be clear on what it is that they are doing or not. A patient of mine sent me a video and this of course not medical person that is self-declared a coach and self-declared helping people on GLP one medications.

You know these people that they just decide like, I'm gonna be a coach. There's no anything behind it. By the way, the reason that this is scary. I'm not hating on all people that, you know, it's coming out of a good place typically, that they wanna help people. It's that you don't understand when you have someone in front of you that has an eating disorder, you don't understand when you have someone that's doing dangerous things, like you don't know where the limits are.

If you come across these type of people, they're dabbling in areas that are not amazing. Okay? So here's what this person was saying in the video. I'm literally watching this video and he tries to pull up studies behind him to validate his point, but I think he totally butchered it. So let me explain what happens with medication so that when you see these videos in the future, you know it's garbage.

When you're losing weight, whether it be with lifestyle alone or with a medication. Initially, let's say the first one to three to six months, your body is happy to release weight. And then as we start to approach the one year mark, the one and a half year mark, that 18 month mark, what you usually notice, most people, not all of you, if you're a hyper responder, but most people will start to plateau.

I like to use the word maintenance, but you will notice that the weight isn't changing anymore. Majority of the studies that we have are capturing that phenomenon that when you're on that medication, most people on average will be able to get X, Y, Z result, and you'll see where it levels off. Keep in mind, in these studies, when they do these really big studies across multiple state, thousands of people, all this kind of stuff, they have a certain study design, right?

So when you really look into it, it's that. There will be certain criteria to get into the study. It might be that this person does not already have type two diabetes. It might be that they're not already on a GLP one medication. They have certain criteria to get into it, and then they might roughly suggest things to people.

But majority of these studies are not taking multi. Faceted approach to weight management. When they're doing these GLP one studies, they're not sitting there and saying, oh, and then can we also add another medication? And can we adjust this exercise and can we adjust nutrition? And what's happening with your stress management?

They're not doing all these other things. So yes, the studies do show at some point, majority of people, if you're just doing that, that there will come a point where your body doesn't wanna release more. So it's at maintenance, but that doesn't mean that you can't still lose fat. And the reason I bring this up, and this is I have to hammer this home with all my patients.

There are so many interventions that you can keep taking. Don't let that data put you in a box. Let the data be inspirational in the sense that, wow, people can keep 14 to 20 plus percent off, which they never could do before. That's inspirational. Amazing. But don't let it be your cage. Don't let it say this is the limit.

Now you know, I've reached this percent and that's what the study showed, and now I'm not gonna lose anymore. No. Even before these medications came around, people were able to lose. Could they keep it off? Practically not, but it's not that it couldn't happen. There are always other medications that can be added, other lifestyle things that can be changed.

There are so many things that can be changed. So today is almost a shorter episode because I just wanna say Yes. Look at data. Yes. See what's going on. But don't let it. Be the ceiling that you can't go past. What I often see happen is that because those numbers from the studies exist, when people start to approach close to them, they say, well, you see, that's where I'm at, and that's what's going on.

Instead of us sitting there and saying, what are all the things that we can do? How can we switch this up? What else can we add? what can we do differently? There's always something to do. And so when you get into this mindset of using the data against yourself, it is not helpful.

And also this language of the medication stops working. No, it just can only support that level for you. But it's not that it stops working. In fact, it is continuing to work. The fact that the weight stays off, it is such a miracle to me. This comes back to this language of when we say, I've only lost 10 pounds or 20 pounds.

I'll sometimes have patients where they get to the 20 pound mark and they think that's. Insignificant in some capacity. And I sit there and I think to myself, if I gave you a 20 pound backpack, you'd be begging Mercy to take it off your back. You wouldn't be able to make it through the day. But yet, you're thinking you need this like full body transformation, right?

It's not about health. It's not about what's possible for your life. It's just about looking a different way. To get back to this with the medication, they very much so still work. One of my main things that I always say to people, I mean this is a little bit facetious, but if you're gonna tell me it doesn't work, I say, okay, great.

Hold that medication one week and you see how rapidly you are hungry again and what happens. And I think it's a really quick lesson to realize it's doing a lot more than I realize. It's gonna be one tool when in the midst of everything else, right? But no, the medication does not stop working. Typically, it can support you to certain levels.

It does not mean that you cannot get past those levels. You very much so can and don't let that be the thing that holds you back. When you watch these videos, it's always very formulaic what they're trying to do. They're always selling something. All of these influencers are selling a supplement, a product, a system. I found a, actually a physician channel the other day, and this person was doing a live, and I thought, oh my gosh, it, it had, it was talking about insulin resistance.

I thought, I'm gonna learn something and then I. I literally just click into their profile. First thing you see, it's like this is a three part supplement system that's gonna help with insulin resistance. And it's such a turnoff because you know that they're not at all listening to what's happening with you.

It's just take this supplement and everything's gonna be solved, which we know is garbage and not true. Alright, so that's the main thing that I wanted to talk about today is that yes, these medications are doing a lot heavier lifting than you're realizing. You just don't feel the same as you did week 1, 2, 3, month, 1, 2, 3.

And so then you extrapolate that, well, this isn't gonna work anymore. And that's not true.

Alright, I hope you guys have a great rest of the week and we'll talk soon.