When GLP-1s Like Ozempic and Mounjaro Don’t Work for Weight Loss
There’s been a lot of buzz around GLP-1 medications like Ozempic (semaglutide) and Mounjaro (tirzepatide)—and for good reason. These medications have helped so many people lose weight, reduce food cravings, improve insulin resistance, and quiet the constant mental “food noise” that many people struggle with. But what happens when they don’t work?
I’ve had several patients come into my clinic, frustrated and defeated, asking:
“Why is everyone else losing weight on this, but not me?”
The answer isn’t that something is wrong with them. It’s that there’s often something deeper going on that we need to explore.
In my experience, there are two main types of people who struggle to lose weight despite being on the maximum dose of a GLP-1 medication:
1. The Patient Who Doesn’t Change their Habits
This patient takes the medication but continues eating out of habit—at the same times, the same portions, and often the same types of foods they ate before starting the medication. They override the signals their body is now trying to send. They might push past the early feeling of fullness, ignore the reduction in cravings, or snack late at night out of routine.
GLP-1s aren’t magic fat burners. They work by enhancing your body’s natural hunger and fullness signals. If those signals are ignored, not only will the weight not come off, but side effects like bloating, heartburn, or nausea often get worse.
So if this is you, it’s not a medication failure—it’s a missed opportunity to practice more mindful eating and build new habits around food.
2. The Emotional Eater
The second patient is the one who eats not because they’re hungry—but because they’re anxious, sad, lonely, bored, or overwhelmed. GLP-1s can effectively reduce cravings and hunger, but they don’t fix why someone eats emotionally.
If food is being used as a coping mechanism for mood, stress, or trauma, then no appetite suppressant is going to help long-term. Emotional hunger doesn’t respond to fullness cues.
For these patients, the real work is in addressing the emotional drivers of eating—often with therapy, mood-stabilizing medications, or building new, healthier coping strategies. Once mood and mental health are more stable, GLP-1s can be incredibly helpful—but only then.
Other Factors to Consider
If neither of these scenarios applies to you, it’s also worth investigating other biological causes that could interfere with weight loss, such as:
Thyroid dysfunction
Hormonal imbalances (especially in women with perimenopause)
Chronic stress and poor sleep
Medications that cause weight gain
The Bottom Line
If you’re on Ozempic or Mounjaro and not seeing results, it’s not a sign of failure—it’s a sign to dig deeper. Ask yourself:
Am I listening to my body’s signals?
Am I eating out of emotion, not hunger?
Are there medical issues affecting my metabolism?
Weight loss is never one-size-fits-all. If you’ve been struggling, there may be more to uncover. And you don’t have to do it alone—these medications are tools, not fixes. The most sustainable changes come from understanding your body, your behaviors, and your emotional patterns—and learning how to support them with compassion and care.
