The latest weight-loss drugs are rightly hailed as game changers for obesity, but in an important way, they are just like every other method of managing weight: They work only to a point for weight loss. The pounds melt off quickly at first and then gradually and then not at all. You can’t lose any more no matter what you do. You’ve hit the weight-loss plateau.
Weight loss triggers a set of powerful physiological changes in the body, which evolved over millions of years to keep us alive through periods of food scarcity. “Everybody plateaus,” says Jamy Ard, an obesity doctor at Wake Forest University. Exactly when varies quite a bit from person to person, but it happens after losing a certain percentage of body weight—meaning some people might plateau while still meeting the criteria for obesity.
For Wegovy, it’s after losing, on average, 15 percent, usually more than a year into starting the drug.
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The only way to get past a plateau is to up the intensity or number of interventions. Doctors might recommend, for example, bariatric surgery and a weight-loss drug. But in the future, novel drugs might be able to pharmacologically up the intensity. The progression from Wegovy to the more effective Zepbound has in fact already brought us one step closer.
