Wegovy not working after a year: why progress stalls and what can help

Step 1: Recognise what a one-year plateau actually means

Around the six-to-twelve month mark, most people taking semaglutide notice that the pace of weight loss slows markedly. The STEP 1 trial, published in the New England Journal of Medicine, followed participants over 68 weeks and found an average reduction of roughly 15% of body weight at the 2.4mg dose. Crucially, that average was reached by the end of the trial period, not maintained as a steady weekly loss throughout. Weight loss tends to front-load in the first few months and flatten progressively.

This plateau is partly physiological. As body weight falls, your resting metabolic rate decreases too, meaning fewer calories are burned at rest. Your body also responds to the appetite-suppressing effect of semaglutide over time, and the contrast with your pre-treatment baseline becomes less dramatic. None of this means Wegovy has stopped doing anything (it may still be preventing regain even when the scales are static) but it does mean that month twelve rarely looks like month three.

If you have been tracking your progress and feel you have genuinely plateaued for more than eight weeks, the right response is a structured clinical review rather than stopping treatment abruptly. A thorough look at what the evidence says about Wegovy's one-year results can also help you frame your expectations before that conversation.

Step 2: Audit the factors that erode Wegovy's effect over time

Before concluding that Wegovy itself is the problem, it is worth working through the most common reasons outcomes drift. The medicine works best alongside a reduced-calorie diet and increased physical activity, not as a replacement for them. Over a year, habits that were strong at the start can quietly slide. The appetite suppression that made eating less feel natural in the early months can become less pronounced, and portion sizes or calorie-dense food choices may creep back without feeling noticeably different day to day.

Dose is the other variable. The 2.4mg weekly injection is semaglutide's licensed maintenance dose for weight management, but not everyone reaches it on the same schedule, and some people are maintained at a lower dose due to side-effect tolerance. If you are not at 2.4mg, there may be clinical headroom remaining. It is also worth checking your injection technique: the medicine should be administered into the abdomen, thigh or upper arm, sites rotated, and stored correctly in the fridge.

If you want a broader view of why progress stalls at earlier dose stages, the page on Wegovy at 1mg not working covers dose-specific patterns in more detail. And if you have concerns that go beyond a plateau (if Wegovy simply has not produced any results at any point) the page exploring why Wegovy has not worked for you specifically addresses a different set of factors.

Step 3: Consider what a prescriber can actually do at the one-year mark

A one-year review is genuinely useful. Your prescriber can look at your weight trajectory since starting, assess whether you have reached the maximum maintenance dose, review your diet and activity alongside the medicine, and consider whether any new health factors are affecting your response. This is not a tick-box exercise, it should be a real conversation about what the next twelve months look like.

One option that is increasingly discussed at this stage is whether a switch to tirzepatide (Mounjaro) may be appropriate. Tirzepatide works on two gut-hormone receptors rather than one, and the head-to-head SURMOUNT-5 trial demonstrated greater average weight loss compared with semaglutide 2.4mg. That does not mean it is automatically right for everyone, but for people who have reached their ceiling on Wegovy, it is a clinically relevant question. Our weight-loss treatment overview outlines both options side by side.

The NHS England guidance on weight-management injections is also clear that ongoing prescribing should involve regular monitoring of progress, if less than 5% weight loss is achieved after six months at the maintenance dose, continuing is subject to clinical review. That threshold matters when you are deciding how to frame your situation to a prescriber.

For context on what treatment costs and what is included in a private service, the Wegovy cost page sets out the honest picture without hidden fees, useful reading before you decide your next step.

Step 4: Approach the decision with a prescriber, not alone

Stopping Wegovy abruptly after a year carries a real risk: weight regain. Clinical data consistently shows that the metabolic and appetite effects of semaglutide reverse when the medicine is discontinued, and weight often returns within months without continued support. That is not a reason to stay on a treatment that is not serving you, it is a reason to make any change as a considered clinical decision rather than a frustrated one you make on a Thursday evening.

If you are on Wegovy privately and feel your current provider is not offering enough clinical engagement, a change of service is entirely reasonable. At nume, a named prescriber, not software, reads your consultation the same day, a question our prescribers hear most weeks is exactly this one: "I've been on Wegovy a year and I'm not sure it's still working." The answer almost always starts with a proper review rather than an automatic prescription renewal.

You can also read about why semaglutide may not be working more broadly, or explore how long Wegovy typically takes to produce results for a clearer baseline. If you want to understand the full picture of Wegovy as a treatment before your next appointment, the Wegovy treatment page covers the medicine's mechanism, licensing and evidence in one place.

When you are ready to talk through your options with a clinical team, start your free consultation and a prescriber will review your situation the same day.