 I have heard it over and over, during the first few months on a GLP-1, the weight comes off steadily, and hunger settles. Clients are happy to report their cravings get quieter, they get full sooner and food no longer takes up quite so much mental space. For many, this food noise reduction is life-changing. But then suddenly, the scale slows down, the food chatter starts back up, and for some, the scale stops moving altogether. The prescriber often advises to "up the dose" to combat this, but the dose may not be the problem. If this is you, before you start second-guessing everything, it is important to know that a plateau doesn't automatically mean the medication has stopped working. It may simply mean your body has adjusted to the weight you have lost. This can happen with semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound), and will likely happen with newer medications like retatrutide as well. Your body changes as you lose weightA smaller body needs less energy, and that part is expected. You have less tissue to maintain and less body mass to carry through the day. If you are eating less, you also burn fewer calories digesting food. Many women move a little less without realizing it, especially when nausea, fatigue, or very low food intake has crept in. Some women lose muscle too, and because muscle is active tissue, losing it lowers the number of calories the body uses at rest. The body may also reduce its energy use a little more than we would expect from the weight loss alone. This is called adaptive thermogenesis. In one recent study, people who lost an average of 18.4 kilograms experienced an extra drop in resting energy expenditure of about 121 calories per day. Some had a much larger response, where others had very little. Those with the greatest reduction also tended to feel a stronger drive to eat. A hundred calories may sound small, but over weeks and months, it can be enough to close part of the calorie gap that was producing steady weight loss. This is one reason that eating less and less is rarely the right response to a plateau. When food intake becomes too low, it becomes harder to get enough protein, vitamins, minerals, and essential fats. Energy drops, movement declines, and muscle becomes harder to hold onto. This can be a recipe for weight loss failure if not addressed. The medication itself can contribute to a plateauGLP-1 medications work by lowering appetite and food intake. That is how they produce weight loss. But the very thing that makes them effective can also feed the slowdown. When you eat significantly less, you lose some of the thermic effect of food, the energy your body uses to digest and process what you eat. If protein intake drops too low, muscle loss accelerates, and less muscle means a lower resting metabolic rate. Add in reduced movement from fatigue or nausea, and the body's total energy use can fall substantially. A 2026 review confirmed what you would expect: GLP-1 medications had no clear independent effect on energy expenditure once the weight loss itself was accounted for. These medications suppress appetite. They do not speed up metabolism. So over time, the calorie gap that was producing weight loss narrows on its own. In a two-year semaglutide trial, average weight loss levelled off around 60 weeks. With tirzepatide, most participants in the trials reached a plateau by week 72. At that point, the medication was often still helping people maintain what they had lost. The body had simply settled into a new balance between what was coming in and what was being used. What about Reta?"Reta" is the name used online for retatrutide, a peptide that acts on GLP-1, GIP, and glucagon receptors. Early results have attracted attention because retatrutide has produced substantial weight loss in trials. It is still being studied and its full safety profile has not been established. As of August 2026, retatrutide has not been approved by Health Canada, the U.S. Food and Drug Administration, or any other regulatory agency though it is going through trials so this will likely change in the coming months. Currently it is legally available only to people enrolled in authorized Lilly clinical trials that are currently in phase III. Any Reta you see that is sold online, through social media, at a peptide clinic, or as a "research chemical" is a black-market or unauthorized product typically coming from China. The source materials needed simply are not readily available, even at at compounding pharmacies. There is no reliable way to confirm it contains retatrutide, that the dose is accurate, that there are no heavy metals or toxins in it, or that it was produced under sterile conditions, aside from doing 3rd party testing. Recently it has come to light that even 3rd party testing isn't always reliable and has been forged at some labs. If you are sourcing retatrutide through the unauthorized market, proceed with caution. Look closely at any claims of independent third-party testing, while recognizing that a certificate alone cannot guarantee accurate dosing, sterility or freedom from contaminants. Also keep in mind that subcutaneous injection bypasses the protective barriers of the digestive tract and the liver’s first-pass processing, so anything in the vial is introduced directly into the tissue and circulation. It is always important to understand the risks and to be as informed as possible about what you are putting into your body. Are Toxins Getting in the Way of Fat Loss?Body fat is living tissue that stores energy and produces hormones. Because some substances dissolve more readily in fat than in water, fat tissue can also hold compounds the body has absorbed from food, water, air and the surrounding environment. These include persistent organic pollutants, or POPs. This group includes certain pesticides, industrial chemicals called PCBs, and related compounds. Many have been banned or restricted, but they remain in the environment and food supply because they break down very slowly. Once inside the body, some can be stored in fat tissue for years and are also cleared slowly. When fat cells shrink, some of these stored compounds move back into the bloodstream. Weight-loss studies in humans have measured this directly, and the largest increases show up after substantial or rapid fat loss, including after bariatric surgery. In one study, people lost about 30% of their starting weight over a year while blood levels of several persistent pollutants rose considerably. In a small study, 16 men followed a calorie-restricted diet for 15 weeks. As they lost weight, several pollutants increased in their blood. At the same time, their T3 thyroid hormone and resting metabolic rate fell. T3 helps regulate how much energy the body uses, which means a lower resting metabolic rate causes the body to burn fewer calories simply keeping you alive throughout the day. Even a modest drop can gradually narrow the gap between the energy you consume and the energy you burn. Due to this, weight loss may slow or stop, despite continuing with the exact same diet. The men with the largest increases in certain pollutants also tended to have the largest drops in T3 and resting metabolism. We don't yet know how large this effect is, who may be most affected, or whether the pollutants directly caused the metabolic changes. Calorie restriction on its own can also lower T3, leptin (our satiety hormone), and energy expenditure. The studies were small, and they were completed years before semaglutide and tirzepatide became widely used. They have yet to directly study GLP-1-induced fat loss and the release of toxins causing a plateau, but the connection is more than plausible from the rapid fat loss alone. Why I take a whole-person approachWeight loss affects far more than appetite, and for women in their 40s, 50s, and beyond, what happens on the scale is shaped by hormonal changes, sleep, stress, thyroid function, muscle mass, insulin sensitivity, nutrient intake, and the speed of the weight loss itself.
Then there is elimination. Many fat-soluble compounds eventually leave through bile and stool. This means that regular bowel function, fibre, hydration, and consuming enough food to support normal bile flow are all important factors during weight loss. Severe restriction and ongoing constipation can completely work against this process. This is one reason I do not view a GLP-1 prescription as a complete weight-loss plan. Medication can be a useful tool for those who need it, but your body still needs nourishment, muscle-building activity, recovery, and support for the systems processing everything released during fat loss. A plateau needs a closer look before calories are cut again or the dose is automatically increased. Here are some of the things I would want to know:
Two women can use the same medication, lose the same amount of weight, and need very different support, and that is exactly what individual care and targeted programs are for. A stalled scale can be really frustrating, especially after the early momentum of a GLP-1, but it can also be a sign that your body's needs have changed. The answer may involve protecting muscle, improving nourishment (and yes, this may mean MORE calories, not less!), supporting elimination, reviewing thyroid or hormone health, or simply slowing the process down. Environmental exposure may be part of it for some women, though we need better research to know how much it contributes. If you are using a GLP-1, considering one, or trying to understand why your results have changed, the best thing you can do is seek guidance that looks at your whole health story. That is the approach I bring to my private work, programs, and books. I help women understand what their symptoms and changing results may be telling them, then build the nutrition and lifestyle support that fits the person behind the prescription. Your body is adapting, and the next step starts with understanding what it is adapting to. This article is for education and is not a substitute for personal medical care. Prescription medications should be used under the care of a qualified prescriber. |
AboutLynnel is a registered Holistic Nutritionist, Health Coach, Director of the NutraPhoria School of Holistic Nutrition, Author. Click HERE to learn more.
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