"How much weight will I lose?" It's the question everyone asks before starting Ozempic, Wegovy, or any GLP-1 medication. Here's what the clinical data shows — and what you can realistically expect.
💡 Quick Answer: On average, patients lose 15% of their body weight on semaglutide (Ozempic/Wegovy) over 68 weeks. For a 200-pound person, that's about 30 pounds. Tirzepatide produces even more — around 20-25% (40-50 pounds for a 200-pound person).
The Clinical Trial Numbers
(Semaglutide 2.4mg)
(Tirzepatide 15mg)
Main Trials
These numbers come from the STEP trials (semaglutide) and SURMOUNT trials (tirzepatide) — large, well-designed studies with thousands of participants.
What This Means in Real Numbers
If You Weigh 180 lbs:
- Semaglutide: ~27 pounds lost (to 153 lbs)
- Tirzepatide: ~38 pounds lost (to 142 lbs)
If You Weigh 220 lbs:
- Semaglutide: ~33 pounds lost (to 187 lbs)
- Tirzepatide: ~46 pounds lost (to 174 lbs)
If You Weigh 280 lbs:
- Semaglutide: ~42 pounds lost (to 238 lbs)
- Tirzepatide: ~59 pounds lost (to 221 lbs)
Typical Weight Loss Timeline
Weeks 1-4: Getting Started
Low starting dose. Modest weight loss (2-5 lbs). Body adjusting to medication. Side effects may peak.
Weeks 5-8: Building Momentum
Dose increases. Weight loss accelerates. Appetite suppression becomes more noticeable. Total: 5-10 lbs lost.
Weeks 9-16: Peak Loss Phase
Approaching or reaching maintenance dose. Fastest weight loss period. Side effects usually improving. Total: 10-20 lbs lost.
Weeks 17+: Continued Progress
Weight loss continues but may slow. At maintenance dose. Most people reach maximum loss by weeks 52-68. Total: 20-40+ lbs lost.
Why Results Vary
That 15% average hides significant variation. In clinical trials:
- Top third: Lost 20%+ of body weight
- Middle third: Lost 10-20% of body weight
- Bottom third: Lost less than 10% (some lost almost nothing)
Factors That Improve Results
- Combining medication with diet improvements
- Adding regular physical activity
- Higher starting BMI (more to lose)
- Reaching and maintaining higher doses
- Consistent medication adherence
- Longer duration of treatment
Factors That Reduce Results
- Unable to tolerate higher doses due to side effects
- Inconsistent medication use
- Certain medications that promote weight gain
- Medical conditions affecting metabolism
- Stopping medication early
⚠️ Set Realistic Expectations: Not everyone will lose 15-20% of their body weight. Even a 5-10% loss produces meaningful health benefits: improved blood sugar, lower blood pressure, reduced joint pain, better sleep.
Month-by-Month Breakdown
Based on clinical trial averages, here's what typical weight loss looks like over time:
- Month 1: 2-4% body weight (~4-8 lbs for 200 lb person)
- Month 2: 4-6% cumulative (~8-12 lbs)
- Month 3: 6-9% cumulative (~12-18 lbs)
- Month 6: 10-13% cumulative (~20-26 lbs)
- Month 12: 13-16% cumulative (~26-32 lbs)
- Month 16+: 14-17% cumulative (maximum effect)
What Happens If You're a "Non-Responder"?
About 10-15% of patients don't respond well to semaglutide. Options if this happens:
- Increase dose: Many non-responders improve at higher doses
- Switch medications: Try tirzepatide — some patients respond better to the dual mechanism
- Add lifestyle interventions: Structured diet and exercise programs can boost results
- Check for interactions: Some medications may blunt GLP-1 effects
The Maintenance Question
Here's the less-discussed reality: most weight regain occurs if you stop the medication. Clinical trials show patients regain ~67% of lost weight within a year of stopping.
GLP-1 medications work best as long-term or indefinite treatment. Factor this into your expectations and budget planning.
The Bottom Line
On average, expect to lose about 15% of your body weight on semaglutide over 12-16 months, or 20%+ on tirzepatide. Individual results vary significantly.
The best predictor of success isn't which medication you choose — it's whether you can afford and access it consistently over time. Pick an option that fits your budget for the long term.