Why Am I Not Losing Weight on Ozempic With PCOS?

At this point, everyone’s heard of Ozempic. It’s gone from a medication for diabetes management to a hugely popular weight loss drug. And if you’re a woman with PCOS, the promise of “easy weight loss” can be super tempting! We all know that losing weight with PCOS is HARD, and Ozempic may seem like a shortcut not just for shedding pounds, but for easing the other frustrating side effects of PCOS too.

But is it really a miracle drug? In my opinion, as a PCOS dietitian, no. Ozempic doesn’t address the root causes of PCOS-related weight gain. Sure, you may lose weight while on it, but when you eventually stop, the weight often comes right back. In fact, those underlying issues can actually prevent you from seeing results with Ozempic altogether.

If you’re a woman with PCOS taking Ozempic and haven’t seen results, I’m here to help. I don’t endorse Ozempic for PCOS, but I do support all Cysters on their journey! In this post, I’ll explain why weight loss may not be happening with Ozempic. After that, I’ll share strategies to help you start making real, long-lasting progress toward your weight loss goals.

Why Am I Not Losing Weight on Ozempic With PCOS?

In this post, I’ll explain what you can expect from taking Ozempic with PCOS. I’ll also help you determine why you might not be dropping pounds with Ozempic and give you alternative solutions for sustainable, permanent weight loss. 

How Much Weight Can You Lose on Ozempic With PCOS in 6 Months?

Of course, the results of Ozempic vary from person-to-person. However, on average women with PCOS lose between 4.4 and 26.5 lbs in the first 6 months. That’s a pretty big range, so don’t be discouraged if you’re only losing half a pound a month. 

How Long Does It Take to Lose Weight on Ozempic With PCOS?

How long it takes to lose weight really depends on when Ozempic starts to suppress your appetite—and that timing can vary! For most people, appetite suppression begins within the first few weeks. For others, however, it can take up to 2 months. That said, women with PCOS can generally expect to see some weight loss within the first 3 months, depending on how their body responds.

Is It Possible to Not Lose Weight on Ozempic With PCOS?

Yes. Ozempic, aka semaglutide, is an injectable medication that works by suppressing appetite, leading to weight loss. However, it doesn’t actually tackle the root causes of PCOS weight issues. Often, appetite isn’t the sole problem. Keep in mind, Ozempic is FDA-approved for diabetes—it’s not designed to address the complexities of a hormonal condition.

What exactly does this mean? Ozempic doesn’t fix insulin resistance, hormonal imbalances, or chronic inflammation. Therefore, some Cysters either don’t lose weight or they hit frustrating plateaus. Pair the lack of results with the negative side effects of Ozempic, and you have a really discouraging combination. 

Let’s dive deeper into why you might not be seeing results:

Why You Are Not Losing Weight on Ozempic with PCOS

High Insulin Resistance 

Up to 80% of women with PCOS have insulin resistance, which means the body doesn’t process glucose correctly. Instead of your cells turning sugar into energy, it gets stored in the body and absorbed into the bloodstream. This can increase body fat, raise blood sugar levels, and worsen cravings, fatigue, and other PCOS symptoms.

Ozempic doesn’t directly fix insulin resistance—though it can sometimes help indirectly. If your appetite changes and your eating habits improve, that can support insulin sensitivity. However, if your habits aren’t changing much on Ozempic, insulin resistance will persist. 

High Calorie Intake 

When your appetite is suppressed, you naturally tend to eat less, making it easier to create the calorie deficits needed for weight loss. But this isn’t true for everyone! If you often eat for comfort or due to cravings, you might still overeat or choose high-calorie, low-nutrient foods. 

That means you could still be consuming more calories than your body needs, and Ozempic can only help so much. It supports a healthier appetite, but it can’t force calorie reduction beyond that.

Wrong Dose or Timing

Just as with any other medication, finding the right dose is key. If your doctor prescribed too low of a dose, you might not notice appetite changes or experience much weight loss. Timing matters too. Taking Ozempic on a consistent day and time each week is super important. Skipping doses or taking it irregularly can cause your appetite to spike and dip, which can slow or stall your weight loss goals. 

No Lifestyle Support 

As I’ve said, Ozempic isn’t a permanent solution. It works while you’re taking it, but the moment you stop, the weight usually comes back. That’s why lifestyle support is key to keeping your results long-term. So if you’ve hit a weight loss plateau or aren’t seeing results, it’s time to look at your eating habits, exercise routine, sleep schedule, and more. I’ll break that down below.

Conflicting Medication 

There are a lot of medications that can counteract the effects of Ozempic. If you’re taking any of these with Ozempic, talk with your doctor to discuss next steps: 

• Corticosteroids (Prednisone): increase appetite and blood sugar
• Certain Antipsychotics (Olanzapine, Risperidone, Quetiapine): cause weight gain
• Some Antidepressants (Mirtazapine, Paroxetine): increase cravings and food intake
• Diabetes Medications that Raise Insulin (Sulfonylureas, Insulin): promote fat storage
• Hormonal Medications (Birth Control, HRT): affect appetite, fat distribution, and fluid retention

Other Medical Conditions

Other health conditions on top of PCOS can affect how your body responds to Ozempic. Conditions that impact your metabolism or endocrine system can increase appetite and fat storage, making it harder to see results. Hypothyroidism, Cushing’s syndrome, gastrointestinal disorders, and even sleep disorders can all interfere with ideal weight loss.

Can Women with PCOS Lose Weight Without Ozempic?

Absolutely. Navigating weight loss with PCOS can feel incredibly discouraging. I’ve been through that frustration too. There was a time when I was exercising intensely and restricting my diet, yet the scale kept going up instead of down. It was confusing, exhausting, and honestly, really disheartening.

It’s all about understanding how PCOS affects your body. When I learned about the cycle of insulin resistance, inflammation, and hormonal imbalances that was triggering all my symptoms, the solution to reversing my condition became much clearer. My results weren’t temporary either. They’re permanent!

The answer isn’t as simple as a better diet and exercise. Instead, you need the right foods, the right exercise, and the right daily habits. You can read my full guide to managing PCOS symptoms naturally HERE, but below I’ll share some of the lifestyle changes that will make the biggest impact. 

Here’s my full PCOS story, if you’re interested! 

How to Lose Weight Without Ozempic 

Gluten- and Dairy-Free Anti-Inflammatory Diet 

If you want to lose weight, you don’t want to excessively restrict calories. This can send your body into a fight-or-flight mode that actually makes it store more weight—especially with PCOS, where our cortisol levels (stress hormones) are already high! 

Instead, you need to be intentional about what you do eat, rather than obsessive about what you don’t. I recommend a gluten- and dairy-free anti-inflammatory diet that focuses on lots of protein, fiber, and healthy fats. You can find tons of PCOS-friendly recipes and meal plans on The Cysterhood app. 

Slow-Weighted Workouts

Not all types of exercise are great for PCOS. Remember kickboxing? That high-impact, high-intensity workout got my heart pumping and spiked my cortisol and adrenaline. That’s not helpful for PCOS weight loss! In fact, it kept my insulin resistance high and even contributed to weight gain.

Instead, slow-weighted workouts are your best friend. This kind of meditative resistance training helps build muscle, balance hormones, and improve insulin sensitivity. Not sure what that looks like? No worries—you can find tons of workout plans on The Cysterhood app, too. Also, make sure to check out “Worst Exercises for PCOS That May Impact Progress” to see which ones you’ll want to avoid!

Hydration

Staying hydrated is key to weight loss. It naturally suppresses your appetite and helps your body burn calories more efficiently! Plus, when you’re properly hydrated, your body responds more effectively to insulin, thereby improving sensitivity. And if you deal with PCOS belly, hydration can also help reduce bloating and swelling. All around—drink more water. 

Better Sleep 

Sleep is an essential part of hormone balance, including insulin. While we sleep, our bodies carry out important processes that regulate all of our systems. If we don’t sleep well or fail to get enough rest, the body doesn’t have time to balance everything out. This can ultimately lead to chronic dysregulation of metabolism and the endocrine system.

That said, I know sleep can be challenging with PCOS. You’re way more likely to have a sleep disorder if you have PCOS than women without this condition! To help you out, check out my post on how to get better sleep with PCOS.

Less Caffeine 

Caffeine is like liquid stress. Drinking it can raise your cortisol levels, triggering your body to enter survival mode. When your body thinks it’s in emergency mode from chronic stress, it stores more fat to preserve energy. Cutting back can help improve weight loss and other PCOS symptoms, too! If you’re still on the fence, here’s more on why you should reduce caffeine with PCOS. 

Testosterone Relief Tea 

One of the PCOS hormonal imbalances that directly affects insulin is high androgens (male sex hormones). When androgens are elevated, your ovaries produce more insulin. To lower insulin resistance and improve metabolic health, it’s important to reduce androgen levels. One of the best ways to do that is with my Testosterone Relief Tea! It’s a herbal tea blend packed with research-backed natural ingredients that support hormone regulation.

Supplements

Supplements give our body the extra support it needs to stay balanced. Even with a super intentional diet, you won’t be able to get all the recommended daily vitamins and minerals. For Cysters, here are the best supplements for PCOS:

Ozempic results can be unpredictable and temporary. Lose weight naturally with intentional lifestyle changes!

Ozempic can feel like a quick fix, but for lasting results with PCOS, lifestyle changes are key. From diet and exercise to sleep and supplements, there’s a lot you can do naturally to support weight loss.

For a deeper dive, read how to lose weight with PCOS next. And don’t miss an episode of the A Cyster and Her Mister podcast! I’m here as a PCOS dietitian and Cyster myself to offer the resources and education to support you on your journey. With the right tools (and community!), the impossible can feel possible.