I hit a wall at month 4 on semaglutide 1.7mg and I almost gave up. From weeks 14-19 my weight literally did not budge — bounced between 219 and 222 for over a month. I was so frustrated I considered stopping entirely.

Here's my full weight log showing the plateau and the breakthrough:

What I changed at week 19:

1. Started actually tracking food again. I had gotten complacent because the appetite suppression was so effective early on. Turns out I had unconsciously increased portion sizes as my body adapted.
2. Added 30 min walks after dinner. Nothing intense, just movement.
3. Increased protein from ~90g to 140g/day. Replaced some of the carbs I was eating with lean protein sources.
4. Fixed my sleep. I was averaging 5.5 hours. Got it to 7+.

The weight started moving within a week. F/41, 5'5".

Plateaus at month 3-5 are incredibly common and I wish more people talked about them. A few things are happening physiologically:

• Your TDEE has decreased because you weigh less and your body has adapted to the lower caloric intake (metabolic adaptation, not "starvation mode" — that's a myth, but adaptation is real)
• Water retention can mask fat loss for weeks at a time, especially in women around the menstrual cycle
• At a lower body weight, the same absolute caloric deficit produces less weight loss per week

The sleep fix was probably huge. Sleep deprivation increases cortisol, increases ghrelin, decreases leptin, and impairs insulin sensitivity. Going from 5.5 to 7+ hours alone could have been the difference.

I'm at week 15 and THIS IS EXACTLY WHAT'S HAPPENING TO ME. Thank you for posting. I've been stuck at 237-240 for three weeks and was starting to think the medication stopped working.

I want to emphasize something from the OP that people often gloss over:

I had gotten complacent because the appetite suppression was so effective early on. Turns out I had unconsciously increased portion sizes as my body adapted.

This is probably the #1 reason for plateaus that I see on this forum. GLP-1s are not magic — they're a powerful tool that makes the caloric deficit easier, but your body WILL adapt and you WILL need to stay mindful about intake. The appetite suppression can diminish somewhat over time, and if you're not paying attention, calorie creep is very real.

100% agree. I think I had fallen into the trap of thinking the medication would do all the work forever. The first 3 months were almost effortless — I just wasn't hungry and the weight fell off. But that honeymoon phase doesn't last forever. It's still WAY easier than dieting without the medication, but it does require engagement.