Why have I plateaued on my GLP-1, and what can I do?

First, reframe: the trial curves all flatten. A plateau after substantial loss is the expected end-state of the dose you’re on — your body now burns fewer calories (smaller bodies do, plus some metabolic adaptation), and at some point the reduced intake and the reduced burn meet. The drug hasn’t stopped working; it’s holding you at a new equilibrium, which is precisely what maintenance means. The decision tree: Happy with the result? Then nothing is wrong. Shift mentally to maintenance: protect muscle, keep habits, discuss maintenance dosing — possibly lower or less frequent. Want more loss? In rough order of yield: 1. Audit before adjusting. Two weeks of honest logging often reveals creep — portions drifting up as tolerance builds, liquid calories, grazing. Cheaper than any dose change. 2. Dose headroom. Not at max maintenance dose? Escalation is the standard answer (e.g., Zepbound 10 → 12.5 → 15 mg). 3. Switch molecules. Plateaued on semaglutide well above goal? Tirzepatide’s head-to-head superiority makes the switch a high-yield move. 4. Recommit to resistance training and protein — adding muscle is the only lever that raises the burn side of the equation rather than squeezing the intake side. 5. Patience. Plateaus of 4–8 weeks mid-journey sometimes break on their own, especially around dose changes. What doesn’t work: crash-dieting on top of the drug (accelerates muscle loss, unsustainable) and stacking unproven “fat-burner” supplements. And if a plateau arrives suspiciously early — month 2–3 at low doses — that’s not a plateau, that’s under-dosing or an intake leak.