WLI failure. What now?

[HeyStack]

Suggestions welcomed for when WLI haven't worked.

I have five stone to lose, and over a year have lost just one stone (mainly on MJ, then switched to Wegovy). The injections did reduce foood noise a bit, I stopped eating bags of crisps in the evening for example, and dropped breakfast. Reduced portion size a bit. But I still felt hungry, the injections didn't work to tell me I was full unless I ate a huge amount. I was still battling food every day, despite being on max dose.
So I guess I am a low responder or whatever they're called.

What's next? Even with the jabs, I didn't have the willpower to just eat tiny tiny amounts, and I was only eating two meals a day with only snackiing being on yoghurt. I am in my 50's with a lifetime of being overweight, and for me, 'move more eat less' doesn't do enough, and eating less seems not to have made much difference anyway. I feel really stuck and miserable after pinning my hope on the injections.

Is there any advicce for those for whom injections haven't worked? Is it just likely that obesity is something my body does, and that's just it now?

There’s bariatric surgery, which is obviously a more physical step. At a lifetime of obesity it’s really difficult to first lose weight and second keep it off, honestly without some sort of external support such as WLIs or bariatric surgery. Situational obesity is easier to recover from (so most of your life at a healthy weight but then weight gain from pregnancy, bereavement, health issues etc) but if being overweight has been your entire lifetime, then I’m sure you’ve tried most of the traditional methods.

Reta will come on to the market at some point and that’s proving more effective than MJ so that may be an option.

In terms of non-external, I think intermittent fasting is probably the most sustainable method of weight loss, if you can handle swapping feeling low to mid level hungry most of the time for feeling more hungry for short periods but eating normally otherwise. 5:2 for example, or doing 16:8. Long-term calorie restriction on a daily basis is extremely hard to stick to past the first stone or so.

Would it be worth giving the Foundayo tablets a go? They only produce modest weight loss but they are a different medication and it may be that it could work for you. Then I would try Retatrutide when it’s legally available in the UK maybe late next year or into 2028. Or as the PP has said, consider bariatric surgery if GLP1s in general don’t seem to work for you.

Why did you drop breakfast? I'm on the WLIs and have been told to stick to 3 meals a day plus one snack if I need it, prioritising protien each time. I have a small but high-protien savoury breakfast which leaves me feeling a little unsatisfied but ok, and the residual hunger disappears about half an hour after eating it. More often than not I'm not that hungry by lunchtime and just have something small - if I underestimate how much lunch I need I'll have a snack mid afternoon but wouldn't be satisfied with just yoghurt so more likely carrot sticks and 25g low fat houmous with 3 or 4 cashews - but if I balance lunch right I'm fine till dinner without a snack, and if that's the case I might have a mini icecream bite after dinner. How much protien were you fitting in to your 2 meals? I find it tricky enough reaching target protien across 3 meals so I'd be surprised if you were getting enough in only 2, which would explain why appetite wasn't dropping enough because protien is what gets you satisfied.

Did you get to max dose of MJ before you switched, as some people need this?

My understanding is that max Wegovy is not usually comparable to or as effective as max MJ.

A few questions

did you eat the recommended 120g protein and 30g of fibre
did you drink 2 litres of water
did you eat main meals of volume (lots of veg)

TBH I’m not sure cutting breakfast was a good idea unless you genuinely didn’t feel hungry until lunchtime. As well as breakfast I would recommend protein powder mid morning and mid afternoon in a bid to try and stay full.

I had similar, but on Wegovy. I switched from Mounjaro to Wegovy as Mounjaro made me really sick all day and night.
Almost a year in and I’ve lost 1.5st.

What feels odd to me is that I’ve lost weight in my arms and legs and my face seems a little slimmer, but I’ve lost nothing around my waist area. I’ve had issues with gas, stomach acid and bloating for years but aside from give me lansoprazole, they haven’t looked into it so I’m thinking that might be connected to why mine isn’t working.

Maybe it’s worth speaking to your GP and see what they suggest?

I would think about changing your goals. Rather than losing weight, could you build muscle instead? You'll see results really quickly and the scales lose their importance.

I'm 62 and have been fat most of my life. But I'm 5 weeks into going to the gym, eating about 80-100g of lean protein a day with my healthy-ish meals and I've dropped a dress size. I've also lost 7lbs. My body is working better and I have more energy. Make your journey more about fitness rather than weight loss and the food noise will reduce. And I say that as a someone with a strong history of binge eating.

Bariatric surgery is likely the next suitable option.

I wondered this.

Yes, it doesn’t work for everyone so if you were taking 15mg Mounjaro and still managing to over eat, then it’s obviously not suitable for you.

It’s a shame but it might be worth waiting for the next WL Drug to be approved and to try that instead?

Where did you get the WLI from? Was there any psychological support/counseling provided

@Mumof1andacat there usually isn’t, why do you ask?

There is if you are prescribed it from the NICE clinical criteria rather than buying it as a "cosmetic" treatment. One of the reasons that the NHS criteria are so narrow is because the original research into WLI effectiveness and value for money showed significantly better outcomes when you have WLI plus backup support, vs WLI alone, and the bottleneck for how many can get that treatment is as much about managing demand for that support as it is about the cost of the drugs.

The vast majority of people accessing WLI are doing so via private prescription, not buying it for cosmetic reasons. A prescription can be private without it being for cosmetic reasons. For example, my BMI was 50 with 1 weight related health condition. I didn't meet the NHS criteria as I didn't have another 3 weight related health conditions. So I got a private prescription. Nothing to do with "cosmetic".

So by "usually" I mean the vast majority of people who access WLI, who are doing so for health reasons, but outside the NHS.

Nope, it’s all about cost with NHS and that’s why the criteria is so tight because otherwise, an awful lot more people would qualify and they simply can’t afford it.

Although arguably, if they supported more people to slim down using these drugs, they’d be looking at treating fewer longer term weight related health issues, such as diabetes, liver and coronary issues etc.

You really don’t need any ongoing support if you take the drug as intended and the vast majority of people buying them from pharmacies are seriously overweight and meet the criteria of having a bmi over 27. You can’t legally buy the drug if you’ve only got half a stone to lose, so I refute your suggestion that people are mostly buying it for cosmetic reasons.

However, in order to maintain your new healthy weight, you will either need to continue taking the drugs for life or be able to control your weight through a combination of healthier eating and lifestyle changes but that does depend on the causes of a person being seriously overweight.

If emotional eating plays a part, then talking therapies might well help that person to find alternative coping strategies as opposed to eating to manage their feelings.

However the NHS doesn’t have a great track record on joining the dots…

Can I ask what dose you went up to on mounjaro and how you moved up and why you moved to wegovy and what dose you went up to on that?

The NHS haven’t rolled it out further because they couldn’t afford to do it all at once. Otherwise they’d have prescribed it much wider. Long-Term Plan: Due to an estimated £15.2 billion cost over five years if all 2.8 million eligible patients were treated at once, NHS England initially negotiated a gradual rollout spanning up to 12 years.

Mine didn't shift until I started counting calories.

I COULD eat more on MJ, but now I know how many calories I need to lose and the MJ helps me stick to that amount. Previously I was still eating too much.

Thanks so much for your replies. To answer some quuestions, I was on max doses of both MJ and Wegovy for several months each. I swapped because of the price increase in MJ.

Both meant I ate less than I normally do. Neither worked to mean I felt less hungry most of the time and I could still eat quite a bit. I skipped breakfast as I wasn't hungry first thing. I didn't stuff my face at lunch or dinner as a result.

What I was hoping for was a big reduction in food noise and a big reduction in how much food I could eat. While there was an impact, it wasn't enough, I was still feeling much the same as I did before and do now - thinking about food a lot and struggling if I reduced portion size as I still feel hungry.

I am way too scared to think about WLL surgery, so I guess I wait for something that is better than MJ in working with my brain to stop me wanting to eat.

I know all the stuff about protein, behaviour change etc. I wanted WL injections to make that easier, and it just didn't. Just a lot of money to feel a little less hungry, but not enough to shift the weight I need to lose.

I've been overweight since my early 20s, behaviour change stuff stuff just hasn't worked sustainably. I wanted something that would overide my hunger.

I really appreciate all of you taking the time to comment and make suggestions, thank you,

I've seen on Reddit that there are trials being recruited for if still over BMI30. It may be that you would respond better to those drugs?

I hope it's ok to add this link to an article and one to a discussion.

https://www.globenewswire.com/news-release/2026/10/15/3382029/0/en/obesity-clinical-trial-and-competitive-landscape-surges-as-200-companies-advance-next-generation-therapies-delveinsight.html

www.reddit.com/r/mounjarouk/s/1vFuqJMpor

Thank you so much for that first link 💐. It has give me hope that there are things on the horizon, hopefully coming soon, that may work in a different way which will suit my physiology.
So I just need to hold on.