How much weight can you actually lose on a GLP-1?

The averages, by medication

Over roughly 60 to 72 week trials in adults with obesity, the published averages stack like this: liraglutide 3 mg (Saxenda) around 8%, semaglutide 2.4 mg (Wegovy) around 15%, tirzepatide at higher doses (Zepbound) around 20%, and the newest combinations and pipeline molecules reporting from the low twenties (CagriSema, retatrutide phase 2). Diabetes versions at their doses run several points lower, and oral semaglutide lands under its injectable sibling.

Translation into pounds for a 220 lb starting point: roughly 18 lb on liraglutide, 33 lb on semaglutide 2.4, 44 lb on tirzepatide, as averages, at trial durations, with trial-grade adherence.

What the averages hide

Every one of those trials contains people who lost more than 25% and people who lost less than 5% on the same medication at the same dose. The average is not a promise; it is the middle of a wide, honest spread. About one in ten to one in seven participants qualify as limited responders even on the strongest drugs, and a similar slice dramatically out-performs the mean.

The other hidden variable is time: those numbers took a year-plus to accumulate, through a slow titration and a long consolidation. Month-one results predict very little; the timeline post maps the curve.

What actually moves your number

• Reaching a therapeutic dose. A large share of real-world underperformance is simply never completing titration, because of side effects, supply, or cost. The titration post covers pacing.
• Staying on it. Trial curves accumulate over 60+ weeks of consistent dosing. Gaps flatten them; our missed dose post covers damage control.
• Protein and resistance training. They do not just protect muscle; they shape what the scale number is made of, which decides how the result looks and holds. See the muscle guide.
• The boring adherence layer: honest logging, sleep, and the food mechanics that keep side effects from derailing doses.

Setting a personal expectation honestly

A reasonable frame: expect meaningful appetite change within weeks, roughly 5% loss by around three months at a working dose (a common clinical checkpoint for whether the medication fits you), and your medication's average as a realistic one-year center of gravity, with your habits deciding which side of it you land on.

Then measure reality instead of vibes: a weekly trend line, waist measurements, and strength checks in DoseLog tell you which curve you are actually on, months before feelings do.