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Average: 2-3 lbs/week first 4 weeks, 1-2 lbs/week months 2-6, 0.5-1 lb/week months 6-12, plateau by month 18. Real-world varies sharply.
STEP-1 trial monthly averages: month 1: 2-4 lbs lost (starter dose, mostly water/inflammation). Month 2-3: 4-6 lbs each (rapid loss as appetite drops). Month 4-6: 4-5 lbs each (steady loss). Month 6-12: 2-3 lbs each (slowing). Month 12-18: 0-2 lbs each (plateau approaching). Total ~30 lbs for 200-lb starter at 68 weeks. Faster loss = higher starting BMI, strict adherence, resistance training. Slower = late titration, lifestyle inconsistency, leaner starting BMI. Plateau is normal — body adapts. Continued use maintains loss; discontinuation = ~60% regain within 12 months.
Editorial answer reviewed by a board-certified clinician. Not medical advice. Coordinate treatment decisions with your prescriber.