What actually happens in your first 6 weeks on Wegovy

Why does week six feel different from week one?

The first four weeks of Wegovy exist primarily to let your body adjust. The 0.25 mg starting dose is not intended to drive significant weight loss, its job is to introduce semaglutide gradually so that the gastrointestinal side effects many people experience are manageable rather than disruptive. By weeks five and six, you have typically moved to 0.5 mg. That step up is where a lot of people notice the shift: appetite suppression that felt subtle becomes more noticeable, and meals that once seemed normal-sized start feeling like too much.

Common side effects at this stage include nausea, constipation, loose stools, burping and occasional fatigue. According to the NHS semaglutide medicines page, these are typically most intense in the days after a dose change and settle for most people within one to two weeks. Week six often lands on the gentler side of that curve, not gone for everyone, but noticeably quieter than weeks two or three were. If nausea is still severe or persistent by now, that is worth raising with your prescriber rather than pushing through alone.

One practical note: the timing of dose steps matters more than the calendar date. If you started mid-month or around a bank holiday, your personal week six may align with a dose step slightly differently. The schedule your prescriber set is the reference, not a rigid six-week clock.

How much weight loss should you expect to have seen by now?

Honest answer: it varies enormously, and six weeks is too short a window to judge whether Wegovy is working for you. The landmark STEP 1 trial, published in the New England Journal of Medicine, measured outcomes over 68 weeks with 2.4 mg as the maintenance dose, a dose most people are nowhere near at week six. The average weight loss reported across the full trial was around 15% of body weight.

In the opening weeks, the changes are largely invisible on the scale. Gut motility shifts, fluid shifts from reduced carbohydrate intake, and the physiological lag between appetite reduction and actual fat loss all combine to make early progress slow to show. Some people see a noticeable drop between weeks four and eight as calorie intake falls consistently. Others see little movement until the dose increases further. Neither pattern means the treatment is failing. If weight loss remains absent well beyond this point, there is more specific guidance on what that might mean and when it warrants a clinical conversation.

For context on what the full treatment trajectory looks like, the Wegovy treatment overview covers the dose schedule through to 2.4 mg maintenance and beyond.

What should you be doing at the six-week mark to support the treatment?

Semaglutide works alongside reduced-calorie eating and increased activity, not instead of them. At week six the appetite suppression starts making the dietary side considerably easier for most people. Meals feel smaller naturally; the effort to eat less is lower. The risk is that some people eat so little that protein and fibre fall too low, which can accelerate muscle loss alongside fat. Keeping protein intake adequate and staying well hydrated matters throughout, particularly while gastrointestinal symptoms are still settling.

Strength-based activity, even light resistance work, helps preserve muscle during weight loss. This does not need to be a gym membership, bodyweight exercises at home count. Your prescriber or a dietitian can give you personal targets; generalised population averages are not the right guide here.

If you are considering what longer-term progress looks like, the eight-week stage is where many people notice their appetite has genuinely reshaped, and the dose schedule is clearer. For those still in the very early stages, the two-week experience and the four-week point are covered separately. You can also read more about semaglutide as a medicine, including how GLP-1 receptor agonism produces these effects. If cost questions are coming up now that you are a few weeks in, a transparent breakdown of what Wegovy costs privately is worth reading. And if you have wider questions about your treatment, our FAQs cover common concerns our prescribers hear regularly.

If you are not yet on Wegovy and are wondering whether this treatment suits your situation, a consultation with one of our prescribers is the right starting point. They review each case personally, speak to our prescribers here.