At what dose do you start losing weight on Wegovy?

Step 1: The 0.25 mg phase, your body's adjustment window

Wegovy treatment starts at 0.25 mg once weekly for four weeks. Almost every person on a semaglutide titration schedule passes through this stage, and it is worth being clear about what it is for: tolerance, not treatment. At 0.25 mg, the appetite-suppressing and gastric-slowing effects of semaglutide are present but modest. Most people lose little, if anything, during this month. That isn't failure, it's the intended design.

Nausea, which is the most commonly reported early side effect, is far easier to manage when the dose climbs gradually. Starting lower and going slowly is why most people can stay on treatment long enough for it to work. If you're on 0.25 mg and concerned nothing is happening, the short answer is that this stage was never meant to produce dramatic results.

The NHS medicines information for semaglutide confirms this stepped approach, noting that 0.25 mg is a starting dose and not intended as a therapeutic maintenance level. Expect this phase to feel like a calm introduction rather than a transformation.

Step 2: 0.5 mg to 1.7 mg, where most people first notice a difference

After the first four weeks, the dose increases to 0.5 mg, then 1 mg, then 1.7 mg, each held for approximately four weeks before the next step. This is where the majority of people start to notice genuine weight loss. Appetite falls more noticeably. Portion sizes that once felt comfortable now feel like too much. Food noise (the constant background thinking about eating) often quietens.

How much you lose at each rung depends on your physiology, your starting weight, and how well you're able to support the medicine with regular meals and activity. There's no single figure that applies to everyone. Some people see their biggest early drop between 0.5 mg and 1 mg; others find 1.7 mg the point where things really shift. If 1 mg hasn't moved the scale, that's a common question our prescribers hear, and the answer often involves looking at diet, hydration and what else is going on.

The Wegovy dose schedule page walks through the full titration in detail, including what each strength means practically.

Step 3: 2.4 mg maintenance, the dose the trial evidence is built on

The 2.4 mg weekly dose is where Wegovy's licensed weight-management effect was established in clinical research. The STEP 1 trial (a 68-week study of adults with obesity, published in the New England Journal of Medicine) found an average weight reduction of around 15% at this maintenance dose alongside lifestyle changes. That's a population average: some participants lost more, some less, and the result reflects consistent weekly dosing over more than a year.

The approved higher dose of 7.2 mg (as announced by the MHRA on 14 April 2026, including a new single-dose pen) reported around 20.7% average weight loss over 72 weeks in trials, narrowing the gap with tirzepatide. Whether that dose is appropriate for you is for a prescriber to assess. If you're already on 2.4 mg and feel the results have stalled, there are several things worth reviewing before concluding it isn't working.

For anyone thinking about cost alongside effectiveness, our guide to Wegovy pricing in the UK covers what the private market looks like and what a legitimate price should include. Treatment is available only on prescription following clinical assessment, so reaching maintenance dose is always a prescriber-supervised journey, not something you move through alone.

What to do if weight loss is slower than you expected

Slower progress than you hoped for at any dose is genuinely common. Weight loss on semaglutide isn't linear, some weeks nothing moves, then several kilograms shift in a fortnight. The body adapts, plateaus and then responds again. Comparing your week five to someone else's week five, usually via a forum post, rarely helps.

A few things are worth checking if the dose feels like it isn't doing enough. Are you eating enough protein to preserve muscle as weight comes off? Is sleep disrupted, which blunts the medicine's appetite effects? Has stress climbed recently? These aren't excuses; they are biological factors a clinician will want to know about. Our prescribers are available seven days a week through aftercare, you don't have to wait for a formal review appointment to raise a concern.

The 1.7 mg stall is one of the most common questions we see, and it's worth reading if you're approaching or sitting at that stage. If you'd like to explore whether Wegovy is the right fit in the first place, the weight loss treatment overview sets out how the different options compare. And when you're ready to take the next step, check your eligibility with our team, a GPhC-registered prescriber reviews every consultation the same day.