Getting Wegovy at the 2.4mg maintenance dose: what actually happens next

Decision one: NHS or private, which route is actually open to you right now?

Wegovy is available on the NHS, but the access criteria are strict. NICE's appraisal of semaglutide for weight management (NICE TA875) recommends it only within a specialist weight management service, for adults with a BMI of 35 or above and at least one weight-related condition, and for a maximum of two years. Waiting lists through those services are commonly long. Lower BMI thresholds may apply for some ethnic backgrounds under the same guidance, but the specialist-service requirement still applies.

Private treatment through a regulated online pharmacy sits alongside that pathway. There is no referral needed, no waiting list, and assessment against the licensed criteria can happen the same day. The licensed eligibility for private prescribing follows the medicine's SmPC: adults with a BMI of 30 or above, or 27 to 29.9 with at least one weight-related condition such as high blood pressure, high cholesterol, obstructive sleep apnoea or type 2 diabetes. A BMI figure alone is never the whole picture, a prescriber reads the full clinical context before approving anything.

You can read more about the treatment overview and both routes on our weight-loss treatment page.

Decision two: which online pharmacy is actually safe to use?

This is the question that matters most, and not enough people ask it before ordering. Wegovy is a Prescription-Only Medicine, which means any seller offering it without a clinical assessment first is operating outside UK law. The MHRA has warned publicly about counterfeit weight-loss pens sold through social media and unofficial websites, and enforcement activity through 2025 involved the seizure of roughly 20 million doses of illegally traded weight-loss medicines with an estimated street value of around £45 million. Some fake pens seized in the UK have contained insulin rather than semaglutide, with real consequences for the people who used them.

The safest check is straightforward: use the GPhC pharmacy register to verify any online pharmacy before you share personal or medical information with it. A legitimate UK dispensing pharmacy has a GPhC premises registration number and will appear on that register. Ours is 9012878, you can confirm it at any point. Red flags to look for elsewhere include sellers who offer these medicines without asking you to complete a health assessment, prices that sit far below anything a regulated UK pharmacy charges, or discount codes attached to a prescription medicine.

If you encounter a suspect seller, report them via the MHRA Yellow Card scheme.

Decision three: what does the step-up to 2.4mg actually involve?

No one starts Wegovy at 2.4mg. Treatment begins at a lower dose while your body adjusts, typically moving through 0.25mg, then 0.5mg, which you can read more about on our step-up dose page, then 1.0mg, then 1.7mg, before the prescriber considers 2.4mg as the maintenance level. Each step takes roughly four weeks, and the timing is a clinical call, not a fixed rule you control. If you are currently working through the earlier stages and want to understand what the 0.5mg or 1.0mg step involves, the process is the same: your prescriber reviews progress before any increase is approved.

The reason for this progression is tolerability. Gastrointestinal effects (nausea, changes in appetite, digestive discomfort) are most noticeable around dose changes and generally settle as your body adapts. Most people find the 2.4mg dose manageable once they reach it, and our 2.4mg page explains what that maintenance stage looks like, but the journey to get there matters. Clinical guidance on dose changes, including what to do if a step causes persistent side effects, comes from your prescriber and the Patient Information Leaflet, not from the dose number alone.

Patients transferring from another provider at the 1.7mg level or already on 2.4mg are welcome to apply; our prescribers will ask for evidence of your current treatment before confirming any repeat or continuation.

Decision four: what actually arrives, and what happens after?

Once a prescriber has reviewed and approved your application, your treatment is dispatched the same day if you ordered before noon on a working day. It arrives the next working day in plain, unbranded packaging via DPD, you get a tracking link on your phone so you know exactly when to expect it, which matters for a medicine that needs refrigerating promptly on arrival. The pen itself is a pre-filled Wegovy device; there are no loose needles to attach and no settings to adjust for the 2.4mg dose.

Aftercare does not stop at the door. Our team is available seven days a week for clinical questions, and every repeat order goes through its own prescriber review, there is no auto-renewal that bypasses that check. If you have questions about what to expect before you start, our FAQs cover the most common ones, and the contact page reaches the team directly. For the full picture on wegovy as a treatment (how it works, the evidence behind it, and who it suits) see our Wegovy treatment hub. When you are ready to apply, check your eligibility and start your free consultation, there is no charge to be assessed, whatever the outcome.