Can I Start Wegovy at 1.0 mg? The Licensed Dose Sequence, Explained

Step 1: Why the schedule starts at 0.25 mg, not 1.0 mg

The dose escalation built into Wegovy's UK licence exists for one practical reason: semaglutide slows gastric emptying, and the body needs time to adjust. Starting at a lower dose means the most common side effects (nausea, loose stools, that heavy, full-too-fast feeling) tend to be milder and shorter-lived than they would be if treatment opened at a therapeutic level.

The schedule, as published in the NHS medicines information for semaglutide, runs: 0.25 mg for four weeks, then 0.5 mg, then 1.0 mg, then 1.7 mg, before reaching the standard maintenance dose of 2.4 mg. If the 7.2 mg option is clinically appropriate, titration continues beyond 2.4 mg under prescriber guidance. Each rung is roughly one month. The 1.0 mg pen is the third step, not a shortcut to skip to.

Some people ask about starting at 0.5 mg instead; that, too, would mean missing the lowest-tolerance phase, and is not the licensed approach. Worth noting: there is no clinical evidence that a faster escalation produces better weight loss, it typically just produces worse side effects.

Step 2: What actually happens at each four-week mark

Once you have completed four weeks at your current dose, your prescriber reviews whether to increase. At nume, that review happens before each repeat order, a real clinician reads your update, not an automated system. If you have had significant nausea or vomiting, the prescriber may recommend staying at the current dose for another four weeks rather than moving up. That flexibility is part of safe prescribing; the schedule is a guide, not a conveyor belt.

For context on where 1.0 mg sits in the broader picture, the Wegovy dose overview covers every step from 0.25 mg to 7.2 mg and what each one is designed to do. The maintenance dose (the level most of the clinical trial evidence is built around) is 2.4 mg. Reaching it typically takes around 16 weeks from the first pen.

If you are transferring from another provider and have already been on semaglutide for some time, your prescriber will ask for evidence of your current dose. Jumping forward to 1.7 mg in the schedule is only appropriate where there is a documented, supervised history, not assumed.

Step 3: Checking whether Wegovy is the right route for you

The dose question and the eligibility question are linked. Wegovy is licensed in the UK for adults with a BMI of 30 or above, or 27 or above where a weight-related condition is present, high blood pressure, sleep apnoea and type 2 diabetes are common examples. Lower BMI thresholds apply for some ethnic backgrounds under UK guidance. Eligibility is assessed at consultation; BMI alone does not guarantee a prescription.

The STEP 1 trial, published in the New England Journal of Medicine, found an average weight reduction of around 15% over 68 weeks at the 2.4 mg maintenance dose. That figure comes from participants who went through the full titration sequence, including the 1.0 mg step, not instead of it.

If you are considering Wegovy, the cost of treatment is one practical factor to understand early, alongside how dispensing works. When a prescription is approved at nume, the pen ships the same day (for orders placed by midday, Monday to Friday) via DPD tracked delivery, a plain, unbranded box arrives the next working day, with the pre-filled pen inside ready to refrigerate. The Wegovy overview page covers what to expect from treatment in more detail.

Step 4: What to do if you want to begin treatment

Because Wegovy is a prescription-only medicine, the right next step is a clinical consultation rather than choosing a dose yourself. A prescriber takes your BMI, your medical history and any current medicines into account before issuing a prescription, and sets the starting dose accordingly. That starting dose will be 0.25 mg.

The weight-loss treatment options page gives an honest comparison of what is available, including how Wegovy sits alongside tirzepatide (Mounjaro). If you have specific questions before or after a consultation, the FAQs page covers the questions our prescribers hear most often. And if you want to understand what clinical oversight looks like at nume, the clinical team profile is a good place to start. When you are ready, check your eligibility through a free consultation, same-day clinical review, no waiting list, no subscription.