The different doses of Wegovy: what the schedule actually means

The biggest misconception: that a lower dose means a smaller effect

Walk into any online forum about semaglutide and you'll find people convinced that the 0.25mg pen is basically a placebo, and that the real treatment only begins at 2.4mg. Neither claim is accurate, but the second one at least has a kernel of truth.

What the dose schedule actually reflects is your body's adjustment to a new mechanism. Semaglutide slows how quickly food leaves your stomach and acts on appetite-signalling pathways in the brain. Start too high, and nausea can make the medicine unbearable. The 0.5mg dose, for instance, is not a therapeutic target, it's a stepping stone that keeps side effects manageable while your system settles.

The 2.4mg dose is where the weight-management benefit shown in clinical trials operates. In the STEP 1 trial, published in the New England Journal of Medicine, participants on 2.4mg semaglutide lost an average of around 15% of their body weight over 68 weeks alongside lifestyle changes. That figure applies at maintenance dose, not at 0.25mg, and not after four weeks. Patience with the schedule is part of how the treatment works.

The different strengths of Wegovy each have a specific clinical purpose, and conflating them leads people to either demand rapid titration or abandon a perfectly on-track programme too early.

What the approved UK dose range looks like from 0.25mg to 7.2mg

The standard Wegovy titration pathway in the UK runs across five strengths. Treatment opens at 0.25mg once weekly for four weeks, a dose set purely to reduce gastrointestinal side effects. From there, the schedule moves to 0.5mg, then 1mg, then 1.7mg, each held for roughly four weeks before a step up. The 2.4mg dose is the licensed maintenance level for most patients.

The step from 1.7mg to 2.4mg is the one people most often ask about, and it's also the step prescribers are most likely to delay if nausea or vomiting is still prominent. There's no clinical shame in staying at 1.7mg a little longer; the prescriber's job is to get you to a dose you can sustain, not the fastest dose you can technically tolerate for a fortnight.

Then there is the 7.2mg pen. The MHRA approved a dedicated single-dose 7.2mg semaglutide pen on 14 April 2026, designed for adults with a BMI of 30 or above. It is a once-weekly injection, auto-dosing, with a covered built-in needle that locks after use. Trial data reported an average weight loss of around 20.7% over 72 weeks at this dose, narrowing the gap considerably with the highest tirzepatide doses. The starting dose remains 0.25mg regardless; the 7.2mg pen is the ceiling, not the launch pad. If you want to understand how many different doses of Wegovy exist across the full approved range, that page covers the count in detail.

For anyone comparing semaglutide with other options, the difference between 5mg and 10mg semaglutide covers the oral Wegovy tablet schedule, which runs on a completely separate dose ladder.

Side effects by dose, and when to tell your prescriber

The side-effect profile of Wegovy is broadly consistent across the schedule, but intensity tends to track dose increases. Nausea is the most commonly reported symptom; vomiting, diarrhoea, constipation and indigestion follow. For most people these are most noticeable in the first week or two after a step-up, then ease as the body adjusts.

The NHS medicines guidance on semaglutide covers the full side-effect list and when to seek help, it's worth reading before you start. One situation that always warrants urgent attention: severe, persistent abdominal pain that radiates to the back, with or without vomiting. This can indicate acute pancreatitis, a known though infrequent risk with GLP-1 medicines. The MHRA's Yellow Card scheme allows patients to report any suspected side effects directly, which helps regulators monitor real-world safety data.

A slower titration schedule is a clinical decision, not a failure. If your prescriber holds you at 1mg for eight weeks rather than four, they're acting on your reported experience. What you tell them matters. That's also why having access to clinical aftercare between doses (not just at initial approval) is a meaningful part of how safe prescribing works.

What determines which dose you stay on

Not everyone ends up at 2.4mg, and the 7.2mg pen is not automatically the goal. The right maintenance dose is the highest one a patient tolerates well and that produces meaningful progress, assessed at regular intervals. NICE's guidance on semaglutide notes that if less than 5% weight loss has occurred after six months at the maintenance dose, continuing should be reviewed. The full NICE recommendation is available at NICE TA875.

Private treatment through a regulated pharmacy like nume follows the same licensed schedule and requires the same clinical oversight. Every repeat order goes through a fresh prescriber review, not an automated renewal. If you're mid-titration and wondering whether your current dose is right, the prescriber reviewing your next order is the right person to ask. You can also explore what's involved in starting by reading about Wegovy treatment more broadly, or take a look at the weight-loss treatments we support.

One practical note: if your titration falls across a bank holiday weekend or a period when you know you'll be away, it's worth flagging this at consultation. Orders placed by 12pm on a working day dispatch the same day for next-working-day delivery, so a Monday order before noon avoids a mid-titration gap if you're organised about it. Small logistical detail, but it matters when you're mid-schedule.