The Different Levels of Wegovy: How the Dose Ladder Works

Step 1: The starter dose (0.25 mg) and why it isn't meant to produce big results yet

The first four weeks on Wegovy are adjustment weeks. The 0.25 mg injection is low enough that most people feel relatively few side effects, but it's also too low to produce meaningful appetite suppression for the majority of patients. Think of it as your system being introduced to semaglutide rather than treated by it. The semaglutide overview covers the mechanism in more detail, but in short: the drug slows gastric emptying and acts on appetite centres in the brain, and the gut needs time to get used to both effects.

During this first month, side effects, if they appear at all, tend to be mild. Nausea and loose stools are the most commonly reported, usually settling within the first week or two. Sticking rigidly to the weekly injection day matters here, because irregular dosing makes the adjustment harder. The Wegovy flu page goes into more detail on what that early adjustment period can feel like.

The NHS medicines page for semaglutide is a reliable starting point for the official side-effect profile at each stage. Your prescriber and the Patient Information Leaflet are the definitive sources for your specific situation.

Step 2: The middle rungs (0.5 mg, 1.0 mg, 1.7 mg) and when you start noticing the difference

Most people report a noticeable shift in appetite somewhere in this middle range, often around the 1.0 mg mark. The 0.5 mg and 1.0 mg months are where the treatment begins to feel purposeful: meals feel satisfying sooner, the pull toward snacking quietens a little, and energy through the day often stabilises. The 1.7 mg step then bridges you toward the standard maintenance dose.

Side effects can resurface at each increase, particularly nausea in the first few days after moving up. This pattern is predictable enough that some clinicians advise being extra careful with portion sizes in the days immediately after an injection at a new level. Plenty of fluids, light meals and keeping protein intake solid all help.

It's also worth knowing that the difference between Ozempic and Wegovy trips a lot of people up at this point in their research: Ozempic is semaglutide too, but it's licensed for type 2 diabetes, not weight management, and its dose range is different. They're not interchangeable.

The Wegovy dose levels page covers each step with more granularity if you want the numbers side by side.

Step 3: Maintenance at 2.4 mg (and what 7.2 mg adds for some patients)

The standard maintenance dose is 2.4 mg per week. This is where the clinical trial evidence sits: in the STEP 1 trial, published in the New England Journal of Medicine, adults on 2.4 mg semaglutide saw an average body-weight reduction of around 15% over 68 weeks alongside lifestyle changes. Most people reach this level by month five, having climbed through four prior steps.

In January 2026, the MHRA approved a higher 7.2 mg maintenance option, initially delivered across three pens per week. A dedicated single-dose 7.2 mg pen followed in April 2026, confirmed by a MHRA announcement. The 7.2 mg level is licensed for adults with a BMI of 30 or above; trials reported average weight loss of around 20.7% over 72 weeks at this dose, closing the gap with tirzepatide's trial results considerably. The titration schedule to reach 7.2 mg still starts at 0.25 mg and follows the same four-weekly pattern.

If you're thinking about how the different semaglutide medicines compare, it's a reasonable question given how many products share the same active ingredient.

For context on what private treatment costs look like across the dose range, the weight-loss treatment overview sets out options clearly.

What affects how quickly you move through the levels

The four-week minimum at each level is a floor, not a ceiling. Prescribers may hold a patient at one level for longer if side effects are significant, if a weight plateau needs monitoring, or if there are other clinical reasons to wait. The decision is always individual.

Things that practically affect timing include how consistently you inject on the right day, whether you're eating in a way that works alongside the medicine, and how your body is tolerating the GI effects. There's no prize for reaching 2.4 mg quickly. Our clinical team at nume reviews each patient before any dose change, not as a formality but as a genuine check that progression makes sense for that person specifically.

If you've landed on this page while researching how Saxenda compares to Wegovy, the dose structure there is quite different; Saxenda is liraglutide and works on a daily injection schedule with its own titration path. The liraglutide versus semaglutide page covers that distinction if it's useful.

If you'd like a clinician to talk through which level would be the likely starting point for you, checking your eligibility with our prescribers is a straightforward next step. There's no obligation and no charge for the consultation itself.