Weight loss on the Wegovy maintenance dose: what the evidence says

What the STEP 1 trial actually measured at maintenance

The STEP 1 trial enrolled 1,961 adults with obesity or overweight and at least one weight-related condition, randomising them to semaglutide 2.4mg or placebo over 68 weeks. Participants spent most of the trial at the 2.4mg maintenance dose, and the headline figure (roughly 15% average body-weight reduction) reflects that sustained period, not just the titration phase. Put simply, the bulk of the weight loss recorded in the trial happened after people reached maintenance.

That matters because a common worry, especially among people who have just arrived at 2.4mg, is that the medicine has done its job and weight loss will stop. If you are wondering whether you still lose weight on the maintenance dose of Wegovy, the data is reassuring: reductions continued throughout the maintenance period in STEP 1, with the greatest losses accumulating over weeks and months at the therapeutic dose. How the maintenance dose works in practice is worth reading if you want a fuller picture of what to expect week by week.

It is also worth knowing that individual responses vary considerably. Some people lose more than 15%, some less. Factors including starting weight, diet, activity levels and biological differences all play a role. The trial average is a guide, not a forecast for any individual.

The 7.2mg dose and what it means for weight loss targets

In January 2026 the MHRA approved semaglutide 7.2mg as an extended maintenance option, and in April 2026 a dedicated single-dose 7.2mg pen was approved, making it simpler to administer. The MHRA's announcement on the 7.2mg pen confirmed it is licensed for adults with a BMI of 30 or above. Trials reported around 20.7% average weight loss at this dose over 72 weeks, which narrows the gap with tirzepatide (Mounjaro) considerably.

Escalation to 7.2mg is not automatic. Your prescriber decides whether moving beyond 2.4mg is appropriate based on your response, tolerability and clinical picture. The starting dose remains 0.25mg regardless of which maintenance level you are eventually working towards, and each step takes roughly four weeks. For those currently at an earlier step, what to expect at the Wegovy 1mg maintenance dose is a useful reference before you reach the full therapeutic level. The full Wegovy dose schedule sets out the titration pathway in detail. Never self-adjust; timing and pace are clinical decisions.

The practical upshot: if you have reached 2.4mg and are still losing weight steadily, that is the expected trajectory. If progress has stalled significantly, it is a conversation for your prescriber rather than a reason to assume the medicine has stopped working.

The NICE six-month checkpoint, and what happens afterwards

NICE's appraisal of semaglutide (TA875) includes a clear checkpoint: if a person has lost less than 5% of their body weight after six months at the maintenance dose, continuing treatment should be formally reviewed. This is not a failure threshold, it is a safeguard to ensure people are getting meaningful benefit from a medicine that carries real clinical weight. For the majority of people in the trials, loss well above 5% was recorded by that point.

What happens when someone reaches their goal weight on Wegovy is a separate question worth planning for early. Weight tends to return if the medicine is stopped without lifestyle changes in place, because semaglutide is managing an ongoing biological process, not curing the underlying condition. Keeping weight off after Wegovy covers what the evidence says about that transition. Some people, after discussing it with their prescriber, continue at a lower dose for maintenance rather than stopping entirely, though that is an individual clinical decision.

One practical note: if your Wegovy supply runs short around a bank holiday or a payday that shifts your usual order date, speak to your prescriber before missing a dose rather than pausing silently. Gaps in treatment affect how your body responds, and the Patient Information Leaflet covers what to do if a dose is missed.

Private prescription versus waiting for NHS access

On the NHS, Wegovy is available through specialist weight management services under TA875, but waiting lists are commonly long, and eligibility criteria are strict. For people who meet the private-prescription criteria (a BMI of 30 or above, or 27 or above with a weight-related condition) a regulated online pharmacy can be a faster route. Where to get a Wegovy prescription in the UK explains the landscape, including what to look for in a legitimate provider.

At nume, every consultation is reviewed by a GPhC-registered Independent Prescriber. A real clinician reads your assessment the same day, not software, not a queue. If you are clinically suitable and order before 12pm on a working day, treatment is dispatched the same day and arrives free the next working day via DPD, in plain packaging. There are no subscriptions; every repeat is clinically re-reviewed. You can verify our pharmacy on the GPhC register (registration number 9012878) at pharmacyregulation.org.

If you are already on Wegovy and want to understand your options, or are considering starting, check your eligibility with our prescribers, the consultation is free.