How high does Wegovy go — and what happens at the top dose?

You're staring at a 0.25mg pen and wondering if this can possibly do anything

That reaction is completely reasonable. You've read about 15% or 20% weight loss, and the pen in your hand is labelled with a number that sounds very small. Here's what that first pen is for: settling your gut, not shifting your weight. Semaglutide slows gastric emptying and dials down appetite signals through GLP-1 receptors in the brain, the mechanism behind Wegovy means those effects intensify as the dose rises. Starting low gives your body time to adjust, and the nausea, loose stools and reflux that trouble some people at higher doses are far less common at 0.25mg.

The licensed escalation runs: 0.25mg for the first four weeks, then 0.5mg, then 1.0mg, then 1.7mg, then 2.4mg as the standard maintenance dose. That journey takes roughly four to five months when each step lands on schedule. A prescriber may slow it if side effects are significant, or hold a dose for longer if that feels clinically sensible. Skipping steps is not recommended; the schedule exists for a reason.

Worth knowing: if you miss several doses and the pen has been out of the fridge for longer than recommended, the medicine may have degraded before you even use it. Storing Wegovy correctly matters across every dose level, not just the higher ones.

What changed in 2026, and why 7.2mg now exists

Until early 2026, 2.4mg was as high as the UK licence went. Then two approvals arrived in quick succession. In January 2026 the MHRA authorised 7.2mg as a new maximum maintenance dose, initially supplied as three 2.4mg pens administered weekly. On 14 April 2026, the MHRA went further and approved a dedicated single-dose 7.2mg pen, one pre-set weekly injection with an auto-dosing mechanism, a covered needle and a lock after use. The gov.uk announcement confirmed the 7.2mg pen is licensed for adults with obesity, meaning a BMI of 30 or above; it is not approved for the cardiovascular indication or for lower BMI thresholds.

The trial evidence behind this is substantial. Over 72 weeks, participants on 7.2mg saw an average of around 20.7% body-weight reduction, a figure that narrows the gap meaningfully with tirzepatide at 15mg. That comparison was one reason the dose was developed; the competitive landscape in weight management medicine moved fast in 2024 and 2025.

The starting dose does not change at 7.2mg. Everyone still begins at 0.25mg. The only difference is where the ceiling sits, and your prescriber decides when (or whether) reaching that ceiling is appropriate for you. Some people find 2.4mg achieves everything they need and never have a clinical reason to go further.

Side effects tend to track the dose, so does the benefit

The most common side effects of semaglutide are gastrointestinal: nausea, vomiting, diarrhoea, constipation, reflux and stomach discomfort, as described in detail by the NHS medicines page for semaglutide. These tend to peak in the first week or two after a dose increase and settle as your body adapts. At 7.2mg they can be more pronounced than at 2.4mg, which is part of why slow, supervised escalation matters.

If you have high blood pressure and are considering Wegovy, it's worth knowing that the relationship between Wegovy and blood pressure is nuanced; semaglutide's cardiovascular data is actually one reason it holds a separate MHRA authorisation for cardiovascular risk reduction. Your prescriber will factor your full health picture into titration decisions.

A note on timing: if you're planning a dose increase around a holiday, a busy work period or even a long weekend away from your fridge, flag it with your prescriber. Many people find it easier to settle into a new dose when the rest of life is reasonably predictable. That's not a clinical rule, just something worth planning around. Storage is also a real consideration on trips; what makes Wegovy go bad covers the temperature and time limits you need to know before you travel.

Where your dose actually lands, and how a prescriber decides

There is no universal answer to how high your Wegovy dose should go. The licence sets the ceiling; your prescriber sets your target. NICE's guidance on semaglutide (TA875) and the NHS framework for weight-management medicines both emphasise ongoing clinical review, not a fixed protocol. If you've lost less than 5% of your body weight after six months on a maintenance dose, NICE recommends reconsidering treatment, that review works in the other direction too. If you're responding well and tolerating the medicine, there may be a clinical case for cautiously moving toward a higher dose. If you're based in the south-east and want support from a local clinical team, our Wegovy Surrey service connects you with GPhC-registered prescribers who can guide titration decisions from the outset.

Understanding the costs involved at each stage is a reasonable part of planning. The Wegovy price page sets out what private treatment typically involves across different dose levels, including what a single transparent price from a GPhC-registered pharmacy covers. There are no hidden extras to account for at consultation, prescription or delivery stage when you go through a properly regulated service.

If you want to explore whether Wegovy could be right for you (at whatever dose that eventually means) check your eligibility with our prescribers. A real clinician reads every consultation the same day; the dose question gets answered as part of that, not as an afterthought.