Starting Wegovy for weight loss: the real-world process, step by step

Step 1: the clinical assessment that makes treatment possible

Before any pen is dispensed, a prescriber must confirm that Wegovy is both licensed and safe for you. That is not a formality, it is the thing that protects you. A thorough consultation covers your current weight and BMI, any existing conditions, medicines you already take, and whether there is anything in your medical history (a personal or family history of medullary thyroid carcinoma, for example, or a history of pancreatitis) that would change the picture.

At nume, a GPhC-registered Independent Prescriber reads every consultation personally on the same day it is submitted. Photo ID is verified, and weight is confirmed on a live video call, not estimated, not self-reported and left unchecked. If the prescriber approves treatment and you order before midday on a working day, your Wegovy is dispatched the same day and arrives free the next working day via tracked DPD delivery, in plain unbranded packaging.

If you want to read more about what eligibility looks like in practice, our guide on getting Wegovy in the UK covers the NHS and private routes side by side.

Step 2: understanding the titration schedule before you inject anything

The titration schedule is the defined journey from a very small starting dose up to the level that does the therapeutic work. For Wegovy, that journey looks like this in outline: 0.25 mg weekly for the first four weeks, then 0.5 mg, then 1.0 mg, then 1.7 mg, and finally 2.4 mg as the standard maintenance dose. Each step lasts approximately four weeks, making the full escalation around 16 weeks from your first injection. The newer 7.2 mg maintenance dose, approved by the MHRA in April 2026 and available as a single-dose pen, follows the same graduated approach (starting at 0.25 mg and building up) but your prescriber will confirm whether that pathway is right for you rather than the standard one.

Why such a gradual climb? The lower starting doses are not meaningfully therapeutic for weight loss; their job is to allow your gut to adapt to semaglutide before the dose rises. Skipping rungs or rushing the schedule significantly increases the chance of nausea, vomiting and diarrhoea. If side effects at a particular step are difficult, your prescriber may hold you at that dose for longer before moving up. That is a clinical conversation, not something to decide alone. If you would like to understand how to start Wegovy safely, including what to expect at each stage of the titration, we have covered that in full detail separately. For more detail on when to expect changes in weight on Wegovy, we have covered the evidence separately.

Step 3: giving your first injection, what to know practically

Wegovy is injected into the skin of your abdomen, thigh or upper arm. Rotate the site each week. You do not need a needle or syringe, the pre-filled pen handles all of that. Before you inject for the first time, read the Patient Information Leaflet that comes with your pen; the injection technique is illustrated clearly and takes most people about three minutes to follow the first time. After that it becomes routine quickly.

Storage before first use: keep the pen in the fridge, ideally somewhere undisturbed (the back of the fridge door works well) between 2 °C and 8 °C. Once you have started a pen, check the leaflet for the room-temperature window; we never quote it here because it can vary, and the leaflet is the definitive source. The NHS semaglutide medicines page also summarises storage requirements in plain language.

Inject on the same day each week. If you miss a dose by fewer than five days, take it when you remember. If the next scheduled dose is closer than five days away, skip the missed one and carry on. This is covered in the leaflet and worth reading before your first injection rather than after. Our guide to taking Wegovy goes into the technique in more detail.

Step 4: what to watch for once you have started

Most side effects cluster in the early weeks and around each dose increase. Nausea is the most common, typically mild to moderate, and usually settles within days to a couple of weeks as your body adjusts. Loose stools, constipation, indigestion and fatigue also appear in the first weeks for some people. Eating smaller portions, avoiding very fatty meals, and staying well hydrated all help. Many people also want to know when Wegovy starts working for weight loss and what the early signs of progress look like, which we have addressed in a dedicated guide.

Certain symptoms need prompt medical attention. Severe stomach pain that spreads to your back, with or without vomiting, can indicate pancreatitis, get urgent help if that happens. The MHRA highlighted this in its January 2026 Drug Safety Update on GLP-1 medicines, and it remains something prescribers take seriously at every dose stage. Signs of a serious allergic reaction (swelling of the face or throat, difficulty breathing) also require emergency care.

You can report any suspected side effect to the MHRA directly via the Yellow Card scheme. If you have questions between reviews, our aftercare team is available seven days a week.

For a fuller picture of how semaglutide works as a medicine, including the mechanism behind appetite regulation, our semaglutide overview is a good next read. If you are ready to take the first clinical step, start your free consultation and a prescriber will review your answers the same day.