What is the maximum dose of semaglutide for weight loss?

What does 'maximum dose' actually mean for semaglutide?

For most of the time Wegovy has been available in the UK, the answer was straightforward: 2.4 mg once weekly. That figure comes directly from the original UK marketing authorisation granted to Novo Nordisk, and it is the dose used in the pivotal STEP 1 trial published in the New England Journal of Medicine, where participants lost an average of around 15% of their body weight over 68 weeks. You will still see 2.4 mg described as the maintenance dose in most clinical settings, and for many people it remains the target they work toward.

The picture changed on 14 April 2026, when the MHRA approved a higher 7.2 mg maintenance dose delivered via a purpose-built single-dose pen. This pen has an auto-dosing mechanism, a built-in covered needle and a lock-out feature once the injection is complete. It is licensed specifically for adults with a BMI of 30 or above; it does not apply to the lower BMI threshold or to semaglutide's separate cardiovascular indication. If you want to understand how the approved ceiling has evolved and what each licensed dose means in practice, our guide to what the maximum dose of semaglutide is and how it has changed goes into the specifics of the 7.2 mg approval in full.

In practice, 'maximum' means the ceiling a prescriber may authorise under the licence. It is not a target every patient is expected to reach; it is the top of the range.

How does semaglutide titration work before the maximum is reached?

Semaglutide's step-by-step schedule exists for a clear reason: the most common side effects are gastrointestinal, and a gradual increase gives your digestive system time to adjust. The standard path runs 0.25 mg, then 0.5 mg, then 1.0 mg, then 1.7 mg, then 2.4 mg, each step held for roughly four weeks before moving up. With the 7.2 mg pen now in the picture, 2.4 mg becomes a waypoint rather than the ceiling for patients who are clinically suitable and tolerating the lower doses well.

A practical habit worth building: before each pen change, take thirty seconds to confirm you are moving to the right dose and that the pen looks exactly as it should. Check the label, the expiry date and the cartridge appearance. It sounds obvious, but a quick visual check catches mix-ups early, especially if you store other medicines in the same fridge. The NHS medicines page for semaglutide covers what to look for if something seems off.

Your prescriber sets the pace. If nausea or other symptoms are bothersome at a given step, staying on the current dose for a further four weeks before moving up is a legitimate clinical decision, not a failure. Trying to push ahead faster than your body is ready for tends to increase side effects without meaningfully improving results. Our guide to semaglutide dosing for weight loss explains each step in more detail, including how formulations such as 2.5 mg/ml semaglutide fit into the broader titration picture.

What do the trial results at the maximum dose show?

The 2.4 mg evidence base is extensive. STEP 1 enrolled 1,961 adults without diabetes and reported roughly 15% average weight reduction over 68 weeks alongside lifestyle support, a result that shaped the NICE recommendation for Wegovy (TA875). Those figures were meaningful enough for NICE to recommend the medicine within specialist weight management services for eligible adults, though that recommendation comes with a maximum treatment duration of two years under the NHS pathway.

At 7.2 mg, trial data reported approximately 20.7% average weight loss over 72 weeks, and our overview of what the maximum dose of semaglutide involves explains how that figure compares with earlier dose levels across the titration schedule. That closes much of the gap with tirzepatide at its highest licensed dose. The SURMOUNT-5 head-to-head trial (published in the New England Journal of Medicine, 2025) found tirzepatide produced greater average weight reduction than semaglutide 2.4 mg, but the 7.2 mg figure suggests the two medicines are becoming more closely matched at their respective ceilings. Which medicine and which dose is right for a given person remains a clinical conversation, not a matter of picking the highest number on a list. If you are weighing the options side by side, the Wegovy overview and the treatment comparison page are good places to start.

Who can be prescribed the maximum semaglutide dose for weight loss?

Both maximum doses sit within Wegovy's UK licence for weight management: adults with a BMI of 30 or above, or 27 or above alongside at least one weight-related condition such as high blood pressure, type 2 diabetes or obstructive sleep apnoea. The 7.2 mg pen carries the tighter restriction of BMI 30 or above only. Lower BMI thresholds apply for some ethnic backgrounds under UK guidance, typically 2.5 kg/m² below the standard figures.

Reaching the maximum dose also depends on tolerating each preceding step. A history of pancreatitis, certain thyroid conditions (medullary thyroid carcinoma or MEN2) and other contraindications listed in the prescribing information mean some people are not suitable candidates at any dose. Semaglutide is not recommended during pregnancy, whilst breastfeeding or when actively trying to conceive, and it is not licensed for under-18s. Specific dose availability (including whether the 7.2 mg pen is in stock) is confirmed at the point of clinical assessment; it is worth raising at your consultation rather than assuming availability. For questions about your own situation, our clinical team reviews every consultation personally. If a private prescription route suits you, the free consultation at nume is the starting point, a GPhC-registered prescriber, not an algorithm, reads your answers the same day.