Your second week of Wegovy: what to expect and what's normal

Step 1: You've had your second injection, here's what the next seven days typically look like

If you followed the prescribed schedule, your second injection came roughly a week after your first. That puts you still firmly in the 0.25 mg phase, which exists for one reason: to let your gut adjust to a new signal it has never received before. The appetite shift that many people are hoping for can be subtle at this stage, and that is completely expected. The STEP 1 trial, published in the New England Journal of Medicine, showed an average weight reduction of around 15% over 68 weeks, the early weeks are about tolerability, not transformation.

Nausea is the most frequently reported experience in week two. It tends to arrive a few hours after injection and, for most people, fades within a day or two. Eating smaller meals, avoiding rich or fatty food, and staying well hydrated all help. Constipation is also common, not dramatic, but noticeable. Some people find the opposite: loose stools for a day or so. Both reflect the way semaglutide slows gastric emptying. If you want a broader picture of the full first month, the week one overview covers the baseline, and this week builds directly on it.

Fatigue and mild headache appear occasionally in week two, possibly linked to eating less than usual. If your appetite has already dropped (even modestly) make a conscious effort to eat enough protein and drink water through the day. These small choices matter more than they sound right now.

Step 2: Recognising what is a normal adjustment and what needs a call to your prescriber

Most of what people experience in week two sits firmly in the normal category: low-level nausea, slightly altered hunger cues, perhaps a day of unusual tiredness. These do not require action beyond the practical steps above. They are your body recalibrating, not a sign that something has gone wrong.

A few things do warrant contact with your clinical team. Vomiting that stops you keeping fluids down for more than a day is one. Dehydration can become a real problem quickly when combined with reduced appetite, and your prescriber may advise pausing or adjusting your plan. Gallbladder-type pain (sharp, upper-right abdominal discomfort) should be reported. And the one sign to treat as urgent: severe stomach pain that does not ease and spreads towards your back. This pattern can indicate acute pancreatitis, which the MHRA highlighted as an infrequent but serious risk in a January 2026 Drug Safety Update on GLP-1 medicines. It is rare. Knowing about it is useful; worrying about it constantly is not. Call 999 or go to A&E if that specific combination of symptoms appears.

Injection-site reactions (a small raised area, mild redness, brief tenderness) are worth noting but not alarming. Rotating sites between your abdomen, thigh and upper arm with each weekly injection reduces them over time. If you have questions about what you're experiencing, our frequently asked questions cover the most common week-by-week concerns, and our aftercare team is available seven days a week.

Step 3: What week two tells you about the weeks ahead

Here is something our prescribers hear regularly: people in week two wondering whether the medicine is actually working. It almost certainly is, even if the scale has not moved yet. Semaglutide's appetite effect builds gradually as the dose increases over months. The 0.25 mg starting dose is the adjustment phase, think of it as your system learning a new resting state. The doses that carry the most clinical weight come later in the titration schedule, as your prescriber takes you through 0.5 mg, 1.0 mg, 1.7 mg and ultimately 2.4 mg over several months.

If you are curious how the picture tends to shift as time goes on, the guide to how long Wegovy takes to work sets out the realistic timeline across the full treatment course. If you would like a detailed day-by-day breakdown of this particular point in your journey, our guide to what to expect in your second week of Wegovy walks through the experience in more depth, and the companion overview of week two on Wegovy covers the same period from a slightly different angle, which some people find useful to read alongside it. Week five, when many people have completed their second dose step, often feels meaningfully different from week two, the week five overview is worth reading when you get there.

One honest thing worth saying: it is completely natural to feel impatient right now, or quietly uncertain whether this was the right call. That feeling is common in week two, and it usually shifts as the weeks move on and the effect becomes clearer. Most people find that patience in this early phase pays off. If you started treatment through a service other than nume and are now wondering about your options, or if you are still at the research stage, you can read more about Wegovy as a treatment or look at the broader range of weight-loss options we offer.

For anyone still deciding whether to start, Wegovy is a prescription-only medicine requiring a full clinical assessment before any treatment can be dispensed. If you would like our GPhC-registered prescribers to review your suitability, check your eligibility with a free consultation and we can take it from there.