Understanding the Semaglutide Cycle on Wegovy

Step 1: The starter phase (weeks 1–4, 0.25 mg)

The first injection you take is not intended to produce noticeable weight loss. At 0.25 mg, the dose is low enough to let your digestive system acclimatise to semaglutide's effects before the therapeutic work begins. Nausea, loose stools and indigestion are the most commonly reported side effects across the whole cycle, and they tend to be most pronounced after a dose increase. Starting small is a deliberate clinical choice to reduce that burden.

You inject once a week, on the same day each week, into the abdomen, thigh or upper arm. Rotating the injection site is recommended. Store your pens in the fridge at 2–8°C and consult your Patient Information Leaflet for the exact room-temperature window allowed when travelling.

After four weeks on 0.25 mg, your prescriber reviews your response. If you have tolerated the dose reasonably well, the next step begins. If side effects have been significant, staying at 0.25 mg a little longer is clinically valid, the schedule is a guide, not a fixed rail.

Step 2: The build phase (weeks 5–16, 0.5 mg to 1.7 mg)

The middle of the cycle covers three further dose levels: 0.5 mg, 1.0 mg and 1.7 mg, each held for roughly four weeks. This is where most people begin to notice a meaningful reduction in appetite. Foods that were previously appealing may feel less urgent; portion sizes often reduce naturally rather than through deliberate restraint.

This phase is also where the cycle's rhythm becomes real. Injection day becomes routine. Many people find it helpful to keep the pen in the same place in the fridge and tie the injection to something they already do weekly, a Sunday evening habit tends to stick better than a midweek one with no anchor.

Side effects generally ease as the body adapts, though each step upward can bring a temporary return of nausea or fatigue. Staying well hydrated helps. Keeping protein intake adequate matters too, because the appetite suppression can inadvertently reduce how much you eat overall; a prescriber or dietitian can advise on practical food choices during this phase. For a fuller picture of what Wegovy involves from the start, our Wegovy overview covers the licensed uses and what to expect.

Step 3: Maintenance (weeks 17 onwards, 2.4 mg and beyond)

Reaching 2.4 mg is the standard maintenance endpoint for most people on the conventional Wegovy cycle. The STEP 1 trial, published in the New England Journal of Medicine, found an average body-weight reduction of around 15% at 68 weeks at this dose, alongside lifestyle support. Individual results vary, and clinical trials report group averages, your own trajectory depends on many factors your prescriber will assess.

In January 2026 the MHRA approved a 7.2 mg maintenance dose for eligible adults with a BMI of 30 or above. The dedicated 7.2 mg single-dose pen was approved on 14 April 2026, with trials reporting around 20.7% average weight loss over 72 weeks. Reaching that dose requires the same gradual titration from 0.25 mg; it is the maximum, not the starting point.

NICE's appraisal of semaglutide (TA875) recommends a maximum treatment duration of two years within a specialist weight management service for NHS prescribing. Private prescribing follows the licensed indication and individual clinical review. Whether you are approaching maintenance or considering what comes next, those decisions belong in a conversation with your prescriber, not a self-managed schedule. You can read more about how semaglutide works at a pharmacological level on our semaglutide page.

Step 4: Clinical review at each repeat, what 'the cycle' really means long term

A common misconception is that the semaglutide cycle is purely about dose increases. In practice, clinical review continues throughout maintenance. Progress is assessed (typically weight loss at six months on the maximum tolerated dose) and if less than 5% has been achieved, continuing treatment is reviewed against likely benefit.

There is also a question many people ask but feel hesitant to raise: can semaglutide affect the menstrual cycle? It is worth noting that this is a real clinical question. Our page on whether Wegovy can affect your menstrual cycle covers what the evidence currently shows. Separately, some people research semaglutide specifically as a weight-loss strategy across a defined period rather than an ongoing treatment; our page on using the semaglutide cycle for weight loss addresses that framing directly.

Every repeat supply at a regulated UK pharmacy should involve a clinical re-review. At nume, a GPhC-registered prescriber reviews each repeat order, no auto-renewals, no automated dispatching without clinical oversight. If you want to understand the cost landscape for Wegovy in the UK before taking the next step, that page sets out what private treatment typically involves. If you are specifically starting out and want guidance on the first stages of dosing, our semaglutide 1 mg page walks through what that point in the titration involves. When you are ready to explore whether treatment is appropriate for you, you can check your eligibility through a free consultation with our clinical team.