Semaglutide dosage for fat loss: how the schedule actually works

Step 1: why the schedule starts so low

The first pen you receive contains 0.25 mg per weekly dose. For many people that feels underwhelming, it is not the dose doing the heavy metabolic work. Its job is settling your digestive system. Semaglutide slows gastric emptying and acts on appetite centres in the brain; introduced too quickly, those effects produce significant nausea, vomiting and disrupted eating. Four weeks at 0.25 mg lets your gut adapt before the dose that actually drives meaningful fat loss arrives.

After that month, a prescriber reviews your progress before you move to 0.5 mg, then 1.0 mg, then 1.7 mg. Each step takes roughly four weeks. You can read more about how these early stages feel on our guide to Wegovy's starting dose. The full progression from the first injection to the maintenance dose takes around four to five months when each step is followed as licensed.

A practical note: people often start at the end of a month or just after payday and then wonder whether they should delay a dose increase over a bank holiday. The honest answer is that a few extra days at a lower dose is harmless; what matters is that the next increase is discussed with your prescriber, not decided independently based on the calendar.

Step 2: reaching and staying at the maintenance dose

For most people, 2.4 mg is the maintenance dose where the significant weight-reduction effect is established. The STEP 1 trial, published in the New England Journal of Medicine, reported an average body-weight reduction of around 15% over 68 weeks at this dose alongside lifestyle changes. That figure is a trial average across a large population, individual results vary, and your prescriber will weigh your response at each review.

Some people tolerate the titration well and move through each step cleanly. Others need more time at an intermediate dose, or find that a dose increase after illness or a break in treatment needs to restart from a lower level. That is normal clinical practice, not a setback. Our overview of semaglutide dosing for weight loss covers how prescribers handle those situations.

Stopping treatment reverses the pharmacological appetite suppression, and weight typically returns without the behavioural changes built during treatment. Semaglutide is not a short course; most clinical guidelines discuss it in terms of sustained use, reviewed regularly.

Step 3: the 7.2 mg dose (what changed in 2026

On 14 April 2026 the MHRA approved a dedicated 7.2 mg single-dose Wegovy pen) a higher maintenance option for adults with a BMI of 30 or above. This followed earlier approval of 7.2 mg supplied as three 2.4 mg pens weekly. Trials at this dose reported average weight loss of around 20.7% over 72 weeks, which begins to approach the results seen with tirzepatide at its highest dose. The titration pathway remains the same (you still start at 0.25 mg and work upwards) with 7.2 mg as the new ceiling for those who tolerate and continue to respond to lower maintenance doses.

The full Wegovy dosage guide details how prescribers currently approach the 7.2 mg pathway in practice. If you want a side-by-side view of how the dose schedule affects cost across the titration, the Wegovy price comparison page covers that context. Specific dose availability is confirmed at consultation, never assume a particular pen format is in stock.

Step 4: what the dosage schedule does not tell you

The numbered schedule above is the licensed framework. It does not tell you whether semaglutide is the right medicine for your situation, whether 2.4 mg or 7.2 mg is the appropriate target for you, or what to do if you miss a dose or need surgery. Those questions are answered by the clinical team, the Patient Information Leaflet, and your prescriber. On our semaglutide dosage chart you can see the schedule laid out clearly alongside the clinical context for each step.

Eligibility for Wegovy as a weight-management medicine requires a BMI of 30 or above (or 27 to 29.9 with at least one weight-related condition such as high blood pressure, type 2 diabetes or obstructive sleep apnoea). The licensed product is Wegovy; semaglutide sold under other brand names (Ozempic, for example) is licensed for type 2 diabetes and is not appropriate for weight management outside that indication. Our Wegovy overview page explains the distinction clearly. If you have questions about how nume's prescribers approach the schedule, our about page sets out how clinical oversight works here.