Semaglutide dosage per week: how Wegovy's weekly schedule works

What the STEP 1 trial tells us about how semaglutide's dose actually produces results

The weekly dosing structure for Wegovy is not arbitrary. It was established through the STEP clinical programme, the most relevant anchor being the STEP 1 trial published in the New England Journal of Medicine, which followed adults with obesity over 68 weeks at the 2.4 mg maintenance dose. Participants lost an average of around 15% of body weight. What that figure does not show is how much of that result depends on the titration phase: the slow, four-weekly step-up exists precisely because GLP-1 receptor agonists affect gastric emptying and appetite signalling in ways the gut needs time to adjust to. Rushing the schedule does not accelerate results, it tends to make nausea and GI side effects worse and increases the chance of stopping treatment early.

The prescriber reviewing your treatment at each stage is making a clinical judgement about whether you have tolerated the current dose well enough to move up. That is why dose changes are not something to self-manage. If you want to understand how semaglutide dosage works across the full titration schedule, including each step and typical timing, that is a good place to start before your next review alongside the semaglutide dosage chart.

One thing worth knowing: if you miss a dose by fewer than five days, you can take it as soon as you remember and continue on your usual day. If more than five days have passed, skip it and resume your next scheduled dose. The NHS semaglutide medicines page covers missed doses and other practical guidance, always a sensible first stop alongside the Patient Information Leaflet in your box.

How the 7.2 mg weekly dose changes the picture

In April 2026 the MHRA approved a dedicated single-dose 7.2 mg Wegovy pen, one pre-set weekly injection for adults with a BMI of 30 or above. This extends the maintenance ceiling beyond the 2.4 mg dose that was standard for several years. Trials at 7.2 mg reported average weight loss of around 20.7% over 72 weeks, which narrows the gap considerably with tirzepatide 15 mg at the same duration. That is a meaningful shift in what semaglutide can achieve for people who reach and tolerate the higher dose.

The titration pathway to 7.2 mg still begins at 0.25 mg weekly. There is no shortcut. The same four-weekly step-up applies, meaning the full journey to the highest dose takes months rather than weeks. This is by design: the slow escalation is what makes the medicine tolerable for most people over the long term. If you are already established on 2.4 mg by weekly injection, moving to 7.2 mg would be a clinical decision made with your prescriber, not a self-directed upgrade. For more on where the higher dose sits within the broader options, Wegovy's full dose range is worth reading before your next review.

One practical note on the pen itself: the 7.2 mg pen is a single-dose device with an auto-dosing mechanism and a covered needle that locks after use. When your treatment arrives (a plain, unbranded box via DPD with tracking to your phone) the pen and all the information you need come together. Specific dose and pen availability is confirmed at consultation; what is stocked can change.

Which weekly dose applies to you, and what changes eligibility

The licensed eligibility for Wegovy in the UK sits at a BMI of 30 or above, or 27 to 29.9 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 a narrower condition: BMI of 30 or above only, not for people below that threshold. Lower BMI thresholds can apply for some ethnic backgrounds under UK guidance, your prescriber will assess this as part of the clinical review.

NICE's appraisal of semaglutide for weight management (TA875) sets out NHS-specific eligibility criteria that are stricter than the licensed population: a BMI of 35 or above with at least one weight-related comorbidity, within a specialist weight management service, for a maximum of two years. Private treatment through a regulated pharmacy like nume follows the licensed criteria rather than NHS commissioning rules, which is relevant for people who do not meet the NHS thresholds or do not want to wait for a specialist referral. A look at how Wegovy is prescribed privately in the UK explains the difference plainly.

People sometimes ask whether the starting dose of 0.25 mg is doing anything useful. It is, just not in the way the maintenance dose does. Its job is to settle your system, reduce the likelihood of early nausea and establish a baseline your prescriber can assess against before the next step. More on that specifically is covered in our page on what to expect from the first week's dose.

What the weekly schedule means for missed doses and long-term use

Consistency matters more than precision with semaglutide. Taking your injection on the same day each week helps maintain steady drug levels, but the medicine has a long half-life (around a week) so a day's variation is not clinically significant. What does matter is not doubling up: if you missed a dose and the next scheduled one is approaching, take the next one as planned and do not inject twice in a week.

Longer-term, the weekly dose you finish on is not fixed forever. If your response at 2.4 mg is limited after six months, your prescriber may discuss the 7.2 mg option if it becomes available and you are eligible. If you achieve good results and tolerate treatment well, continuing at your current maintenance dose is usual. Stopping and restarting is also something to manage with clinical input, not something to do independently, appetite suppression and metabolic effects tend to reverse when treatment ends.

For people considering costs alongside the clinical schedule, the cost landscape for Wegovy in the UK sets out what legitimate private pricing typically covers and where headline prices can be misleading. And if you have broader questions before deciding, our FAQs cover the questions our prescribers hear most often. When you are ready to take the next step, checking your eligibility with our clinical team is free and takes a few minutes.