Semaglutide injection dose for weight loss: the titration schedule explained

The myth: a higher dose means faster results, so you should push up quickly

This is the belief that gets people into trouble. The titration schedule for the semaglutide weight-loss injection is not a waiting game designed by bureaucrats, it reflects how the body actually responds to a GLP-1 receptor agonist. Semaglutide slows gastric emptying and reduces appetite by acting on receptors in the gut and brain. Both of those effects intensify with dose. Start too high or move up too fast and the gastrointestinal side effects, nausea, vomiting, diarrhoea, reflux, become the story rather than the weight loss.

Clinical trials used the stepped schedule precisely because it produced better adherence. The STEP 1 trial, published in the New England Journal of Medicine, ran participants through exactly this pathway over 68 weeks and recorded an average body-weight reduction of around 15% at the 2.4 mg maintenance dose. That result came from people staying on the medicine. Rushing the titration often means people stop it.

The 0.25 mg starting dose carries almost no therapeutic weight-loss signal on its own. Think of it as the body's introduction to the medicine, a chance to adjust before the doses that actually shift appetite kick in. The practical implications of each dose step are worth understanding before you begin.

What the five steps look like week by week

Weeks one to four: 0.25 mg. This is purely about tolerance. Most people notice some mild nausea in the first week, which usually settles by week three. Weeks five to eight: 0.5 mg, the first step where appetite suppression becomes noticeable for many patients. Weeks nine to twelve: 1.0 mg. Weeks thirteen to sixteen: 1.7 mg. From week seventeen onward: 2.4 mg maintenance.

The four-week minimum at each level is built into Wegovy's UK licence. A prescriber may keep you at a lower dose for longer if side effects are significant, that is a clinical decision, not a failure. The NHS semaglutide medicines page gives patient-level detail on what to expect at each stage and when to contact a healthcare professional.

Injection sites rotate between the abdomen, thigh and upper arm. Many people settle into a routine that fits naturally alongside something else they do weekly, keeping the pen in the fridge door next to the milk makes it harder to forget. Storage is refrigerated; the exact room-temperature window if you are away from home is in the leaflet inside your box, and that is the only version you should follow.

The 7.2 mg dose approved in April 2026 is the maximum and sits above the standard 2.4 mg pathway. It is for adults with BMI ≥30 and requires a prescriber to work through the full preceding schedule first. More on the 7.2 mg pen is covered separately.

Who the licensed dose schedule applies to, and where the NHS fits in

The Wegovy injection is licensed for adults with a BMI of 30 or above, or 27 to 29.9 alongside at least one weight-related condition such as high blood pressure, high cholesterol or obstructive sleep apnoea. Lower BMI thresholds apply for some ethnic backgrounds under UK guidance. A prescriber assesses the whole picture, BMI alone does not determine suitability.

On the NHS, access to semaglutide follows NICE guidance (TA875), which recommends it only within specialist weight management services and for a maximum of two years. Waiting lists are substantial in most areas. For people who do not meet the current NHS criteria or prefer not to wait, a regulated private pharmacy is the alternative, provided it is one you can verify on the GPhC pharmacy register. Checking registration takes under a minute and is the single most reliable way to confirm a service is legitimate.

Semaglutide is not recommended during pregnancy, while breastfeeding, or for people trying to conceive. It is not licensed for anyone under 18. Certain conditions (including a history of pancreatitis) require a detailed conversation with a prescriber before treatment can begin. The Wegovy overview covers contraindications in full.

Cost context: what private treatment involves beyond the pen

A question our prescribers hear regularly is whether the monthly price covers everything or just the pen. Legitimate private treatment should include the clinical consultation, the prescription, and ongoing prescriber access, not just the medicine itself. Since Eli Lilly's list-price increase in September 2025, Mounjaro market prices have shifted significantly, and Wegovy private pricing sits in a comparable range; any quoted figure below the realistic market floor is worth scrutinising carefully.

For context on what the private cost of semaglutide treatment typically covers, the guide to where to get Wegovy in the UK walks through what to check. If you want a broader look at your options, including how your semaglutide injection dose is matched to your starting point and health history, starting a free consultation is the clearest way to find out which treatment suits your situation. A prescriber, not a dose chart, makes that call.

Semaglutide is a prescription-only medicine. The dose schedule here describes the licensed pathway; your own titration is managed by your prescriber, with the Patient Information Leaflet as your go-to reference between appointments. If you have questions about your specific treatment, including whether a semaglutide 5mg injection is relevant to where you are in your titration, the FAQs and aftercare team are there for exactly that.