The semaglutide regimen: how the Wegovy dosing schedule actually works

You've just been prescribed Wegovy, what does week one actually look like?

The first pen contains the 0.25 mg dose. That number can feel anticlimactic if you were hoping for immediate results, but the regimen is deliberately front-loaded with caution. Semaglutide slows gastric emptying and acts on GLP-1 receptors in the brain to reduce appetite; those same mechanisms are what cause nausea, vomiting, and digestive upset in some people, especially early on. The starter dose is there to let your system adjust before the medicine ramps up to a level where it drives meaningful weight loss.

You inject once a week, rotating sites between the abdomen, thigh, and upper arm. The day of the week is your choice, pick one you can stick to. Some people tie it to a routine that already exists, which helps; one of the questions our prescribers hear most weeks is simply 'does it have to be the same day?' The answer is yes, as consistently as possible, though your Patient Information Leaflet covers what to do if you miss a dose. For specific missed-dose guidance, always follow the leaflet or speak to your prescribing team rather than improvising.

After four weeks at 0.25 mg, the standard Wegovy regimen moves to 0.5 mg, and so on through 1.0 mg and 1.7 mg before reaching the 2.4 mg maintenance dose at around week 17. In January 2026, the MHRA also approved a higher 7.2 mg dose, which you can read more about on our Wegovy overview page. Not everyone reaches the highest dose; the regimen is guided by what you tolerate and what your prescriber decides is appropriate.

Why the regimen takes months rather than weeks

The gradual step-up is not bureaucratic caution, it is the design of the clinical programme. The STEP 1 trial, published in the New England Journal of Medicine, ran over 68 weeks with 2.4 mg semaglutide as the maintained dose. Participants lost an average of around 15% of their body weight by the end of the study. That figure came from spending the majority of the trial at or near the maintenance dose, not from the titration weeks.

What the titration period does is reduce the chance that side effects push you to stop before the medicine has had time to work. Gastrointestinal effects (nausea most commonly, along with constipation, diarrhoea, or reflux in some people) are most pronounced at the start or after a dose increase, and they typically settle within a couple of weeks. Pushing straight to 2.4 mg would shorten the regimen on paper but would likely produce more discontinuations. The slower route gets more people to a dose that actually produces results.

It also means the regimen is not just about injections. The licensed indication for Wegovy requires it to be used alongside a reduced-calorie diet and increased physical activity. A prescriber reviewing your progress at each stage is partly checking the scale but also checking whether the lifestyle element is in place. If less than 5% weight loss is achieved after six months at the maintenance dose, continuing is reviewed, as set out in NICE's appraisal of semaglutide for weight management (TA875).

The 7.2 mg dose and how the regimen may evolve

For people who have reached 2.4 mg and are responding well, there is now an additional option. The MHRA approved semaglutide 7.2 mg (supplied initially as three 2.4 mg pens weekly and later as a dedicated single-dose pen) in early 2026. Trial data at this higher dose showed average weight loss of around 20.7% over 72 weeks, narrowing the gap with tirzepatide. The 7.2 mg dose is approved for adults with a BMI of 30 or above and is not indicated for the cardiovascular risk reduction use. Whether it forms part of your regimen is a clinical decision made with your prescriber, not something to request based on wanting a faster result.

It is also worth knowing that semaglutide is not a course of treatment with a fixed end date in the way antibiotics are. Weight tends to return when treatment stops, because the biological drivers of appetite return too. Stopping abruptly is not medically dangerous for most people, but it is not the same as completing a regimen. If you are thinking about that question, our page on stopping Wegovy covers what the evidence says. For a broader look at how costs stack up across private providers, our Wegovy price comparison sets out the context.

Who the semaglutide regimen is licensed for, and how private access works

Wegovy is licensed in the UK for adults with 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. Lower BMI thresholds apply for some ethnic backgrounds under UK guidance. The medicine is not licensed for anyone under 18, and it is not recommended during pregnancy, while breastfeeding, or for anyone trying to conceive.

On the NHS, semaglutide is available through specialist weight management services under NICE TA875, though waiting lists are often long and eligibility criteria are strict. Private routes, including regulated online pharmacies, allow access without a referral, subject to clinical assessment. At nume, a GPhC-registered prescriber on our clinical team reads every consultation personally before any prescription is issued. There is no algorithm making that call. If you are exploring your options, the weight-loss treatments overview sets out what is available and how they compare. You can also visit our FAQs for common questions about the process.

The regimen itself (the doses, the intervals, the decision to titrate or pause) belongs to the prescriber. What you bring is the commitment to use it properly. Check your eligibility and speak to our prescribers by starting a free consultation if you want a clinical view on whether this is right for you.