The stages of Wegovy: what happens at each step of the dose schedule

Stage 1, starting at 0.25 mg: adjusting, not treating

The first stage of Wegovy begins at the lowest available dose: 0.25 mg once weekly. If you look at this number and wonder whether anything is actually happening, you are asking exactly the right question. The 0.25 mg dose is not the therapeutic target. It is a settling-in stage, giving your digestive system time to adapt to a GLP-1 receptor agonist before the dose increases. Nausea, mild stomach discomfort and occasional loose stools are the most common experiences here, and they usually peak in the first few days after each injection then ease. Many people find that injecting on an evening, staying well hydrated, and eating smaller portions at mealtimes makes this stage considerably more comfortable. The semaglutide information page has more background on how GLP-1 receptor agonists work in the body.

One practical habit worth building now: keep a brief weekly note of how you feel, appetite, energy, any side effects and their duration. It takes under a minute and gives your prescriber something concrete to work with at your next review.

Stages 2 and 3, stepping up through 0.5 mg and 1.0 mg

After four weeks at 0.25 mg, the schedule moves to 0.5 mg, then to 1.0 mg four weeks after that. These middle stages of the Wegovy journey are where most people begin to notice a meaningful shift in appetite. Hunger cues become less insistent. The urge to eat between meals quietens. For some people this begins at 0.5 mg; for others it only becomes noticeable once they reach 1.0 mg. Both experiences are normal.

Side effects at this point follow a similar pattern to the first stage: a short spike of GI discomfort in the days after stepping up, then gradual settling. The disadvantages of Wegovy page covers the full side-effect profile honestly, including what usually resolves and what warrants a call to your prescriber. According to NHS guidance on semaglutide, common GI effects are most prominent at the beginning of each new dose level and generally improve over time. If side effects at any stage are difficult to tolerate, your prescriber may hold the current dose for an extra four weeks rather than pressing ahead, this is clinically sensible, not a setback.

Stage 4, reaching 1.7 mg: the penultimate step

By the time you reach 1.7 mg, around 12 weeks into treatment, most people's bodies have adapted significantly. The pattern of side effects at stage transitions tends to be milder here than it was at the start, though it varies. Appetite suppression is usually well-established. This is also the point where the full Wegovy treatment overview is worth revisiting, because some people's clinical needs are met at 1.7 mg and their prescriber may assess whether continuing to 2.4 mg is appropriate for them. Most people do progress, but the schedule is personalised, not automatic.

Practical things your prescriber will want to know at this stage: how your weight loss is tracking, whether side effects are interfering with daily life, and whether any changes to other medicines or health conditions need factoring in. The consultation before each repeat is the right time to raise these points, this is exactly what clinical review at every stage is for.

Stage 5, maintenance at 2.4 mg (and the newer 7.2 mg option)

The standard Wegovy maintenance dose is 2.4 mg weekly. This is the dose used in the STEP 1 clinical trial, which reported an average weight reduction of around 15% over 68 weeks, a figure from the STEP 1 paper published in the New England Journal of Medicine, involving adults with obesity without type 2 diabetes. For most people, 2.4 mg is where the majority of weight-management benefit accumulates.

A higher option exists: the MHRA approved a 7.2 mg maintenance dose in January 2026, and on 14 April 2026 approved a dedicated single-dose 7.2 mg pen for adults with a BMI of 30 or above. Trials at this dose reported average weight loss of around 20.7% over 72 weeks, approaching results seen with tirzepatide at its highest strength. The full breakdown of all Wegovy stages including the 7.2 mg pathway covers this in more detail. Whether 7.2 mg is appropriate for a given patient is a clinical decision; it is not a universal next step after 2.4 mg. Specific pen availability is confirmed at consultation, and it is also worth reading about Wegovy shortages if you want to understand how supply constraints may affect which pens and doses are accessible at any given time.

For anyone weighing up the full picture of private access to Wegovy, our guide to sourcing Wegovy through a regulated UK pharmacy explains what to look for and what legitimate supply actually involves. And if you are curious how Wegovy compares to other weight-management medicines available in the UK, the weight-loss treatments overview sets that out clearly. When you feel ready to talk it through with a prescriber, you can speak to our prescribers through a free consultation.