The therapeutic dose of Wegovy: what it is and when you reach it

You've been on Wegovy for a few weeks and you're wondering: is this actually doing anything yet?

Most people feel a difference long before they reach the therapeutic dose of Wegovy. A change in appetite, slower eating, feeling full sooner, these can start on the starter steps. But 0.25 mg, the opening dose, is not designed to produce substantial weight loss. Its job is to let your body acclimatise to semaglutide so that the increases that follow are tolerable.

The standard titration path runs: 0.25 mg for four weeks, then 0.5 mg, then 1.0 mg, then 1.7 mg, then 2.4 mg, each level held for roughly a month before stepping up. If you want a closer look at how each step works and what to expect from it, our guide to the Wegovy dose schedule walks through the full titration in detail. The NHS semaglutide medicines page gives an accessible overview of the schedule and what to expect at each stage.

Worth saying plainly: side effects tend to be at their worst after a step-up, not once you have settled at a given level. Nausea, loose stools, and fatigue typically ease within a week or two. That is the pattern for most people, not a sign that the medicine is not working.

If you are curious about the broader dose picture, our overview of all available Wegovy doses sets out the full range, including the newer 7.2 mg option.

What the 2.4 mg therapeutic dose actually produces

The STEP 1 trial (68 weeks, over 1,900 adults without diabetes) found an average weight reduction of around 15% at 2.4 mg semaglutide weekly, compared with around 2.4% on placebo, alongside lifestyle support. That trial, published in the New England Journal of Medicine, remains the principal evidence base for the 2.4 mg licence.

Those are averages. Some people lose considerably more, some less; biology, diet, activity and how long you have been at the therapeutic dose all influence the outcome. Six months on the full maintenance dose is a reasonable minimum before drawing conclusions, and NICE guidance suggests that if weight loss remains below 5% after six months at maintenance, continuing should be reviewed with your prescriber.

For most people the therapeutic dose is also where appetite suppression is most consistent. The GLP-1 receptor agonist mechanism slows gastric emptying and signals satiety to the brain; at 2.4 mg those signals are at their most sustained, which is why the titration exists rather than starting there. Some people also wonder whether weight-loss treatment affects hormone levels, and if that applies to you, our page on whether Wegovy increases testosterone looks at what the evidence actually shows.

If you want to understand how the cost of treatment relates to the dose schedule, the Wegovy price comparison page sets out what private treatment typically involves across providers.

The 7.2 mg option: is there a dose above 2.4 mg?

Yes, and it is a relatively new development. The MHRA approved a 7.2 mg semaglutide maintenance dose in January 2026, and on 14 April 2026 approved a dedicated single-dose 7.2 mg pen, making it the highest licensed Wegovy dose available in the UK. Trials reported an average weight reduction of around 20.7% over 72 weeks at 7.2 mg, which narrows the gap with tirzepatide (Mounjaro) considerably.

The titration still begins from 0.25 mg; 7.2 mg is the ceiling, not a starting point. The 7.2 mg pen was approved for adults with a BMI of 30 or above (not for the cardiovascular indication) and whether it is appropriate is a clinical decision. If you want a full breakdown of every strength available, our page on what doses of Wegovy there are covers the complete range and what each one is used for. Our page on doses above 2.4 mg covers the approval and what it means in practice.

One practical note: dose availability can vary. If you are thinking about starting treatment or moving to a higher dose, a clinical review confirms what is stocked and what is right for your situation. That is true whether you are ordering on a Monday in January or picking up a repeat prescription after a bank holiday.

What happens if you cannot tolerate the therapeutic dose

Not everyone reaches 2.4 mg on schedule, and that is not unusual. Some people find a lower dose produces sufficient side effects that their prescriber recommends staying at 1.0 mg or 1.7 mg for longer before stepping up, or in some cases not progressing further.

Remaining at a sub-maintenance dose because of tolerability is different from stopping. A clinician might also look at dietary adjustments (smaller meals, lower-fat food, adequate hydration) which can meaningfully reduce gastrointestinal side effects without abandoning the titration. That conversation belongs with your prescriber, not a forum.

If you are already on Wegovy through another provider and want to continue or transfer, a clinical review of your current dose and history is part of any responsible intake process. You can read about our clinical team and how prescribing decisions are made on the clinical team page, and our FAQs cover the most common questions about transferring treatment. Wegovy is a prescription-only medicine; the prescriber, not the patient, sets the pace of titration. If you have questions about whether treatment is right for you, starting a free consultation is the straightforward next step.