Reaching the top dose of Wegovy: what the evidence actually shows

What the MHRA approval of the 7.2 mg pen actually changed

For the first five-plus years of Wegovy's availability, 2.4 mg was the ceiling. That changed in January 2026, when the MHRA authorised a higher 7.2 mg maintenance dose, initially supplied as three 2.4 mg pens administered in a single weekly session. Then, on 14 April 2026, the regulator approved a dedicated single-dose 7.2 mg pen: one pre-set injection per week, with an auto-dosing mechanism, a built-in covered needle, and a lock-out after use. If you're wondering whether there is an extra dose in the Wegovy pen, that page explains how the locking mechanism and fill volume work in practice. That pen is licensed for adults with a BMI of 30 or above; it is not currently approved for the cardiovascular indication or for lower BMI thresholds. The starting dose remains 0.25 mg regardless of which maintenance level someone ultimately reaches, and titration is guided throughout by the prescriber. You can read more about how Wegovy pen doses are structured across the full schedule.

One misconception worth setting aside: some people assume that requesting the top dose at the outset will speed up results. It won't, and it could make side effects considerably harder to manage. The titration schedule exists because the body needs time to adjust, and a prescriber will not jump ahead of it.

The trial evidence behind the top Wegovy dose

The 7.2 mg dose was supported by phase 3 trial data before the MHRA granted approval. Over 72 weeks, participants receiving 7.2 mg of semaglutide weekly lost an average of around 20.7% of their body weight, compared with roughly 15% typically seen at 2.4 mg in the STEP 1 trial, which followed 1,961 adults over 68 weeks and was published in the New England Journal of Medicine. The 7.2 mg figure brings semaglutide notably closer to tirzepatide's results, though head-to-head comparisons at the newer dose are still limited. These are trial averages across large groups; individual results vary depending on diet, activity, adherence and a range of biological factors. No medicine produces identical outcomes for everyone, and the top dose is not a guarantee of maximum loss for any given person.

For a fuller picture of how different strengths compare across the schedule, the overview of Wegovy doses sets out each step and what the evidence says at each level.

Who reaches the top Wegovy dose, and who might not

Titration through the Wegovy schedule is guided by tolerability as much as by time. Most people move through 0.25 mg, 0.5 mg, 1.0 mg, 1.7 mg and 2.4 mg before a prescriber considers whether 7.2 mg is appropriate. Some people find that gastrointestinal side effects (nausea, loose stools, reflux) are more noticeable after each increase and may need longer at a given step before moving on. Others tolerate the escalation smoothly. The NHS guidance on weight management injections notes that stopping treatment should be considered if less than 5% weight loss has occurred after six months at the maintenance dose, a benchmark that applies at 2.4 mg and equally at 7.2 mg.

Wegovy is licensed for adults with a BMI of 30 or above, or 27 to 29.9 alongside at least one weight-related health condition such as high blood pressure, type 2 diabetes or obstructive sleep apnoea. Lower BMI thresholds may apply for some ethnic backgrounds under UK guidance. The top dose is not separately licensed for those with a BMI below 30. Pregnancy, breastfeeding, and trying to conceive are all situations where Wegovy is not recommended; the same applies for under-18s. Any history of pancreatitis or certain other conditions will be explored at consultation before any dose is considered appropriate. If you want to understand what higher-dose Wegovy involves in more detail, that page covers the clinical context specifically.

Cost, availability and what a private route looks like

The 7.2 mg pen is a newer format, and availability through private providers may vary. Specific dose or pen format availability at any point in time is confirmed through the clinical assessment rather than assumed, a prescriber will factor in what is suitable and what is accessible. If you're thinking about what Wegovy costs at different doses, it's worth knowing that private pricing has shifted since Eli Lilly's list price changes in 2025; Novo Nordisk pricing for semaglutide follows its own structure. The principle that applies across the board is that a legitimate private price includes the prescription and clinical review, not just the medicine.

At nume, a GPhC-registered Independent Prescriber reviews every consultation personally, your answers go to a clinician, not an automated system. If you're considering treatment and want to know whether the Wegovy schedule is right for you, or whether tirzepatide might be a closer fit, starting with a free consultation is the sensible first step. There's no pressure to reach any particular dose; that decision is made with your prescriber over time, based on how your body responds. You can also explore our treatment options overview to compare what's currently available.