Wegovy 2.4mg: the maintenance dose explained

Why doesn't treatment start at 2.4mg?

The titration schedule exists to protect your digestive system. Semaglutide slows gastric emptying and alters gut-hormone signalling, two mechanisms that are effective for weight management but, at full strength from day one, can cause significant nausea and vomiting in many people. Starting at 0.25mg gives your body several weeks to adapt before the dose climbs. Think of each step as your system finding its footing.

The schedule runs: 0.25mg for roughly four weeks, then 0.5mg, 1.0mg, and 1.7mg at the same interval, bringing most patients to 2.4mg around week 17. Your prescriber sets the pace; if side effects are difficult at a particular step, staying on that dose a little longer is a recognised option. The full Wegovy dose range and what each rung in the schedule is designed to do is covered in more detail if you want the broader picture.

Reaching 2.4mg is not a finish line, either. It is where the therapeutic work is concentrated, appetite suppression, changes in food preference, and slower gastric emptying all become more pronounced. Most of the weight-loss outcomes seen in clinical trials were measured in participants who had been at this dose for an extended period.

What does arriving at 2.4mg actually look like in practice?

When your prescription moves to the maintenance dose, what turns up is a Wegovy pre-filled pen set at 2.4mg, delivered in plain, unbranded packaging via DPD, with a tracking notification on your phone so you know exactly when to expect it. The pen itself contains one dose; you inject once a week, rotating between the abdomen, thigh, or upper arm.

Side effects at 2.4mg tend to be most noticeable in the first week or two after reaching this dose, mirroring what often happens after earlier increases. Nausea is the most commonly reported symptom; diarrhoea, constipation, and indigestion follow. For most people, these settle. If they do not, that conversation belongs with your prescriber, not a dose you self-adjust.

The step from 1.7mg to 2.4mg tends to produce the biggest appetite change people notice, the point at which many patients describe feeling genuinely full on smaller portions. That shift is real and is what the maintenance dose is designed to sustain. Details about the physical pen and how to use it are covered on the Wegovy 2.4mg pen page.

Who is eligible to be prescribed Wegovy 2.4mg in the UK?

Wegovy's UK licence covers adults with a BMI of 30 or above, or a BMI of 27 or above alongside at least one weight-related condition such as high blood pressure, type 2 diabetes, high cholesterol, or obstructive sleep apnoea. Lower BMI thresholds apply for certain ethnic backgrounds under UK clinical guidance. A prescriber assesses the full clinical picture, BMI alone does not settle the decision.

Wegovy is not licensed for people under 18, and it is not recommended during pregnancy, while breastfeeding, or for anyone actively trying to conceive. A history of medullary thyroid carcinoma or MEN2 syndrome is a contraindication; previous pancreatitis warrants careful prescriber review. The NICE technology appraisal for semaglutide (TA875) sets out the NHS eligibility criteria, which are stricter, requiring a specialist weight management service and at least one weight-related comorbidity, with a BMI of 35 or above in most cases.

Private treatment through a regulated pharmacy does not require a specialist referral. If you want to understand how eligibility works for private prescribing, the consultation overview explains the process. For a broader look at how semaglutide doses compare, the Wegovy milligram guide sets out the full licensed range.

Is 2.4mg always the highest dose you can be prescribed?

Until January 2026, yes. The MHRA then approved a 7.2mg maintenance dose (initially delivered as three 2.4mg pens weekly) and in April 2026 approved a dedicated single-dose 7.2mg pen. Trial data for 7.2mg showed average weight loss of around 20.7% over 72 weeks, narrowing the gap with the highest tirzepatide doses. The 7.2mg option is licensed for adults with a BMI of 30 or above only; it is not available for the cardiovascular indication. Full details are on the semaglutide 2.4mg overview, and the guide to getting Wegovy through a registered UK pharmacy covers what that process looks like in practice.

For most people, 2.4mg remains the appropriate endpoint. Moving to 7.2mg is a clinical decision, not a straightforward next step. If you have been at 2.4mg for six months and lost less than 5% of your starting weight, that is one of the situations where continuing at all (at any dose) would typically be reviewed by your prescriber. That is not a failure of the medicine; it is a signal that a different approach may suit you better. The weight-loss treatment overview sets out the alternatives worth understanding.