Wegovy 3.4mg: the dose that doesn't exist, and what that means for your treatment

What the STEP 1 trial data actually shows about how Wegovy is dosed

The STEP 1 trial, published in the New England Journal of Medicine, enrolled 1,961 adults with a BMI of 30 or above (or 27-plus with a weight-related condition) who did not have type 2 diabetes. Participants on semaglutide 2.4mg lost an average of around 15% of body weight over 68 weeks. That figure comes from a careful titration process, starting low to help the body adjust, stepping up gradually, landing at 2.4mg as the maintenance dose. The schedule the trial used, and that the licensed product follows, has five steps: 0.25mg, 0.5mg, 1mg, 1.7mg, and 2.4mg. A 3.4mg rung was never part of it. The results at 2.4mg were substantial enough that the MHRA licensed the medicine on that basis, and NICE subsequently recommended it within specialist weight management services for eligible adults. More recently, a higher 7.2mg dose has been approved (more on that below) but the intermediate steps between 2.4mg and 7.2mg do not include a 3.4mg pen. Titration exists for a reason: the GI side effects of semaglutide, nausea in particular, are most pronounced when the dose is new or recently increased. Moving carefully through the schedule keeps most people on track.

Why searches for Wegovy 3.4mg happen, and where the confusion comes from

If you found yourself searching for a 3.4mg dose, you're not the first. A few things could explain it. Ozempic, the semaglutide product licensed for type 2 diabetes, has a different titration schedule that includes a 1mg and a 2mg pen, neither of those is 3.4mg, but confusion between Ozempic and Wegovy doses is common. Some non-UK sources discuss tirzepatide (Mounjaro), which has its own schedule entirely, and dose numbers can blur when people are researching across multiple products at once. It's also possible you've seen a misprinted or misquoted figure on a forum or social media post. None of this is unusual, the GLP-1 space moves fast, and the information online doesn't always keep up with the actual licensed schedules. The reliable source for the Wegovy titration is the Summaries of Product Characteristics and Patient Information Leaflets held on the electronic Medicines Compendium, which are updated whenever the licence changes. If you want to understand how semaglutide works more broadly, our semaglutide overview covers the mechanism and evidence in plain language.

The 7.2mg approval: how the top of the schedule changed in 2026

On 14 April 2026 the MHRA approved a dedicated single-dose 7.2mg Wegovy pen, a pre-set, once-weekly injection with a built-in covered needle that locks after use. Before that, 2.4mg had been the ceiling. The new pen is licensed for adults with a BMI of 30 or above and follows the same bottom-up titration: you still begin at 0.25mg and work upward, with 7.2mg as the new maximum maintenance dose. Trials reported average weight loss of around 20.7% over 72 weeks at 7.2mg, which narrows the gap with tirzepatide 15mg results from the SURMOUNT programme. The MHRA's announcement confirms the 7.2mg pen is for the obesity weight-management indication only, not the cardiovascular or MASH indications. The dose steps between 2.4mg and 7.2mg follow the prescriber's clinical judgement; there is no standardised 3.4mg intermediate. If you're considering where Wegovy fits relative to other options, the 7.2mg Wegovy page covers that approval in detail, and our Wegovy treatment overview gives the full picture from eligibility to evidence. For cost context, treatment pricing across both products is set out on our weight-loss treatments page.

Eligibility, safety notes, and the clinical decision behind each dose step

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, high cholesterol, obstructive sleep apnoea or type 2 diabetes. BMI thresholds under UK guidance are 2.5 kg/m² lower for South Asian, Chinese, Middle Eastern, Black African or African-Caribbean backgrounds. A prescriber looks at the full clinical picture, not just the number on the scale. Side effects are mainly gastrointestinal: nausea, constipation, diarrhoea, reflux and fatigue are the most commonly reported. They tend to be worst around a new or increased dose and often settle within one to two weeks. The MHRA has highlighted acute pancreatitis as a known but infrequent risk across GLP-1 medicines, anyone on Wegovy who develops severe, persistent stomach pain that spreads to the back should get urgent medical attention rather than waiting for a scheduled review. Pregnancy, breastfeeding and trying to conceive are all situations where these medicines are not recommended, and the same applies to anyone under 18. These medicines are not suitable for cosmetic weight loss and are not assessed by the MHRA for that purpose. If you're unsure whether Wegovy is the right route for you, our weight-loss treatment overview sets out the options side by side. If you're ready to talk to a prescriber, you can check your eligibility with no obligation.