What happens to your weight loss with Wegovy after 6 months?

You've hit the six-month mark and the scales have slowed, here's why that happens

Picture this: you started Wegovy in the winter, worked through the nausea of the early doses, and by month three the weight was shifting more visibly than it had in years. Now it's month six and the weekly changes are smaller. You're eating less, you're moving more, but the graph has flattened. This is, almost universally, how semaglutide works.

In the STEP 1 trial (68 weeks, 2.4mg semaglutide versus placebo) the greatest rate of weight loss occurred in the first 20 weeks or so, before levelling into a slower but sustained decline. The STEP 1 paper, published in the New England Journal of Medicine, reported an average weight reduction of around 15% at 68 weeks. Most of that was earned early; the later months consolidated it. So if your rate has slowed at six months, you are likely on schedule, not stalling.

There is also a physiological reason for the plateau. As body weight falls, your resting energy needs fall too, the body adapts. Semaglutide continues to suppress appetite and slow gastric emptying, but those adaptations work against a backdrop of a smaller body. This is not a failure of the medicine or of you. It is biology. What matters clinically is the total weight lost so far and whether health markers (blood pressure, blood glucose, cholesterol) have moved in the right direction alongside it. Those shifts can occur even when the scales have stopped moving dramatically. For a fuller picture of what to expect at three months, that page sets out the earlier trajectory in detail.

What the six-month check actually looks like under UK clinical guidance

NICE's guidance on Wegovy (TA875) includes a specific six-month review point. If a person has lost less than 5% of their starting body weight after six months at their maintenance dose, the guidance says the prescriber should consider stopping treatment. This is not a punishment; it is a clinical signal that semaglutide may not be producing sufficient benefit in that individual to justify continuing. Most people who respond to the medicine will have exceeded that 5% threshold well before month six.

At a reputable service, the six-month review is a proper clinical conversation, not a rubber stamp. A prescriber (not an automated system) looks at your weight trajectory, any changes in relevant health conditions, how well you've tolerated the doses, and what you'd like to do next. At nume, our clinical team reviews every repeat order individually; there is no auto-renewal. If you want to understand the decision some people face at this point about whether to continue, this page on stopping Wegovy after six months covers that specifically.

The NHS notes that Wegovy is licensed for weight management alongside a reduced-calorie diet and increased physical activity. The medicine does its job best when those lifestyle elements are genuinely in place. At month six, it is worth taking an honest look at whether diet quality, protein intake and movement have remained consistent, sometimes a plateau reflects a gradual drift back towards old habits that the medicine can only partially offset.

Health gains that matter beyond the number on the scales

Weight loss is one measure. It is not the only one. At six months, many people on Wegovy notice improvements in blood pressure, resting heart rate, sleep quality if obstructive sleep apnoea was a factor, and blood sugar regulation. These changes are clinically real and matter to long-term health regardless of whether the weight graph is still moving steeply.

The NHS medicines page for semaglutide notes that treatment is intended to support weight management as part of a broader plan. Prescribers considering whether to continue beyond six months will weigh up these wider health signals, not just total kilograms lost. It is also worth flagging any side effects that have persisted beyond the adjustment period, nausea, constipation and reflux that haven't settled warrant a conversation with your prescriber, not just patience.

If you're comparing how six months compares to the earlier part of the journey, the two-month stage tends to be when the medicine first becomes noticeably effective for most people. Looking at that alongside the evidence for the full treatment course gives a clearer sense of the arc. You can also read a detailed account of the clinical picture at six months specifically, which covers the trial evidence and real-world context in more depth.

Where to go from here, and how a clinical review works in practice

At month six, you broadly have three paths: continue at your current dose with another clinical review in due course, discuss whether any adjustment is needed, or make a planned decision to stop. None of those should happen in a vacuum. The right next step depends on a conversation with a prescriber who has sight of your full health picture.

If you are with a private service, that review should happen before any repeat supply is issued. A quick note on the cost side: the Wegovy pricing page sets out what private treatment involves financially, because the question of whether to continue is sometimes shaped by what continued treatment costs as much as clinical factors. That's a real consideration and worth thinking through honestly.

One thing our prescribers hear fairly often at this stage: people who've lost a meaningful amount of weight feel the momentum has stalled and wonder whether they should just stop. The morning of a repeat prescription, after checking the DPD tracking before the school run, is not the moment to make that call alone. Stopping without clinical input can lead to weight regain, the evidence on this is consistent. A proper conversation is always the better step. You can explore your options through a free consultation with our prescribers, where suitability for continued treatment is assessed individually. Details of how we work are on the about page if you'd like to know more before getting started.