A Clear Wegovy Dose Guide: How the Titration Schedule Works

Step 1, the first four weeks at 0.25 mg

Treatment begins at 0.25 mg, injected once a week. For many people this feels almost anticlimactic. There is a widespread expectation that the first pen will produce dramatic appetite suppression straight away, and when it doesn't, some wonder whether something has gone wrong. It hasn't. The 0.25 mg phase is not designed to treat, it is designed to let your digestive system adjust to a GLP-1 receptor agonist for the first time. The most common early side effects are gastrointestinal: nausea, loose stools, indigestion, sometimes burping. Starting low keeps those manageable for most people. The NHS medicines information for semaglutide confirms this tolerability rationale. You inject into the abdomen, thigh or upper arm, rotating the site each week. If you want to understand exactly how each pen is set up and used, our guide to the Wegovy pen dose walks through the practical details, including what the room-temperature window means if you need to travel.

There is nothing to do clinically at this stage except take the dose, note how you feel, and let the four weeks pass.

Step 2, moving through the intermediate doses

After the first month, your prescriber reviews how you've tolerated the 0.25 mg dose and, if you're well, moves you to 0.5 mg. If you want a closer look at what that first step up involves, our page on the Wegovy .5 dose explains what to expect as your body adjusts to the higher amount. The schedule continues upward in roughly monthly steps: 0.5 mg, then 1.0 mg, then 1.7 mg. Each increase carries a small risk of GI symptoms returning briefly, this is normal, and it usually settles within a week or two. The principle throughout is the same: the dose rises when your body is ready, not on a fixed calendar that ignores how you're doing.

It is worth knowing that the pace can slow. If a particular dose causes persistent nausea or vomiting, your prescriber may hold you there for longer before attempting the next step. Pushing upward through bad side effects is not the goal. Reaching the highest dose you can tolerate comfortably is. You can read more about how each stage of the Wegovy dose progression tends to feel in practice, including what manageable side effects look like versus ones that need clinical attention.

Across the STEP 1 trial (68 weeks, with 2.4 mg as the maintenance dose) participants achieved an average body-weight reduction of around 15%, as published in the STEP 1 paper in the New England Journal of Medicine. Those results were built over the full titration period, not the first few weeks.

Step 3, reaching and sustaining maintenance

For most people on the standard schedule, 2.4 mg is the maintenance dose, and our Wegovy dosage guide sets out how you reach it after approximately four months of titration and what staying there for the duration of treatment typically looks like, including what NICE recommends for NHS use, though your own prescriber sets the clinical plan. At 2.4 mg, appetite suppression is usually at its most consistent, and the GI side effects that troubled the earlier steps have often largely settled.

Since January 2026, a higher maintenance dose has been available. The MHRA approved 7.2 mg semaglutide (initially as three 2.4 mg pens taken weekly) and on 14 April 2026 approved a dedicated single-dose 7.2 mg Wegovy pen for adults with a BMI of 30 or above. Trials at that dose reported average weight loss of around 20.7% over 72 weeks, which narrows the gap considerably with the highest tirzepatide doses. If you want to understand how the broader semaglutide titration framework supports that journey, our semaglutide dose guide explains the clinical reasoning behind each step, from the 0.25 mg starting point up to the higher ceiling that some people, on clinical review, may now reach. Whether you'd be a candidate is a conversation with a prescriber, not a self-assessment.

For a broader look at how Wegovy fits into the private treatment landscape, including what the cost of a course of treatment typically involves, the Wegovy price page sets that out plainly.

What happens if doses are missed or a step is repeated

Life happens. A missed injection, a week where the pen was left at room temperature too long, a decision by the prescriber to hold the dose steady, none of these mean the schedule has failed. The patient information leaflet gives specific guidance on missed doses; the general principle (per the SmPC) is that a missed dose can be taken within five days of the scheduled day, and if more than five days have passed, you skip that dose and continue with the next scheduled one. Never double up.

Some people find they do best staying at an intermediate dose rather than pushing to the maximum. A good maintenance dose is the one that balances weight-loss progress with quality of life. Our prescribers at nume hold a clinical review before each repeat, including before any dose increase, to make sure that balance is right for you. If you have specific questions about your own situation, the FAQs cover a range of common scenarios, and our team is reachable through the contact page seven days a week.

If you're ready to talk through whether Wegovy is clinically right for you and where on the schedule you might start, speak to our prescribers through a free consultation, reviewed the same day by a real clinician, not automated software.