How Wegovy dose increments work — the full step-by-step schedule

Step 1, the first four weeks at 0.25 mg

The starting dose of Wegovy is 0.25 mg once weekly. This isn't a therapeutic dose in the weight-loss sense; its job is to accustom your system to semaglutide before you feel its full effect. GLP-1 receptor agonists slow gastric emptying and alter appetite signalling, and that shift can cause nausea, bloating or loose stools if introduced too abruptly. Keeping the first four weeks at 0.25 mg substantially reduces the chance of those effects becoming severe enough to make someone quit early.

Clinically, most people notice very little change in appetite or weight during this phase. That's expected. Your prescriber will typically ask about tolerance before clearing a move to the next increment, so if you're experiencing persistent vomiting or significant discomfort, flag it rather than waiting for your next review. The licensed Wegovy dose structure is built around communication between patient and prescriber at each step.

Step 2, building through 0.5 mg, 1.0 mg and 1.7 mg

After the initial month, the schedule steps upward roughly every four weeks: 0.5 mg, then 1.0 mg, then 1.7 mg. Each rung brings a progressively stronger appetite-suppressing effect, and most people begin to notice meaningful changes in hunger and food intake somewhere in the 0.5–1.0 mg range. The 1.7 mg step is the final increment before reaching the standard 2.4 mg maintenance dose, and it's the one where GI side effects can resurface briefly as the body adjusts again.

The full four-week increments are there for a reason, but real prescribing isn't rigid. If someone is struggling with persistent nausea at 1.0 mg, a clinician may suggest staying at that dose for an extra four weeks before moving on. If tolerance is good and the person is progressing well, the schedule holds as written. You can find a detailed breakdown of each increment alongside the typical timeline on a separate reference page. The NHS patient information for semaglutide, available on the NHS medicines pages, also summarises the standard titration steps.

Step 3, reaching 2.4 mg maintenance (and when 7.2 mg applies)

The 2.4 mg weekly dose is the established maintenance level for Wegovy, and it's where the trial evidence is strongest. The STEP 1 trial (68 weeks, semaglutide 2.4 mg versus placebo) reported an average body-weight reduction of around 15% at this dose. Most people who tolerate the full titration schedule reach 2.4 mg at around week seventeen or eighteen of treatment.

In January 2026, the MHRA approved a 7.2 mg maintenance dose of Wegovy, and on 14 April 2026 confirmed a dedicated single-dose 7.2 mg pen (one pre-set weekly injection) for adults with a BMI of 30 or above. Trial data at 72 weeks showed an average loss of around 20.7% at this dose, narrowing the gap with tirzepatide 15 mg results. The 7.2 mg option is not a separate product bought off-the-shelf; reaching it still requires titrating through the standard steps from 0.25 mg upward, with a prescriber confirming suitability at each stage. This is a meaningful development if you're already established on 2.4 mg and want to discuss whether a higher dose is appropriate. What triggers a dose increase is a question worth exploring with your prescriber at your next review. If you're unsure whether your Wegovy dose is supposed to increase over time, that page explains how the escalation works in practice. You can also read about when the right moment to increase your Wegovy dose might be, including the clinical signals your prescriber will look for.

Side effects to expect at increment changes, and when to contact someone

Each upward step carries a short recalibration period. Nausea, loose stools, constipation, indigestion and fatigue are the most commonly reported effects after a dose change, and they typically ease within a week or two as the body adjusts. Eating smaller portions, avoiding high-fat meals, and staying hydrated all help. These effects don't mean the medicine is wrong for you, they're the dose doing its job on the GI system before the appetite effects settle in.

There are symptoms that need prompt medical attention rather than watchful waiting. Severe, persistent stomach pain that radiates toward the back (with or without vomiting) should be assessed urgently, as this can be a sign of acute pancreatitis. The MHRA issued a Drug Safety Update in January 2026 specifically highlighting pancreatitis as a known, infrequent but serious risk with GLP-1 medicines. Signs of a serious allergic reaction, significant dehydration from vomiting or diarrhoea, or a sudden low mood also warrant contacting a clinician the same day rather than waiting. You can read more about managing weight-loss treatment practically on the main treatment overview. Suspected side effects can be reported via the MHRA's Yellow Card scheme at the link above.

For anyone considering starting Wegovy through a regulated private route, check your eligibility with our prescribers, each consultation is reviewed by a GPhC-registered Independent Prescriber the same day.