How a Wegovy dose increase works — and what happens next

Step 1: Starting low, on purpose

The first Wegovy dose is 0.25 mg once weekly. This is a tolerability step, not a therapeutic one, its job is to let your system settle into semaglutide rather than hit it hard from week one. Most people notice little obvious effect on appetite at this level, which is by design. The goal is to reduce the chance of nausea and other gastrointestinal symptoms before the dose climbs to where it becomes clinically meaningful.

After four weeks on 0.25 mg, the next step is 0.5 mg, then 1.0 mg, 1.7 mg, and finally the standard maintenance dose of 2.4 mg. The Wegovy dose increase chart lays this ladder out clearly if you want a visual reference. Four weeks at each step is the standard interval, though your prescriber may advise staying longer at a given dose if side effects are significant, a detail covered in detail on our page about when to move up a Wegovy dose.

The NHS medicines page for semaglutide explains the titration rationale in plain terms and is worth bookmarking alongside your Patient Information Leaflet.

Step 2: What actually changes when you go up a dose

Each increase in semaglutide dose tends to strengthen the appetite-suppressing signal. GLP-1 receptor agonists like semaglutide slow gastric emptying and reduce hunger cues from the brain; a higher dose sustains that effect more strongly through the week. Many people find that the appetite reduction they noticed at 1.0 mg becomes noticeably more consistent at 1.7 mg, and again at 2.4 mg.

The flip side is that side effects (nausea, loose stools, indigestion, burping, fatigue) tend to peak in the first few days after stepping up, then ease. This is the normal pattern; it is not a sign that something has gone wrong, and it usually settles within a fortnight. Eating smaller portions, staying well hydrated, and avoiding rich or very fatty meals in the days around a dose change all help. If symptoms are prolonged or severe, contact your prescriber rather than waiting it out alone. Our frequently asked questions cover side-effect management in more detail.

One practical note: if your dose-increase week falls around a bank holiday or you are away travelling, plan ahead. A missed or delayed injection can disrupt your schedule, and your prescriber should know before you adjust timing, the Patient Information Leaflet and your clinical team are the right guides here.

Step 3: Reaching maintenance, including the 7.2 mg option

For most people on Wegovy, 2.4 mg weekly is the maintenance dose. The STEP 1 trial, published in the New England Journal of Medicine, found that participants at this dose achieved an average body-weight reduction of around 15% over 68 weeks alongside lifestyle changes, a meaningful result that is cited in NICE's appraisal of semaglutide.

There is now a higher option. The MHRA approved a 7.2 mg maintenance dose in January 2026, and a dedicated single-dose 7.2 mg pen was given the green light on 14 April 2026, making it easier to administer than the earlier three-pen approach. Trial data suggest roughly 20.7% average weight loss over 72 weeks at 7.2 mg, narrowing the gap with tirzepatide results. Whether this higher dose is appropriate is a clinical decision: it is licensed only for adults with a BMI of 30 or above, and the starting and escalation schedule remains the same. You can read more about the full range of Wegovy doses and what the evidence says for each.

If you are curious how Wegovy's results compare with tirzepatide (Mounjaro) at their respective maintenance doses, the broader picture is covered on our Wegovy overview page. Our page on whether increasing your Wegovy dose increases weight loss goes into the evidence specifically.

When a dose increase may be paused or reconsidered

Not every four-week point is automatically the right moment to move up. NICE's guidance on semaglutide notes that if someone has not lost at least 5% of their body weight after six months at the maintenance dose, continuing treatment should be reviewed. That same principle applies earlier in the schedule: if tolerability is poor, staying at a lower dose for longer is clinically reasonable and sometimes preferable to pushing through.

A prescriber may also recommend pausing escalation if a patient has had a significant illness, recent surgery, or a period of very poor oral intake, all situations where the gastrointestinal effects of a dose increase would compound things unnecessarily. Telling your clinical team about any such circumstances before a repeat prescription is issued is exactly the kind of information a clinical review exists to capture. At nume, every repeat order goes through a qualified prescriber before it is dispensed, not a checkbox system. For context on how private prescription costs fit into this, our Wegovy pricing page explains what a legitimate service includes. If you are ready to discuss where you are in your schedule, you are welcome to speak to our prescribers.