Wegovy maintenance dose schedule: how titration works in practice

Step 1: the starting weeks (0.25 mg)

The first four weeks of Wegovy aren't intended to produce significant weight loss. The 0.25 mg dose is a settling-in period, its job is to let your digestive system adapt to semaglutide before you move to a dose that works therapeutically. Nausea, loose stools and reduced appetite are common here; they tend to be most noticeable in the first few days after each injection and usually ease before the next one is due.

One misconception worth clearing up: many people assume that because they feel strong effects at 0.25 mg, they're already on an effective dose and should stay here. In practice, the clinical evidence (including the STEP 1 trial published in the New England Journal of Medicine) was built on maintenance at 2.4 mg. The starter dose is, by design, not therapeutic. Moving through the schedule matters.

Injection sites at any dose (abdomen, thigh, or upper arm) should be rotated each week. Keeping a note of where you injected last is a small habit that makes a real difference over months of weekly injections. For further detail on the full titration sequence, the Wegovy dose schedule page sets out each step clearly.

Step 2: building through 0.5 mg and 1.0 mg

After week four, a prescriber-led review determines whether you move to 0.5 mg. Assuming tolerability is good, you'll step up, then repeat the four-week hold before moving to 1.0 mg. These middle rungs of the schedule are where many people notice the clearest shift in appetite, eating less feels natural rather than effortful, and fullness arrives sooner.

Side effects can recur briefly with each increase, particularly nausea and, for some, constipation or reflux. They're almost always transient. The NHS semaglutide medicines page lists the full side-effect profile with practical guidance on managing them. If GI symptoms are severe or persistent, that's a conversation to have with your prescriber before moving to the next dose, not a reason to push through without clinical input.

At 1.0 mg some people are already seeing meaningful weight change. Others notice less. If you're curious about what this intermediate point means clinically, our page on the Wegovy maintenance dose at 1 mg explains where it sits in the broader titration picture and what to expect from it.

Step 3: reaching and holding 1.7 mg, then 2.4 mg maintenance

The 1.7 mg step is a bridge rather than a destination, though your prescriber may keep you here longer if tolerability warrants it. Four weeks later, 2.4 mg (the standard Wegovy maintenance dose) becomes the target. At this level, the STEP 1 trial reported an average body-weight reduction of around 15% over 68 weeks alongside lifestyle changes, in adults without type 2 diabetes.

Reaching 2.4 mg typically takes around 16 weeks from the first injection, assuming smooth progression. If you've spent extra time at any earlier step, it'll be longer. That's fine, the schedule exists to protect tolerability, not to hit a deadline. What life looks like at the Wegovy maintenance dose covers what to expect once you're there.

For people who tolerate 2.4 mg well but want to know whether a higher dose is now an option: the MHRA approved a 7.2 mg pen in April 2026 for adults with a BMI of 30 or above. The route there still begins at 0.25 mg, there is no shortcut through titration regardless of which maintenance dose you're aiming for. Specific availability of the 7.2 mg pen is confirmed at consultation.

Thinking about private access and ongoing clinical review

Because the Wegovy maintenance dose schedule spans months and involves multiple prescribing decisions, continuity of clinical oversight matters. At nume, every repeat order is reviewed by a GPhC-registered prescriber before it's dispatched, the same-day review applies to dose-change requests as it does to new starts. There are no auto-renewals; each review is a real clinical look at where you are, including what comes next for those thinking about maintaining their results after Wegovy.

If you're weighing up what private treatment costs relative to what's included, our Wegovy price comparison page explains the UK market context honestly, including what headline prices sometimes leave out. A treatment schedule that runs for a year or more is one where aftercare, not just the first prescription, shapes the experience. Check your eligibility with our clinical team if you'd like to understand whether Wegovy's titration schedule suits your situation.