Wegovy milligram doses: the step-by-step schedule and what each one does

Step 1: why Wegovy begins at 0.25mg and not a therapeutic dose

The first four weeks of Wegovy treatment look deliberately unambitious on paper. At 0.25mg the injection is doing almost none of the appetite work it will eventually do, that is the point. Semaglutide slows the movement of food through the stomach and acts on appetite centres in the brain, and both of those effects can cause nausea, especially when the medicine is new to your system. Starting low lets most people get through the initial adjustment without significant disruption.

A question our prescribers hear most weeks is whether it is worth staying on 0.25mg or skipping ahead. The honest answer is that the escalation schedule exists because people who rush it tend to experience more side effects and sometimes stop treatment altogether. If you want to understand how the full schedule is structured, our guide to Wegovy doses walks through each step and what to expect at every level.

This is also why the full picture of Wegovy treatment looks different from the headlines: the dramatic results come from sustained time at maintenance doses, not from the first pen.

Step 2: the middle doses (0.5mg, 1.0mg and 1.7mg

Once the 0.25mg phase is complete, the dose moves to 0.5mg for roughly four weeks, then 1.0mg, then 1.7mg) each step held for about a month before the next increase is considered. Your prescriber makes that call based on how you are tolerating things, not on a rigid timer.

Appetite suppression builds meaningfully through these middle doses. Most people begin to notice reduced hunger and earlier fullness somewhere between 0.5mg and 1.0mg, though the experience varies considerably. Gastrointestinal side effects (nausea, loose stools, reflux) tend to be most noticeable in the 24 to 48 hours after an increase and usually settle within a week or two.

There is no shame in spending longer at a particular step. Staying at 1.0mg for eight weeks rather than four is a legitimate clinical choice if 1.7mg brings significant discomfort. The goal is the dose you can maintain, not the dose you reached fastest. For a closer look at how the pen itself delivers each dose, the Wegovy pen doses guide covers the mechanics.

Step 3: reaching maintenance, 2.4mg and the newer 7.2mg option

The standard Wegovy maintenance dose is 2.4mg weekly. In the STEP 1 trial, published in the New England Journal of Medicine, participants who reached and sustained 2.4mg over 68 weeks saw an average body-weight reduction of around 15% alongside lifestyle changes. That figure comes from a clinical trial population; individual results vary, and weight loss is not guaranteed.

The 7.2mg option is newer and worth understanding properly. The MHRA approved it on 14 April 2026, initially as three 2.4mg pens combined weekly, and then as a dedicated single-dose pen on the same date, confirmed in the gov.uk announcement. Trial data at this dose showed average weight loss of around 20.7% over 72 weeks, which closes much of the gap with tirzepatide at its highest doses. Critically, 7.2mg is licensed only for adults with a BMI of 30 or above, not for the BMI 27–29.9 range that qualifies for lower doses under the standard licence.

Starting dose remains 0.25mg regardless of whether 7.2mg is the eventual target; the escalation steps are the same. A useful practical detail is that, as our page on Wegovy delivering four doses from a single pen explains, each pen covers a full month of treatment at your current dose level. If you are thinking about what treatment might cost at different dose levels, the Wegovy pricing page gives honest context on how private costs work in the UK.

What the milligram figures mean for real-world use

Something that catches people off guard: the dose on the pen label is not the total volume you inject, it is the amount of semaglutide in a set volume of solution. Understanding Wegovy doses in millilitres clarifies how the pen delivers each strength, which matters if you are ever comparing pens or checking your own pen markings.

Each Wegovy pen is pre-filled and pre-set to its labelled dose; you cannot dial up or down. The NICE appraisal of semaglutide (TA875) recommends that if less than 5% weight loss is achieved after six months at the maintenance dose, continuation should be reviewed, a decision made with your prescriber, not unilaterally. You can explore broader eligibility questions through the weight-loss treatment overview.

If you are ready to find out whether Wegovy suits your situation, check your eligibility with a free consultation, a GPhC-registered prescriber reads your answers the same day.