What Wegovy patients should know before they begin

Step 1: the assessment that has to come first

Before a single dose is prescribed, a clinician reviews your medical history, current medicines, BMI, and any conditions that affect whether semaglutide is suitable for you. This is not a box-ticking formality. Wegovy is not recommended during pregnancy, breastfeeding, or if you are actively trying to conceive, and it is not licensed for anyone under 18. Certain conditions (a personal or family history of medullary thyroid carcinoma, or a condition called MEN2) rule it out entirely, as does a history of pancreatitis in most cases. Your prescriber will also look at your other medicines. If you take an oral contraceptive pill, they may advise adding a barrier method for the first few weeks, since GLP-1 medicines can reduce how much of a tablet your body absorbs.

At nume — at our pharmacy, every consultation is read by a GPhC-registered Independent Prescriber on the day it arrives, not processed by software. Identity and weight are verified before anything is dispensed. That standard exists because Wegovy is a prescription-only medicine, and the clinical review is the part that keeps the treatment safe. If the assessment raises a question, the prescriber will follow it up rather than simply approving the request.

Once your prescriber is satisfied, the titration schedule begins. The first pen delivers the 0.25 mg starting dose, a dose chosen to let your body adjust, not one expected to produce much weight loss by itself. If you want to understand more about how the medicine works at a biological level, our page on the main ingredient in Wegovy explains what is actually driving the appetite and glucose effects. The patient information resource on our site covers what the assessment looks at in more depth.

Step 2: working through the titration, weeks 1 to 16

Most patients move through four dose steps before reaching the 2.4 mg maintenance level: 0.25 mg, then 0.5 mg, then 1.0 mg, then 1.7 mg, each held for roughly four weeks before the next increase. The pace matters. Increasing too quickly is associated with worse nausea and vomiting, so the schedule exists for a reason. Your prescriber decides the pace; the plan in the leaflet is a guide they may adjust based on how you are tolerating each level.

Side effects are most common at the start and after each step up. Nausea is the one patients mention most. Vomiting, loose stools, constipation, indigestion, and fatigue are also reported. For most people these ease within a week or two as the body settles. Eating smaller portions, avoiding very fatty or rich food, and staying well hydrated all tend to help. Severe or persistent symptoms are a reason to contact your prescriber, not to push through alone.

One practical habit worth building now: once a week, before you inject, check the pen visually, the liquid should be clear and colourless with no particles. It takes under a minute and catches a storage problem before it becomes a missed dose. You can download and keep a copy of the Wegovy patient instructions PDF, which covers exactly what to look for and is straightforward to print out or save to your phone. Detailed guidance on what to look for is in the patient information leaflet, which your prescriber or pharmacist can walk you through.

The STEP 1 clinical trial (68 weeks, published in the New England Journal of Medicine) found that participants on semaglutide 2.4 mg lost around 15% of body weight on average. That figure is a trial average; individual results vary depending on adherence, diet, activity and other factors.

Step 3: maintenance, monitoring, and the longer picture

Reaching 2.4 mg is not the end of the clinical relationship, it is where the real work of monitoring begins. At maintenance dose your prescriber should be reviewing whether you are tolerating the medicine, whether weight loss is progressing, and whether any new symptoms have appeared. Under NICE's recommendation for semaglutide (TA875), if you have not lost at least 5% of your starting weight after six months on the maintenance dose, continuing is unlikely to be the right call. That is a clinical judgement your prescriber makes with you.

The MHRA approved a higher 7.2 mg maintenance dose in January 2026, and a dedicated single-dose 7.2 mg pen in April 2026, for adults with a BMI of 30 or above. Trials at this dose reported around 20.7% average weight loss over 72 weeks. Whether it is appropriate for you is a decision for your prescriber; never self-escalate beyond the dose you have been prescribed.

If you are on the NHS route, access to Wegovy sits within specialist weight management services and comes with multidisciplinary support, dietetic input, behavioural support, and structured follow-up. Waiting lists are long in most areas. Private treatment through a regulated online pharmacy is the alternative for people who meet the licensed criteria but prefer not to wait or do not qualify for the NHS pathway. You can read more about what that route involves on our weight loss treatment overview.

Two things to know about reporting: if you experience a side effect you think is worth flagging, you can do so directly at the MHRA's Yellow Card scheme, patients as well as clinicians can submit reports. And if you have questions between prescription reviews, our aftercare team is available seven days a week; the contact page has all the details.

Step 4: what happens if you need to pause or stop

Life intervenes. Illness, surgery, travel, or a period of severe side effects can all mean a break from treatment. If you stop Wegovy, appetite typically returns gradually as the medicine clears your system, and if you want a fuller picture of how semaglutide behaves in the body over time, including its half-life and clearance, our dedicated page goes into the detail. Regain is common if lifestyle changes are not maintained, which is why Wegovy is designed to be taken alongside behavioural support rather than as a standalone fix.

Before any surgical procedure, tell the anaesthetist and surgical team that you are taking a GLP-1 medicine. NHS England's guidance specifically recommends this because of the effect these medicines have on gastric emptying, it affects the risk associated with anaesthesia. That conversation is the patient's responsibility to initiate, and it matters.

If you are considering Wegovy and want to understand whether you are likely to be suitable, reading through Wegovy patient reviews from people who have been through the same process can give you a realistic sense of what to expect before you begin. Starting a free consultation is the right first step. A prescriber will review your answers the same day and let you know whether treatment is appropriate for you.