Following a Wegovy plan: what the process really looks like

Step 1: The clinical assessment that comes before the first pen

Before a single dose of semaglutide is prescribed, a clinician needs to know enough about you to judge whether Wegovy is appropriate. That means reviewing your BMI, any existing health conditions, your current medicines, and whether there are reasons the treatment should not be used. The licensed eligibility threshold is a BMI of 30 or above, or a BMI of 27 to 29.9 alongside at least one weight-related condition such as high blood pressure, high cholesterol, prediabetes, or obstructive sleep apnoea. Lower thresholds may apply for some ethnic backgrounds under UK guidance.

This is not a box-ticking exercise. Certain conditions, including a personal or family history of medullary thyroid carcinoma or a diagnosis of pancreatitis, require careful discussion before proceeding. Pregnancy, breastfeeding, and trying to conceive are situations where Wegovy is not recommended. The NHS semaglutide medicines page lists the full contraindication picture clearly. At nume, a GPhC-registered Independent Prescriber reads every consultation personally (the same day it arrives) before anything is dispensed. You can read more about how we work if you want to understand the clinical structure behind that process.

Identity is verified with photo ID, and weight is confirmed on video. Those are not bureaucratic hurdles; they are the checks that keep the supply chain trustworthy and keep you safe.

Step 2: Starting low and titrating steadily

The Wegovy schedule begins at 0.25mg once weekly. This first dose exists for one reason: to let your body adjust before the therapeutic doses arrive. Most people experience more nausea at the start than they will during stable treatment, and the gradual ramp is designed to reduce that. From 0.25mg the schedule moves through 0.5mg, then 1.0mg, then 1.7mg, with roughly four weeks at each level before moving to the next, subject to tolerability. The standard maintenance dose is 2.4mg.

The MHRA approved a higher 7.2mg maintenance dose in early 2026, including a dedicated single-dose pen confirmed on 14 April 2026, for adults with a BMI of 30 or above. Whether that option is appropriate for you is a clinical decision made at the time, availability and suitability are both confirmed during your consultation rather than assumed in advance.

The full Wegovy overview covers the mechanism in more detail, but in practical terms: semaglutide is a GLP-1 receptor agonist that signals fullness and slows how quickly the stomach empties. Appetite genuinely decreases for most people. Food noise (the background preoccupation with eating that many patients describe) often quietens too, which is something a lot of people tell us they hadn't expected but found meaningful.

Step 3: What you eat and how you move on treatment

Wegovy is licensed for use alongside a reduced-calorie diet and increased physical activity, those words appear in the licence for a reason. The medicine suppresses appetite, but it works best when the meals you do eat are nourishing rather than minimal. Protein intake matters: with less total food volume, getting enough to preserve muscle becomes more deliberate. Hydration matters too, particularly in the early weeks when GI side effects can increase fluid loss.

A Wegovy-compatible eating approach does not need to be complicated. NHS guidance on healthy eating alongside weight-management medicines is a reasonable starting point, and a dietitian referral is worth considering if you have complex dietary needs. Similarly, movement does not mean daily gym sessions. Building in activity you can sustain (walking, swimming, resistance work) tends to produce better long-term results than an intensive burst that stops when treatment stops. The exercise guidance for people on Wegovy covers this with more practical detail.

For anyone wondering about travelling with treatment, the guidance on flying with Wegovy explains storage and airline rules clearly. It is a question worth planning for before the trip rather than at the airport.

Step 4: Monitoring progress and managing side effects

The most common side effects across the Wegovy programme are gastrointestinal: nausea, loose stools, constipation, reflux, and burping appear most often in the STEP trials and in clinical practice. They tend to be worst after a dose increase and usually settle within a week or two for most people. Eating smaller meals, avoiding very fatty or spicy food, and staying hydrated all help. The NICE appraisal of semaglutide (TA875) provides the clinical backdrop to how efficacy and side-effect data were weighed when the medicine was recommended.

Severe, persistent stomach pain that radiates to the back is different in character from ordinary nausea and should prompt urgent medical attention, pancreatitis, while infrequent, is a known risk with GLP-1 medicines and one the MHRA has highlighted in formal safety communications. Any suspected side effect can be reported through the MHRA's Yellow Card scheme, which you can use directly. Your prescriber reviews your case before every repeat order; that is the checkpoint where dose changes, concerns, and progress are discussed.

If you have reached 2.4mg and six months have passed without at least 5% weight reduction, your prescriber will review whether continuing is appropriate. That review is built into the clinical pathway, not an afterthought. For a broader look at what the private treatment route involves, you can explore our Wegovy weight loss plan, which sets out how diet, activity, and medication work together across the programme. When you are ready to compare options and costs, our Wegovy plans page explains what is included at each level so you can choose with confidence. When you are ready to explore whether you are a suitable candidate, you can speak to our prescribers through a free consultation.