Wegovy sizes: what the dose ladder looks like and what's changed

Where the evidence starts: what NICE and the trial data say about Wegovy's dose range

The NICE appraisal of semaglutide for weight management (NICE TA875) reviewed Wegovy at its standard 2.4mg weekly maintenance dose. The key trial underpinning that appraisal, STEP 1, ran for 68 weeks and reported an average body-weight reduction of around 15% at that dose in adults with obesity, alongside lifestyle changes. Those figures shaped the UK licence and the clinical thresholds that prescribers still use today. Importantly, NICE noted that treatment should be reconsidered if someone achieves less than 5% weight loss after six months at their maintenance dose, a clinical checkpoint, not a punishment.

The titration pathway in that evidence base starts at 0.25mg, a size whose job is tolerability rather than weight loss. From there the schedule moves through 0.5mg, 1.0mg and 1.7mg before reaching 2.4mg, with roughly four weeks at each level. The pacing matters: most of the gastrointestinal side effects people experience (nausea, loose stools, a sense of fullness that arrives faster than expected) tend to be heaviest after a dose increase and ease within a couple of weeks as the body adjusts. Moving up too quickly is not clinically supported, which is why dose size decisions sit with the prescriber, not the patient.

For a broader look at how semaglutide works as a medicine, the semaglutide overview covers the mechanism alongside the clinical evidence in more detail.

The 7.2mg approval: what it is and what changed in 2026

In January 2026 the MHRA gave approval for a 7.2mg weekly maintenance dose of semaglutide (Wegovy), initially delivered as three separate 2.4mg pens per week. Then on 14 April 2026 the regulator approved a dedicated single-dose 7.2mg pen, one pre-set injection per week, with an auto-dosing mechanism and a covered needle that locks after use. The MHRA's announcement confirmed that this pen is approved for adults with a BMI of 30 or above only; it is not indicated for BMI below 30 or for cardiovascular risk reduction.

The starting dose remains 0.25mg. Patients working up through the standard schedule reach 2.4mg as before; 7.2mg is the new ceiling for those who progress further under prescriber guidance. Trial data at this higher dose reported average weight loss of around 20.7% over 72 weeks, closing the gap with tirzepatide's results at its highest strength. That said, 7.2mg is not automatically the right destination for everyone on Wegovy; clinical suitability, tolerability and individual progress all factor into whether a prescriber considers it appropriate.

Questions about the specific pen format (dimensions, needle gauge, how the auto-mechanism works) are well answered by the Wegovy pack size page, which covers what physically arrives with each size.

What the licensed eligibility criteria mean for dose size in practice

Wegovy's UK licence covers adults with 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, type 2 diabetes, high cholesterol or obstructive sleep apnoea. The 7.2mg pen carries a narrower criterion: BMI 30 or above only. Ethnicity-based adjustments apply throughout, with thresholds typically 2.5 kg/m² lower for South Asian, Chinese, Middle Eastern, Black African or African-Caribbean backgrounds under UK guidance.

None of this means a person who meets the BMI threshold will be prescribed the largest available size. The prescriber begins everyone at 0.25mg regardless of starting weight, then reviews progress and tolerability before each step up. Jumping to a higher dose because it seems more effective is not how this medicine works, and clinically, it isn't safer or faster. The guide to Wegovy pen sizes explains the physical specifications of each strength if that detail is useful. For context on how Wegovy's cost varies across the dose schedule, the weight-loss treatment overview at nume covers what private treatment involves at each stage.

Under-18s are not covered by the licence. Wegovy is not recommended during pregnancy, breastfeeding or while actively trying to conceive; a prescriber will discuss timing of any contraception or family-planning considerations as part of the consultation. The FAQs page picks up a number of questions on eligibility that come up most often at consultation.

What arrives when you're prescribed Wegovy, and how size affects the practicalities

Each Wegovy pen contains four weekly doses of its labelled strength, so one pen per month of treatment at that level, or a single use in the case of the 7.2mg format. When you order through a regulated UK pharmacy such as nume, the pen is dispatched in temperature-controlled, plain unbranded packaging via DPD; you can follow it on your phone with the tracking link that arrives the same morning. At home it goes straight into the fridge at 2°C to 8°C. The exact room-temperature window (for when the pen is out of the fridge) is stated in the Patient Information Leaflet and should be followed to the letter; that detail varies by format and should not be sourced from a webpage.

Injection sites are the abdomen, thigh or upper arm, rotated each week. The needle itself is pre-attached and covered; there is no assembly. The semaglutide syringe size page goes into the needle dimensions for those who find them relevant to planning their injection technique. Storage, disposal and travel considerations are worth raising during your consultation, a question our prescribers hear regularly, particularly from people who commute or travel frequently for work.

If you'd like to understand how Wegovy compares to other options or explore whether it suits your situation, speaking to a prescriber is the clearest route. You can start that conversation (free, with same-day clinical review by a GPhC-registered prescriber) through the weight-loss treatments page.