Wegovy doses for weight loss: what the titration schedule actually looks like

Step 1: why the schedule starts low

A lot of people arrive expecting to start at 2.4 mg. They don't. The first pen is 0.25 mg, a dose low enough that your digestive system rarely notices it, which is exactly the point. Semaglutide slows how quickly your stomach empties and acts on appetite centres in the brain via GLP-1 receptors, so even at 0.25 mg there is biological activity. Beginning here just means the side-effect burden stays low while your body acclimates.

You stay at 0.25 mg for four weeks, then move to 0.5 mg, then 1.0 mg, then 1.7 mg, each step separated by at least a month. That brings you to the 2.4 mg maintenance dose after around four to five months, assuming no pauses. If you want to understand what the doses for semaglutide mean in practice, the full breakdown covers each step in the titration pathway.

Some people experience nausea or loose stools around dose increases. This is common and usually settles within a week or two. If it doesn't, your prescriber may recommend holding the current dose longer before moving up, something to discuss with them rather than decide alone.

Step 2: what happens at 2.4 mg, and whether 7.2 mg changes the picture

Until early 2026, 2.4 mg was the ceiling. The MHRA changed that on 14 April 2026 when it approved a dedicated single-dose 7.2 mg Wegovy pen for adults with a BMI of 30 or above, the first new maintenance dose since the original approval. Trials at 7.2 mg reported around 20.7% average weight loss over 72 weeks, which narrows the gap with tirzepatide's results at its highest dose. You can read more about the full highest Wegovy dose and what the evidence says about it.

The 7.2 mg dose isn't a shortcut to faster results from week one, the titration still starts at 0.25 mg and works through the same intermediate steps. The difference is where you can end up, subject to clinical review. Not everyone will be a candidate; your prescriber assesses whether moving beyond 2.4 mg is appropriate based on your response and tolerability.

It is worth being precise about what 7.2 mg is approved for: weight management in adults with obesity (BMI ≥30). The cardiovascular risk-reduction indication, approved separately for semaglutide, uses a different dosing context. None of this changes how you start.

Step 3: pausing, holding and what the prescriber monitors

Real-world titration is rarely a neat staircase. Many people hold a dose for longer than four weeks, sometimes because side effects need more time to settle, sometimes because a pen delivery coincides with a busy week, sometimes on prescriber advice after reviewing progress. Holding a dose is not failure; it is often the sensible move.

What a prescriber is watching across the schedule: weight response, tolerability, any new symptoms, and whether the dose increase is clinically justified. At the six-month mark, if weight loss at the highest tolerated dose is under 5%, NICE's guidance on semaglutide (published as TA875) recommends reviewing whether continuing is appropriate. That threshold applies on the NHS; privately, the clinical conversation is similar.

If you're mid-schedule and have questions, the place to raise them is with your prescriber or aftercare team, not a forum. Our clinical team is available seven days a week, precisely because dose decisions shouldn't wait until Monday morning.

Eligibility, the oral option and where cost fits in

Wegovy injection is licensed in the UK for adults with a BMI of 30 or above, or 27 to 29.9 with at least one weight-related condition such as high blood pressure or type 2 diabetes. Those thresholds drop by 2.5 kg/m² for certain ethnic backgrounds under UK guidance. BMI is the starting point; the prescriber weighs the full picture before confirming suitability.

If injections feel like a barrier, it is worth knowing that as of June 2026 there is now a licensed oral semaglutide tablet (Wegovy tablets) approved by the MHRA, the first oral GLP-1 for weight management in the UK. It has its own dose schedule (1.5 mg, 4 mg, 9 mg, 25 mg) and no refrigeration requirement. Our Wegovy treatment overview covers both formulations alongside the full clinical context.

Cost comes up quickly when people research this treatment. A transparent breakdown of what's included in private treatment (and how to think about pricing rather than just headline figures) is on our Wegovy cost page. One thing worth knowing before you get there: legitimate private treatment at any dose includes a prescription following clinical assessment. A price that seems to skip that step is a red flag, not a bargain.

Understanding how Wegovy's doses are structured is straightforward once you see the logic of the schedule, and our page on choosing the right Wegovy dose for weight loss explains how that translates into real outcomes. If you have questions about whether treatment is right for you, or where you might sit in that titration, speak to our prescribers, consultations are free, reviewed the same day, and there's no obligation to proceed.