What Are the Increments of Wegovy, and Why Do They Matter?

Step 1: Why Wegovy starts at 0.25 mg (and what that pen is actually doing)

Most people starting Wegovy expect the first pen to feel transformative. It rarely does, and that's intentional. The 0.25 mg weekly dose is there to settle your gut into the medicine, semaglutide slows gastric emptying and acts on brain receptors involved in appetite, and introducing that effect at full strength from day one would leave most people feeling queasy for weeks. At 0.25 mg, the drug is doing calibration work rather than heavy lifting.

After roughly four weeks at 0.25 mg, the prescriber typically moves you to 0.5 mg. Then 1.0 mg. Then 1.7 mg. Minimum one month at each rung before stepping up. The full Wegovy treatment overview has more detail on what each phase involves day-to-day.

A practical note: the pens are pre-set at each strength, so there's no measuring involved. You inject once a week, on the same day each week, rotating sites between your abdomen, thigh or upper arm. The NHS medicines page for semaglutide covers injection technique, storage and what to do if you miss a dose, always the right first reference.

Step 2: Reaching the 2.4 mg maintenance dose, and deciding whether to go further

For most patients on the standard schedule, 2.4 mg is reached around month five. This is where the clinical evidence sits: the STEP 1 trial, published in the New England Journal of Medicine, found an average body-weight reduction of around 15% over 68 weeks at 2.4 mg, in adults with obesity who didn't have type 2 diabetes. That's a meaningful result, and it's the dose that underpins Wegovy's NICE recommendation.

Since April 2026, a 7.2 mg maintenance dose is also licensed in the UK, approved as a dedicated single-dose pen by the MHRA. Trials at this higher level reported average weight loss of around 20.7% over 72 weeks, which narrows the gap with tirzepatide meaningfully. The MHRA's approval announcement for the 7.2 mg pen confirms it is licensed for adults with a BMI of 30 or above only, not for lower BMI thresholds or for the cardiovascular indication. The step-up from 2.4 mg to 7.2 mg still follows prescriber direction.

If you're curious how the Wegovy increments compare between the standard and higher-dose schedules, that question has its own dedicated page.

Step 3: What happens if you can't tolerate a particular increment

The titration schedule is a guide, not a deadline. Some people sail through 0.25 mg to 2.4 mg without much bother. Others find 1.0 mg kicks off a week of nausea every time they dose. The right response to that isn't to push on, it's to stay at the current increment longer, or in some cases to step back, until the side effects ease.

The gastrointestinal effects that tend to appear at each step up (nausea, loose stools, bloating, reflux) are typically most intense in the first few days after a dose change and settle within one to two weeks for most people. Understanding the downsides of Wegovy before you start helps set realistic expectations. Small meals, staying well hydrated, and avoiding high-fat or very rich food around injection day makes a noticeable difference for many people, something our prescribers mention most weeks when patients are finding a new dose tricky.

For a full picture of what the stages of Wegovy treatment look like beyond just the dose ladder, including the lifestyle changes that sit alongside it, that page covers the wider journey.

How a prescriber (not an algorithm) manages your titration

At nume, every repeat order is clinically reviewed before dispatch. That means a GPhC-registered prescriber, not software, looks at your progress and tolerance before each dose step is confirmed. This matters most at dose increases: moving from 1.7 mg to 2.4 mg, or from 2.4 mg to 7.2 mg, requires evidence that you've tolerated the current level adequately.

For anyone weighing up whether Wegovy suits their situation, our semaglutide information page sets out the eligibility criteria and what the clinical assessment involves. The licensed eligibility for Wegovy covers adults with a BMI of 30 or above, or 27 or above alongside at least one weight-related condition such as high blood pressure, type 2 diabetes or high cholesterol, though a BMI figure alone never guarantees approval, because the prescriber assesses the whole picture.

Wegovy is a prescription-only medicine, and it's worth remembering that where you obtain it matters as much as the dose schedule itself. The MHRA has warned repeatedly about counterfeit semaglutide pens sold via social media and websites that supply it without a prescription. Any legitimate supply comes from a pharmacy you can verify on the GPhC register. You can also read about weight-loss treatment options more broadly if you're still working out which approach fits best.

If you'd like to check whether you're eligible for Wegovy through nume, our free consultation puts your case in front of a prescriber the same day, no waiting list, no referral needed. Check your eligibility and start a free consultation here.