What dosage of Wegovy works best — and how the schedule gets you there

Step 1: the starter dose settles your system, not your weight

The first four weeks of Wegovy treatment sit at 0.25 mg weekly. This dose is not the one doing the heavy lifting on weight loss. Its job is to let your body adjust to semaglutide (a GLP-1 receptor agonist that slows gastric emptying and reduces appetite) before higher concentrations arrive. Starting too high almost guarantees nausea significant enough to make people stop. So the 0.25 mg pen is, in effect, a foundation week, not a result.

After four weeks the dose steps to 0.5 mg, then 1.0 mg, then 1.7 mg, each held for roughly a month. If you want to understand how the full Wegovy dosage schedule unfolds from first injection to maintenance, it is worth reading before you begin, because the timeline shapes expectations. A common misconception is that staying at a lower dose longer somehow protects you from side effects once you step up, it generally does not; the stomach adjusts at its own pace regardless. The mechanics of the dose schedule are worth understanding before you start, because the timeline shapes expectations.

The NHS medicines page for semaglutide describes the titration process in plain language and is a good first read alongside your Patient Information Leaflet.

Step 2: the 2.4 mg maintenance dose (what the evidence shows

Once you reach 2.4 mg, you are at the dose studied in the STEP 1 trial) the largest randomised controlled trial of semaglutide for weight management. Over 68 weeks, participants lost an average of around 15% of body weight alongside a reduced-calorie diet and increased activity. That figure comes from the full population, meaning some people lost considerably more and some less. Trial results describe averages; your outcome is individual.

NICE recommended semaglutide for weight management (TA875) within specialist services and with appropriate comorbidities, and the NHS's own guidance on weight management injections describes the eligibility criteria clearly. Privately, the licensed criteria are broader: adults with a BMI of 30 or above, or 27 to 29.9 with at least one weight-related health condition. Lower thresholds apply for some ethnic backgrounds under UK guidance. None of this automatically means a prescription follows, the prescriber's assessment of the whole clinical picture decides that.

If fewer than 5% weight loss has occurred after six months at the maintenance dose, NICE's guidance is that continuing should be reviewed. That is not a failure; it is a clinical signal worth acting on, and our page on what Wegovy dose works for different patients puts that clinical picture in broader context.

Step 3: the 7.2 mg dose (who it's for and what's different

On 14 April 2026, the MHRA approved a dedicated single-dose 7.2 mg Wegovy pen) one pre-set weekly injection with a built-in covered needle that locks after use. This is the highest Wegovy dose now licensed in the UK and is authorised for adults with a BMI of 30 or above. It is not approved for people with a BMI below 30 or for the cardiovascular risk indication.

Trials of 7.2 mg semaglutide reported average weight losses of around 20.7% over 72 weeks, which narrows the gap with tirzepatide meaningfully. You can read the official announcement on the GOV.UK news page for the 7.2 mg approval. The starting point remains 0.25 mg; our guide to what strength of Wegovy works at each stage of treatment explains how the prescriber titrates the schedule over time to reach that higher target. Whether this higher target is appropriate for a given patient (or whether 2.4 mg is the sensible ceiling) depends on tolerability and clinical response at each review.

For context on how Wegovy's costs sit alongside the dose options, the Wegovy price guide covers what private treatment typically involves. And if you are weighing up one treatment against another, the broader Wegovy overview gives a fuller picture of where semaglutide sits in the UK weight-loss landscape.

What 'works best' actually means clinically

The question of which dose works best cannot be answered with a single number. The maintenance dose that produces meaningful weight loss without intolerable side effects (and that you can sustain) is the one that works best for you. Some people reach 2.4 mg with no GI trouble at all. Others take longer through the early steps or find a dose increase uncomfortable enough that the prescriber holds the titration for an extra month.

Side effects are worth understanding going in. Nausea, loose stools, constipation, burping and fatigue are the most common; they are typically worst in the first week or two after a dose step and ease as the body adjusts. Severe, persistent stomach pain that extends to the back is not a normal titration symptom, that warrants urgent medical attention, and the MHRA has highlighted acute pancreatitis as an infrequent but serious risk with GLP-1 medicines. Any concerns between reviews are worth raising with your clinical team promptly.

Our prescribers review every repeat order before it is approved. There is no automatic renewal, no hands-off subscription, a real clinician looks at your case each time. If you have more questions about the process, the FAQs page covers the most common ones, or you can reach the support team directly. To explore whether Wegovy could be right for you, speak to our prescribers via a free consultation.