What dose of Wegovy should I start with?

Step 1: why 0.25 mg is where everyone starts

The 0.25 mg weekly dose exists for one purpose: to let your body adjust to semaglutide before the medicine begins working at therapeutic levels. At this stage the primary goal is tolerability, not weight loss. Nausea, stomach discomfort and loose stools are the most commonly reported side effects, and they tend to be most noticeable at the start of treatment or after a dose increase; keeping the initial dose low reduces that burden for most people.

This is not a question of patience or willpower, it is how the medicine's licensed schedule was designed, tested and approved. The STEP 1 trial, published in the New England Journal of Medicine, used exactly this graduated approach and recorded around 15% average body-weight reduction over 68 weeks at the 2.4 mg maintenance dose. The trial's results were built on a foundation of careful titration, not speed.

You can read more about how the first dose of Wegovy is structured if you want a closer look at what to expect in those first weeks.

Step 2: moving through the dose ladder (the four-week intervals

After four weeks at 0.25 mg, the schedule moves to 0.5 mg, then 1.0 mg, then 1.7 mg, and finally to the standard 2.4 mg maintenance dose) each step separated by at least four weeks. The NHS medicines page for semaglutide sets out this ladder clearly. The point of those intervals is straightforward: your prescriber needs enough time to see whether side effects have settled before increasing the dose further.

Not everyone moves at the same pace. If nausea or other GI symptoms remain difficult at a given step, a prescriber may choose to stay at that dose for longer (eight weeks instead of four, for instance) before stepping up. That is not a failure; it is the schedule doing its job. Trying to rush titration without clinical input is one of the more common mistakes people make when they source these medicines without proper oversight.

The question of when to increase your Wegovy dose is covered in detail separately, including what signs suggest you are ready to step up and what to do if side effects make an increase feel premature.

Step 3: what happens when you reach maintenance, including the 7.2 mg option

For most patients, 2.4 mg weekly has been the endpoint. In April 2026, the MHRA approved a higher 7.2 mg maintenance dose for adults with a BMI of 30 or above, delivered via a dedicated single-dose pen. Trials at this dose recorded around 20.7% average weight loss over 72 weeks, narrowing the gap with the results seen in tirzepatide trials. Whether 7.2 mg is appropriate for you is a clinical assessment, not something to request on the basis of headlines alone.

What actually arrives when you are dispensed Wegovy through a regulated UK pharmacy is straightforward: a discreet, unbranded parcel, tracked through DPD, containing the pre-filled pen or pens for that prescription period. The pen itself is designed for self-injection and comes with a patient information leaflet; storage requires a fridge until first use. If you are considering the cost side of treatment, a comparison of Wegovy pricing in the UK sets out what different providers include in their headline figures.

For a fuller picture of the complete dose range across all strengths, the guide to Wegovy doses covers each step and what the clinical literature says about results at different levels. And if you are weighing up how Wegovy compares with other weight-loss treatment options available in the UK, that page is a useful starting point.

What shapes the decision your prescriber makes

A prescriber reviewing your consultation is not simply matching your BMI to a dose on a chart. They are looking at the full picture: your current health conditions, any medicines you take, how you responded to a previous dose if you are transferring from another provider, and whether you have any contraindications that affect which doses are suitable. Women taking oral contraceptives should be aware that semaglutide may reduce pill absorption during titration, adding a barrier method for the weeks around a dose change is something to discuss with your prescriber.

The consultation at nume is reviewed the same day by a GPhC-registered Independent Prescriber, a named clinician, not an automated system. If you have questions about your specific situation before or during treatment, our clinical team is available seven days a week. The question of which Wegovy dosage is right for you personally ultimately depends on that conversation. You can also find answers to common queries on our FAQs page, or get in touch directly if something specific is on your mind.