What to do if you're not losing weight on Wegovy

The first question: are you far enough into treatment to judge?

Timing matters more than most people realise when they're worried about progress. The titration schedule for Wegovy means you begin at 0.25mg and move through 0.5mg, 1.0mg, and 1.7mg before reaching the 2.4mg maintenance dose. Each step takes roughly four weeks. So if you're asking this question in month one or two, you may simply not yet be at the dose where the medicine does its main job.

The STEP 1 trial, published in the New England Journal of Medicine, ran for 68 weeks: average weight loss at 2.4mg across that period was around 15%. That's an average across that full timeframe, not a six-week result. There's a detailed breakdown of how the timing of weight loss tends to unfold on our page about when weight loss typically starts on Wegovy.

The practical question to ask yourself: have you been at your full maintenance dose for at least eight to twelve weeks? If not, the honest answer is that it's still early. If you ordered in January and your payday-routine means you've occasionally been a few days late on a repeat, those gaps compound too. Consistency at the maintenance dose matters for a fair assessment, and if you want a clear summary of whether Wegovy actually produces weight loss and under what conditions, our dedicated page covers the evidence in full.

What 'non-response' actually means, and how rare it is

Some people do respond less well to semaglutide, and that's not a moral failing or a sign of poor effort. The NHS semaglutide medicines page notes that weight-loss medicines work alongside a reduced-calorie diet and increased activity, which points to something real: the medicine reduces appetite, but it can't override a large persistent caloric surplus, and it can't substitute for the basics of energy balance.

Beyond behaviour, individual biology plays a substantial role. Gut hormone receptor sensitivity varies between people. Underlying conditions such as hypothyroidism, polycystic ovary syndrome, or insulin resistance can blunt response. Some medicines (including certain antidepressants and corticosteroids) are associated with weight gain that competes directly with any loss semaglutide might produce. None of this is visible without a clinical review.

A genuine non-responder (someone who has been fully adherent at 2.4mg for several months and seen less than 5% weight reduction) is in a meaningfully different position from someone still titrating. NICE's guidance on semaglutide (TA875) recommends reviewing continuation if less than 5% weight loss has occurred after six months at the maintenance dose. That's a practical clinical threshold worth knowing about, and it's one our prescribers apply when reviewing how semaglutide works across different people.

The decision in front of you: adjust, switch, or review the whole picture

If you're genuinely not responding, three broad paths are worth considering with a prescriber. First, reviewing lifestyle factors honestly: not as a rebuke, but because the medicine is designed to work with dietary change, not instead of it. A prescriber or dietitian can help identify whether protein intake, meal timing, or alcohol consumption is quietly undermining progress.

Second, switching medicines. Tirzepatide (Mounjaro) activates both GIP and GLP-1 receptors, while semaglutide targets GLP-1 alone. The SURMOUNT-5 head-to-head trial (published 2025 in the New England Journal of Medicine) found greater average weight loss with tirzepatide over 72 weeks. That doesn't mean it will work better for every individual, but for someone who hasn't responded to semaglutide, the dual mechanism offers a biologically distinct option. You can read more about how these two medicines compare on our Wegovy overview and the weight-loss treatments section.

Third, pausing to assess whether weight management medicine is the right tool right now at all. Weight is shaped by sleep, stress, mental health, and metabolic factors that a single medicine can't fully address. A prescriber who reviews your full picture, not just your injection schedule, is in the best position to advise honestly.

For a broader view of how to approach weight loss on semaglutide when things aren't going to plan, our page on making the most of Wegovy goes into practical detail.

What a clinical review at nume actually involves

At nume, every repeat order is clinically re-reviewed before dispatch. That's not a formality. If weight loss hasn't progressed as expected, that's exactly the kind of pattern a prescriber should know about. Our clinical team (you can read about the people involved at our clinical team page) review your information on the day you submit it, and the aftercare line is open seven days a week if something changes between orders.

There's a real difference between a service that auto-renews your prescription and one where a named clinician looks at your case before the pen ships. If you have questions about whether Wegovy is still the right option for you, or whether a different approach might produce better results, a consultation is the right place to start. You can also review pricing and what's included at our Wegovy cost page before deciding. When you're ready, start your free consultation and a GPhC-registered prescriber will review your details the same day.