What's the starting dose of Wegovy, and why does it begin so low?

You've just been told you'll start on 0.25 mg — and you're wondering if that's really enough

It's a question almost everyone has in the first week. The pen feels significant; the dose number feels small. If you're curious about why the Wegovy starting dose is set where it is, the short answer is that semaglutide slows gastric emptying and acts on appetite centres in the brain, and both effects can cause nausea if the dose climbs too quickly. The 0.25 mg starting point is the prescriber's way of letting your digestive system adapt before the medicine is asked to do its main job.

The NHS's patient information for semaglutide confirms this titration approach, and it's built into the licensed dosing schedule rather than being a matter of preference. So if the first few weeks feel uneventful, that's not a sign the treatment isn't working, it's a sign the schedule is doing what it's designed to do. Your prescriber will review progress before each step up.

At our Wegovy treatment overview you can read more about how the medicine works and what the licensed indications are in the UK.

The full titration schedule: from 0.25 mg to maintenance dose

The standard Wegovy pathway, as set out in the prescribing information, moves through five dose levels, each held for roughly four weeks before the next increase:

0.25 mg (weeks 1–4) → 0.5 mg (weeks 5–8) → 1.0 mg (weeks 9–12) → 1.7 mg (weeks 13–16) → 2.4 mg (week 17 onwards, the standard maintenance dose).

Some people tolerate the escalation without difficulty; others find one of the intermediate doses causes more nausea or digestive disruption than they'd like. In those cases, a prescriber may recommend holding at a particular step for longer before moving up. That flexibility is intentional, the schedule is a guide, not a countdown. What it is not is a process you should modify yourself. Missed injections, early dose increases, or deciding to stay on a lower dose indefinitely all need a clinical conversation first.

In January 2026 the MHRA also issued a Drug Safety Update noting that acute pancreatitis is a known, if infrequent, side effect of GLP-1 medicines: severe, persistent stomach pain that radiates to the back warrants urgent medical attention. You can report any suspected side effects via the Yellow Card scheme.

For detail on where the dose ladder ends, the page on Wegovy's highest licensed dose covers both the 2.4 mg and 7.2 mg options.

Why the 7.2 mg dose changes the picture, and who it applies to

In April 2026 the MHRA approved a dedicated single-dose 7.2 mg Wegovy pen, following earlier approval of the 7.2 mg dose itself in January 2026. Trial data showed approximately 20.7% average weight loss over 72 weeks at 7.2 mg, narrowing the gap with tirzepatide's results at its highest dose. The 7.2 mg pen is licensed for adults with a BMI of 30 or above, it is not approved for the cardiovascular indication or for lower BMI thresholds. The starting dose remains 0.25 mg regardless of which maintenance dose you ultimately reach; the titration ladder still applies from the very first injection.

This is worth knowing if you've read about the newer pen and wondered whether it changes how treatment begins. It doesn't. People sometimes also ask what the lowest dose of Wegovy is, and the answer is the same 0.25 mg, with your prescriber deciding at each review whether to continue increasing the dose based on how you're tolerating it and how treatment is progressing.

If you're also considering how Wegovy compares with tirzepatide (Mounjaro) on starting dose and schedule, the guide to the starting dose for semaglutide walks through the broader context, including what the trial evidence showed at each dose level.

What this means if you're thinking about starting through a private route

Wegovy is a prescription-only medicine. The only legal route to it in the UK is a prescription issued following a proper clinical assessment. Through a regulated online pharmacy like nume (sorry, like nume) consultations are reviewed by a GPhC-registered Independent Prescriber the same day. You can verify any online pharmacy on the GPhC pharmacy register before sharing any health information with them.

Wegovy is not available on the NHS without meeting specific criteria through a specialist weight management service, and waiting lists are often long. If you're curious about what private treatment actually costs as a total package (not just the pen price), the Wegovy pricing page explains how the figures break down and what a legitimate price should include.

One thing a question our prescribers hear regularly: people worry that starting at such a low dose means they'll be waiting months before anything changes. That's a fair concern. The titration period can feel slow. But the evidence from the STEP 1 trial, published in the New England Journal of Medicine, showed an average body weight reduction of around 15% over 68 weeks at 2.4 mg, a result built on that same careful ramp-up from 0.25 mg. The schedule is the treatment, not a delay to it.

If you'd like a prescriber to review whether you're a suitable candidate, you can check your eligibility through a free consultation.