What strength of Wegovy do you actually need?

What the trial evidence says about why the schedule matters

The STEP 1 trial, published in the New England Journal of Medicine (68 weeks, semaglutide 2.4 mg vs placebo), recorded an average body-weight reduction of around 15% at the standard maintenance dose. That figure is the one most people quote when they ask about Wegovy results, but it came from participants who completed the full titration schedule, not from those who jumped straight to the higher dose. The gradual increase exists primarily to reduce gastrointestinal side effects: nausea, vomiting and diarrhoea are common early on and typically settle as the body adjusts over days to a couple of weeks. Skipping steps or rushing them doesn't make the medicine work faster; it generally makes tolerability worse.

The 7.2 mg approval adds a further dimension. Trials at that dose reported average weight reduction of around 20.7% over 72 weeks, which narrows the gap considerably with the highest doses of tirzepatide. That context matters when you are weighing up which treatment to explore, and a prescriber will consider both options when you have a consultation. For more on how the two compare, the Wegovy overview page covers the evidence across the full licensed range.

What determines the dose your prescriber chooses

Your prescriber looks at several things, not just your starting weight. How you tolerate each four-weekly step is the primary driver: if nausea or digestive discomfort is significant at 1.0 mg, staying there a little longer before moving to 1.7 mg is a reasonable clinical decision and not a failure. There is no benefit to moving up before your body is ready.

Eligibility for the 7.2 mg pen also has a specific condition attached: the MHRA approved it for adults with a BMI of 30 or above only, it is not licensed for the BMI 27–29.9 group who qualify for standard Wegovy on the basis of a weight-related condition. So the ceiling you can reach depends partly on your BMI at the time of that clinical review. If you want a clear breakdown of what the Wegovy strengths are and how they differ from one another, that page sets out the full range alongside the licensing conditions that apply to each. The page on Wegovy's highest strength walks through the 7.2 mg criteria in more detail if that is the dose you are particularly interested in.

Transfer patients (those moving from another provider) need to supply evidence of their current dose before a prescriber can continue at that level. That is not bureaucracy for its own sake; it is how a responsible prescriber verifies you have tolerated each step appropriately.

The practical side of working through the schedule

Most people starting Wegovy reach 2.4 mg around week 16, assuming no pause at any step. From there, moving to 7.2 mg requires additional titrated steps through intermediate doses. Each step needs at least four weeks, and your prescriber makes that call, not a standard timeline. If you want to understand more about how your Wegovy strength is determined at each stage of the schedule, that page explains how prescribers approach those decisions in practice. If you are ordering around a busy period (before a bank holiday Monday, or with Christmas deliveries to work around) it is worth timing your next repeat order so a clinical review happens before you run out rather than after, because missing doses during titration can disrupt the schedule.

Storage is also worth thinking about at each dose: Wegovy pens require refrigeration at 2–8°C. Always check the Patient Information Leaflet for the exact window your pen can be kept at room temperature, because that figure matters for holidays and travel. The full Wegovy dose guide covers storage alongside the schedule in one place.

One question our prescribers hear regularly: "Can I stay on a lower dose indefinitely if I prefer it?" The answer is that the 2.4 mg and 7.2 mg doses are the maintenance doses the licence and the trial evidence are built around. A prescriber will discuss what continuing at a sub-maintenance dose would mean for you specifically. That is a conversation for your clinical review, not a decision the dose schedule makes for you.

Getting the right strength starts with a proper clinical assessment

Because Wegovy is a prescription-only medicine, the only legitimate route to any strength is a prescription following an assessment by a qualified prescriber. There is no shortcut that changes that. At nume, every consultation is read the same day by a GPhC-registered Independent Prescriber (a real clinician, not software) who reviews your health history, current medicines and eligibility before any prescription is issued. The process is outlined on our about us page for anyone who wants to understand how the service is structured.

If you are currently comparing treatment costs alongside this question, it is worth reading about weight-loss treatment options together; understanding what is included in a private prescription price is as important as the dose schedule itself. For clinical context on the wider semaglutide options available for weight management, NICE's appraisal of semaglutide (TA875) explains the clinical evidence base that informs prescribing decisions. When you are ready to have your eligibility reviewed, and want to understand what strength of Wegovy is likely to work for your situation before you begin, our prescribing team can talk through that as part of your free consultation.