When do you increase your Wegovy dose?

Step 1: the first four weeks at 0.25 mg

The first pen you use contains 0.25 mg per weekly injection. This is not a therapeutic dose in the usual sense; its job is to let your digestive system adjust to semaglutide gradually. Most people notice some nausea, and starting low reduces how sharp that is. You stay here for a full four weeks before anything changes.

After those four weeks, your prescriber will want to know how you got on. If nausea, vomiting or other gastrointestinal symptoms were manageable, the standard path is to move to 0.5 mg. If side effects were significant enough to disrupt daily life, staying at 0.25 mg for another four weeks is a reasonable clinical choice, and a common one. There is no shame in a slower climb; the evidence base for Wegovy was built on careful titration, not speed.

One checking habit worth building: at the end of each four-week pen, note in your phone or on paper whether each week felt broadly similar to the last, or whether weeks three and four were meaningfully easier than week one. That pattern (settling symptoms) is exactly what a prescriber needs to hear before approving the next step. It takes under a minute and makes the review conversation much more useful.

Step 2: moving through 0.5 mg, 1.0 mg and 1.7 mg

The middle three steps follow the same logic: a minimum of four weeks at each dose, then a clinical review before going further. The NHS medicines information for semaglutide sets out this schedule clearly, and it is the schedule every legitimate prescriber works from.

Most people find that nausea peaks in the first week or two after each increase, then eases. If it does not ease, or if vomiting is making it hard to stay hydrated, that is a conversation to have with your prescriber before the next step, not something to push through alone. At 1.0 mg and above, many people also notice appetite suppressing more noticeably, which is a sign the medicine is working as intended. Actual weight loss patterns vary considerably between individuals, so try not to read too much into a single week on the scales.

The 1.7 mg step is often where people ask whether they even need to reach 2.4 mg and what the right moment to move up looks like. The answer depends on your response and your prescriber's assessment. Some people reach a good outcome at an intermediate dose; others need the full maintenance dose to see the results the clinical trials demonstrated. That is a conversation shaped by your individual data, not a generic rule.

Step 3: reaching 2.4 mg, and whether 7.2 mg is now part of the picture

The standard maintenance dose is 2.4 mg weekly. This is where most adults stay long-term, provided it is tolerated. The STEP 1 trial, published in the New England Journal of Medicine, recorded an average body-weight reduction of around 15% over 68 weeks at this dose, a figure that underlines why reaching maintenance matters. You can read more about the full evidence base on our Wegovy overview page.

In January 2026 the MHRA approved a higher 7.2 mg dose for eligible adults, and in April 2026 a dedicated single-dose 7.2 mg pen received authorisation. This option is for adults with a BMI of 30 or above and represents a further titration step beyond 2.4 mg, subject to prescriber assessment. If you are already on 2.4 mg and wondering whether 7.2 mg is appropriate for you, that question belongs in a clinical review, not a self-directed switch. Trials at this higher dose reported average losses approaching 20.7% over 72 weeks, narrowing the gap with tirzepatide results, but availability of specific dose formats is confirmed at consultation rather than guaranteed upfront. For a fuller look at how the different doses compare, our Wegovy doses guide covers the licensed schedule in more detail.

If after six months at the highest tolerated dose weight loss is less than 5%, NICE guidance recommends reviewing whether continuing is appropriate. That review happens with your prescriber, drawing on NICE's appraisal of semaglutide for weight management.

What can slow or pause a dose increase

Several things legitimately delay moving up. Persistent nausea or vomiting that has not settled is the most common; a prescriber may recommend staying at the current dose for an additional four weeks rather than adding a new source of discomfort on top of existing symptoms. Gallbladder symptoms, severe abdominal pain that radiates to the back, or signs of dehydration from prolonged GI illness are reasons to contact a clinician promptly rather than waiting for a scheduled review. The MHRA's Yellow Card scheme at yellowcard.mhra.gov.uk is the place to report any unexpected or serious side effect.

There is also a practical supply point worth knowing: if you are mid-titration and your dose is temporarily unavailable, do not self-adjust. A prescriber should guide any change in that situation, and our guide to when to increase your Wegovy dose explains how that decision should be made at each stage. Our guide to what happens when you increase your Wegovy dose covers what to expect physically at each step. If you are thinking about the cost of staying on treatment across those steps, our Wegovy cost guide explains what a legitimate price should include.

At nume, every repeat order goes back to a GPhC-registered prescriber for review before dispatch. A real clinician reads your update (not software) and that review includes whether your current dose is still right or whether a step up makes clinical sense. To discuss your titration with our prescribers, you can start a free consultation here.