When to up your Wegovy dose — and how the process actually works

Step 1, Start at 0.25 mg and expect to stay there a month

Wegovy's starting dose is 0.25 mg once weekly. It exists to let your body adjust to semaglutide rather than to produce meaningful weight loss from day one. Most people tolerate it without significant difficulty, though some nausea is common in the first week or two. The NHS patient information on semaglutide notes that gastrointestinal effects tend to be most noticeable after starting or following a dose increase, and that they typically settle as your body adapts.

The four-week minimum at each step is not arbitrary. Semaglutide takes time to reach a steady concentration in the body, and your prescriber needs to see how you are responding before recommending a change. If you are still feeling nauseated, vomiting regularly or struggling to stay hydrated at week four, staying at the current dose for another month is usually the safer call. Pushing up before side effects have resolved rarely ends well. If you are unsure about your own situation, it helps to read about when you go up a dose on Wegovy and what the usual triggers for that decision are.

A practical note on timing: if your next pen is due around a bank holiday or you have planned travel, it is worth flagging that to your prescriber rather than quietly delaying. A short gap is usually manageable, but a prolonged break can affect how you tolerate your next dose. The Wegovy overview page covers storage and travel considerations in more detail.

Step 2, Moving through 0.5 mg, 1.0 mg and 1.7 mg

After the first month, the schedule moves in four-weekly increments: 0.25 mg to 0.5 mg, then 1.0 mg, then 1.7 mg. Each step is conditional on tolerating the previous one. Your prescriber reviews your response (including any side effects, your weight trajectory and your general health) before confirming a move up. That review is the safeguard; it is also why requests to jump two steps at once fall outside what a responsible clinician would sanction.

Side effects often flare briefly with each increase and then settle again. Understanding what happens when you increase your Wegovy dose can make that pattern feel less alarming when it occurs. If they do not ease, or if you experience anything more serious (severe stomach pain that spreads to the back, for instance) that warrants urgent medical attention rather than waiting for your next check-in. The MHRA's Yellow Card scheme is the place to report any suspected side effects from a licensed medicine.

Some people find one of the middle doses is where they feel best, both in terms of results and tolerability. Maintenance does not have to mean 2.4 mg if a lower dose is working and is well tolerated, that conversation belongs with your prescriber.

Step 3, Reaching the 2.4 mg maintenance dose (and beyond)

For most people following the full schedule, 2.4 mg is the standard maintenance dose, reached around month five. The word "maintenance" matters here: this is the dose Wegovy's trials were powered around, and it is where the headline trial evidence sits. The STEP 1 trial, published in the New England Journal of Medicine, recorded around 15% average body-weight reduction over 68 weeks at 2.4 mg alongside lifestyle changes.

Since April 2026, a 7.2 mg dose is also MHRA-licensed, delivered via a dedicated single-dose pen for adults with a BMI of 30 or above. Early data suggest average weight loss at this dose approaches the results seen with tirzepatide in some analyses. Whether it is clinically appropriate for any individual is a prescriber's call, informed by how they have responded to lower doses and their overall health picture. You can read more about when you increase your Wegovy dose and how those criteria are assessed in practice.

Dose increases are not automatic. At every step, the prescriber is weighing up efficacy against tolerability. If weight loss stalls at 2.4 mg and tolerability is good, a move to 7.2 mg might be discussed. If side effects remain difficult at a lower dose, the answer might be staying put or revisiting lifestyle factors rather than pressing upward. There is no single right answer that applies to everyone.

What a clinical review at each step actually involves

At each repeat, a prescriber is not simply rubber-stamping the next pen. They are checking whether the current dose has been effective, whether side effects are manageable, whether your circumstances have changed (new medication, a planned procedure, pregnancy plans), and whether continuing makes clinical sense. This is also where the question of cost can surface honestly, understanding the full treatment costs and what they include is part of making an informed decision about continuing.

For transfer patients (people moving from another provider) evidence of the current dose and a treatment history is standard. You cannot simply request the top dose at first contact; a prescriber needs to understand where you are in the process. That is not bureaucracy for its own sake. It reflects how the medicine is supposed to work, and reading about when to increase your Wegovy dose is worth doing before that conversation with your prescriber.

At nume, every repeat order goes through a fresh clinical review by a GPhC-registered prescriber. No subscription, no auto-renewal, no algorithm waving you through. If you have questions about where you are in the titration schedule, the team is available seven days a week. A good place to start, though, is a free consultation with our prescribers, who can assess your situation properly.