Wegovy Dose Guide UK — 0.25mg to 7.2mg Complete (2026)

Alan

Wegovy (semaglutide) is a weekly injection prescribed on a carefully controlled dose schedule — starting at 0.25mg and stepping up every four weeks to a standard maintenance dose of 2.4mg. As of January 2026, a new higher dose of 7.2mg has been approved by the MHRA in the UK, offering an additional option for people who plateau or want to lose more weight.

This guide covers every dose in the Wegovy schedule in detail — what to expect week by week, average weight loss at each level, how side effects change, nutrition priorities, which supplements matter at each dose, and the key decisions: when to progress, when to hold, whether to try 7.2mg, and what happens if you stop.

⚡ Quick answer: Wegovy titration: 0.25mg for 4 weeks → 0.5mg for 4 weeks → 1mg for 4 weeks → 1.7mg for 4 weeks → 2.4mg maintenance. The new 7.2mg dose (MHRA-approved January 2026) is an optional additional step for people who plateau at 2.4mg. STEP-1 trial showed 14.9% average weight loss at 2.4mg; STEP UP trial showed 20.7% at 7.2mg. Semaglutide half-life is 7 days — miss a dose by more than 48 hours and skip it, don’t double up.
⚠️ Medical note: This post is for general information only and does not constitute medical advice. Always follow your prescriber’s instructions. Contact your prescriber or GP if you experience severe side effects or want to change your dose. Nothing here replaces a conversation with your clinical team.

How Wegovy titration works — and why it matters

Titration means starting at a low dose and increasing gradually over time. For Wegovy, this means beginning at 0.25mg — a dose specifically designed for tolerance-building, not weight loss — and stepping up every four weeks until you reach the maintenance dose that works for your body.

Semaglutide has a half-life of approximately 7 days (168 hours) — nearly twice as long as tirzepatide’s 5-day half-life. This means it takes approximately 4–5 weeks to reach steady-state plasma concentrations at each dose level. The clinical implications:

Pharmacokinetic fact Clinical implication
Half-life ~7 days Steady-state reached at ~4–5 weeks per dose
Peak concentration 1–3 days post-injection Side effects concentrated in first 2–3 days after each injection
Once-weekly injection Choose a consistent day — weekly rhythm is important for stable levels
Dose-proportional exposure Each step up produces predictable increases in appetite suppression
No food-timing requirement Can inject any time of day, independent of meals
Missed dose window: 48 hours If more than 48 hours from next scheduled dose, take it. Less than 48 hours — skip it. (Different to Mounjaro’s 96-hour rule.)

Why the 0.25mg starting dose is intentionally weak

The 0.25mg starting dose of Wegovy is classed as an initiation dose only — it is not intended to produce meaningful weight loss and is not a maintenance dose under any circumstances. Its sole purpose is to allow GLP-1 receptors in the gut and brain to adapt to semaglutide before higher doses are introduced. People who expect significant results at 0.25mg and interpret the subtle effects as the medication “not working” frequently abandon treatment before reaching the therapeutic dose range. Give it the full schedule — the real effect is at 1.7mg and 2.4mg.

0.25mg
Weeks 1–4
Start here
→
0.5mg
Weeks 5–8
First effect
→
1mg
Weeks 9–12
Momentum
→
1.7mg
Weeks 13–16
Near-therapeutic
→
2.4mg
Weeks 17+
Standard max
→
7.2mg
Month 6+
NEW 2026

Minimum 4 weeks at each dose before progressing. 7.2mg is optional — for those who plateau or need more. Not everyone needs it.

Full Wegovy dose schedule UK 2026 — 0.25mg to 7.2mg

Week Dose Status Average cumulative weight loss Side effect level
1–4 0.25mg Initiation dose only — not for weight loss 1–4lbs (mostly water) ⭐ Very low
5–8 0.5mg First escalation 3–8lbs total ⭐⭐ Low-moderate
9–12 1mg Second escalation 6–14lbs total ⭐⭐⭐ Moderate
13–16 1.7mg Third escalation — approaching therapeutic 10–22lbs total ⭐⭐⭐ Moderate
17+ 2.4mg Standard maintenance dose 14–35lbs+ total ⭐⭐⭐ Moderate (settles)
Month 6+ (optional) 7.2mg New high dose — MHRA approved Jan 2026 Additional loss for those who plateau at 2.4mg ⭐⭐⭐ Similar profile to lower doses

Weight loss ranges are broad because individual response varies significantly based on starting weight, dietary approach, exercise, and adherence to protein targets. STEP trial data showed considerable variability — roughly one in three people on 2.4mg lose 20%+ of body weight, while one in three loses less than 10%.

0.25mg — Weeks 1 to 4: The starting dose

0.25mg
Weeks 1–4 | Initiation dose only
Average weekly loss 0.25–1lb/week average (primarily water weight in weeks 1–2)
Appetite suppression Very mild — subtle reduction in appetite in the 24–72 hours post-injection
Main side effects Usually minimal or none. Possible mild nausea or injection site redness.
Nutrition priority Protein: establish your daily routine immediately. Electrolytes: start from day 1.
Key supplements Daily Fuel (protein), Electrolyte Drink, Vitamin D3+K2 — build the habit now

What you need to know at this dose: The 0.25mg dose is a tolerability-building dose, not a weight loss dose. Novo Nordisk’s prescribing information explicitly states it is ‘not intended for glycaemic control or weight loss’ at this level — it exists purely so your body adapts to semaglutide before higher doses are introduced. The scale may drop 2–4lbs in weeks 1–2 due to water weight from reduced carbohydrate intake; this is not indicative of your long-term results.

Week-by-week at 0.25mg

Week Appetite Side effects Scale What to focus on
Week 1 Slightly reduced 24–72hrs post-injection only Usually none or very mild. Possible injection site marking. Down 1–4lbs (water weight) Establish injection routine. Start protein shake daily. Electrolytes every day.
Week 2 Consistent subtle appetite reduction developing Possible mild nausea on injection day — usually passes by evening Slows as water weight settles Don’t judge the medication yet. This is adaptation, not the effect.
Week 3 Steady-state beginning to establish Usually settling well 0.25–0.5lb/week actual fat loss beginning Walk 7,000–10,000 steps daily if possible. Protein targets every day.
Week 4 Full 0.25mg effect established — still modest Well tolerated for almost everyone Consistent slow loss Ready for 0.5mg? Side effects settled? 4 weeks done?

The most common 0.25mg mistake

“Nothing is happening” — losing patience too early. 0.25mg is deliberately designed to feel like very little. The scale drop in weeks 1–2 is primarily water weight, not fat. When it slows in week 3, the medication has not failed — real fat loss is just beginning. Stick to the schedule. The difference between 0.25mg and 2.4mg is enormous; the titration is the bridge between them.

0.5mg — Weeks 5 to 8: The first real effect

0.5mg
Weeks 5–8 | First escalation
Average weekly loss 0.5–1.5lbs/week | Starting to feel meaningfully different
Appetite suppression Noticeably stronger than 0.25mg — most people feel genuinely different
Main side effects Nausea more likely here, particularly 1–2 days post-injection. Eating too fast at this dose is reliably punished.
Nutrition priority Protein first at every eating opportunity. Slow eating — 20 minutes minimum per meal.
Key supplements Electrolytes (essential now), Triple Magnesium from this dose, Daily Fuel

What you need to know at this dose: 0.5mg is where the majority of people first notice that Wegovy is genuinely changing their relationship with food. The afternoon hunger that previously arrived reliably at 3pm often simply does not come. Portions feel satisfying sooner. This is also where the first meaningful nausea typically occurs — almost always from eating too fast or too much. The fix is not antiemetics; it is slowing down and stopping at 70–80% full.

Week-by-week at 0.5mg

Week What changes Side effect watch Scale
Week 5 (first 0.5mg injection) Noticeably stronger appetite suppression within 24–72hrs Nausea more likely — eat something small before injecting if morning injection Often a small additional drop as dose increases
Week 6 Food aversions may begin — certain foods become less appealing If nausea is significant, do not progress to 1mg yet — wait until settled 0.5–1lb/week genuine fat loss
Week 7 Constipation can appear at this dose — water intake critical Bowel habits changing? Increase water to 2.5L, add psyllium husk if needed Steady fat loss establishing
Week 8 Full 0.5mg effect established Side effects typically settled by now Cumulative 3–8lbs from week 1

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Dehydration symptoms (headaches, fatigue, dizziness) are extremely common at 0.5mg as thirst becomes suppressed alongside appetite.

1mg — Weeks 9 to 12: Building real momentum

1mg
Weeks 9–12 | Second escalation
Average weekly loss 1–2lbs/week | Where consistent fat loss becomes clearly established
Appetite suppression Strong and consistent — food is genuinely less interesting
Main side effects Nausea risk moderate at first injection of this dose. High-fat and spicy meals are now reliable nausea triggers.
Nutrition priority Protein harder to hit consistently — daily protein shake should be non-negotiable from here.
Key supplements Daily Fuel (possibly twice daily on difficult days), Triple Magnesium (sleep quality matters now), Electrolytes (essential)

What you need to know at this dose: 1mg is where Wegovy treatment genuinely feels established. Many people describe a fundamental shift in their relationship with food at this dose — the constant background mental chatter about food (‘food noise’) quietens significantly. This is also the dose where nutritional management becomes critical, because food intake drops enough that hitting protein targets through food alone requires daily planning.

What changes at 1mg that catches people off guard

Diarrhoea becomes more common. Unlike Mounjaro where constipation dominates, Wegovy has a higher rate of diarrhoea — 29% vs 24% for constipation in STEP trials. The 1mg dose is where this often first becomes noticeable. If diarrhoea occurs: reduce fibre temporarily, stay well hydrated with electrolytes, avoid high-fat and fried food. Usually resolves within 1–2 weeks at the new dose.

Injection site reactions more common. Wegovy has a higher injection site reaction rate (~14–26%) than Mounjaro (~3–8%). At 1mg, pay attention to rotation — do not inject the same site more than once per month. Always let the pen reach room temperature. Allow the alcohol wipe to dry completely before injecting.

Hair loss may begin here. Telogen effluvium — the temporary hair shedding triggered by rapid weight loss — typically begins 2–4 months after significant weight loss starts. For most people on Wegovy, this means around weeks 9–12 as results accelerate. Protein and vitamin D3 are the most important interventions.

1mg concern Why it happens What to do
Diarrhoea GLP-1 receptors in the gut affect motility in both directions; some people experience loose stools rather than constipation Reduce high-fat food, stay hydrated with electrolytes, low-fibre foods on difficult days
Hair shedding beginning Telogen effluvium from physiological stress of rapid weight loss — not the medication directly Protein daily, Vitamin D3+K2, consider Biotin Plus. This is temporary — the follicles are not damaged.
Injection site reactions More common with Wegovy than Mounjaro — immune response to higher injection frequency at same site Rotate sites consistently; room-temperature pen; dry alcohol wipe before injecting
Plateauing at 1mg Some people find strong results at 1mg and wonder if escalating is necessary If 1–1.5lbs/week is continuing, consider whether you want to escalate. 1mg is not a valid maintenance dose — 1.7mg is the last step before standard maintenance.

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At 1mg many people need a daily protein shake to reliably hit targets. On difficult days, two shakes may be needed.

1.7mg — Weeks 13 to 16: Approaching full therapeutic effect

1.7mg
Weeks 13–16 | Third escalation
Average weekly loss 1–2.5lbs/week | Near-maximum effect
Appetite suppression Very strong — most people feel they have reached a meaningful therapeutic level
Main side effects Nausea typically manageable by this point for people who have titrated carefully. First injection at 1.7mg may bring a brief return of nausea.
Nutrition priority Protein supplementation is not optional here. Aim for at least one shake daily minimum.
Key supplements Full existing stack. Add Biotin Plus if hair loss is present. Consider Pre+Pro 15 probiotics.

What you need to know at this dose: 1.7mg is the penultimate step before 2.4mg maintenance. The Wegovy prescribing information specifically notes that if 2.4mg is not tolerated, 1.7mg can be used as a maintenance dose for up to 4 weeks before re-attempting 2.4mg. This makes 1.7mg a clinically legitimate maintenance dose for people who cannot tolerate the full 2.4mg — not a failure point.

1.7mg as a maintenance dose — a valid option

Novo Nordisk’s prescribing information for Wegovy states: “If the 2.4mg dose is not tolerated, the dose can be reduced temporarily to 1.7mg for a maximum of 4 weeks, and then increased back to 2.4mg.” While this is framed as a temporary measure, some people find 1.7mg is their optimal long-term maintenance dose. Discuss with your prescriber if 1.7mg provides excellent results with acceptable tolerability and 2.4mg consistently produces intolerable side effects.

Starting weight Average cumulative loss by week 16 What this looks like
14 stone (89kg) 10–18lbs Down one clothing size; waist 2–3 inches smaller
16 stone (102kg) 12–22lbs Noticeably smaller; energy improving; stairs easier
18 stone (114kg) 14–26lbs Down one clothing size; joint pain reducing
20 stone (127kg) 16–30lbs Approaching 2 stone; health markers likely improving

2.4mg — Week 17 onwards: Standard maintenance dose

2.4mg
Week 17+ | Standard maintenance dose
Average weekly loss 1–2lbs/week ongoing | STEP-1 average: 14.9% total body weight at 68 weeks
Appetite suppression Maximum available at this dose — strong, consistent appetite suppression; significant ‘food noise’ reduction
Main side effects For most people who titrated carefully, 2.4mg is well tolerated. First injection at this dose may bring a brief nausea return.
Nutrition priority Protein maintenance critical every day. Food feels like less of a priority — treat protein shake as non-negotiable medication.
Key supplements Full stack: Daily Fuel, Electrolytes, Triple Magnesium, Vitamin D3+K2. Add Biotin Plus if hair loss is present; Collagen Plus if skin laxity concerns.

What you need to know at this dose: 2.4mg is where the STEP-1 trial produced its landmark 14.9% average weight loss result. One in three people on 2.4mg lose more than 20% of body weight. One in three lose less than 10%. Individual response varies substantially — genetics, adherence to protein targets, exercise, and sleep quality all play major roles. The plateau conversation typically arrives at 9–12 months for most people at 2.4mg.

Long-term at 2.4mg — what the data shows

STEP trial Population Average weight loss at 2.4mg Key finding
STEP-1 (2021) Adults without T2DM, N=1,961, 68 weeks 14.9% 68% lost ≥10%; 32% lost ≥20%
STEP-2 (2021) Adults with T2DM, N=1,210, 68 weeks 9.6% Lower loss with T2DM — consistent with mechanism
STEP-3 (2021) Intensive lifestyle intervention + 2.4mg 16.0% Adding intensive lifestyle support improves outcomes
STEP-4 (2021) Withdrawal study — stopped at week 20 +6.9% regain over next 48 weeks Confirmed significant weight regain after stopping
STEP-5 (2022) 2-year trial, N=304 15.2% at 2 years Results maintained with continued treatment

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7.2mg — The new high dose: MHRA approved January 2026

7.2mg
Month 6+ | Optional additional dose — MHRA approved 12 January 2026
Average weekly loss Additional 3–5% body weight loss on top of 2.4mg plateau results (STEP UP data)
Appetite suppression Stronger than 2.4mg — STEP UP participants reported significant additional appetite suppression at this dose
Main side effects Similar GI profile to lower doses. STEP UP showed only 3.3% discontinuation due to side effects — better than expected.
Nutrition priority Same as 2.4mg — protein and electrolytes most critical. Do not let nutrition slip when escalating.
Key supplements Full stack maintained. Ashwagandha KSM-66 may be worth adding here — cortisol management through the additional adaptation.

What you need to know at this dose: 7.2mg was approved by the MHRA on 12 January 2026 and is available through private providers now, with NHS access expected later in 2026. The STEP UP Phase 3b trial showed average weight loss of 20.7% at 7.2mg vs 17.5% at 2.4mg over 72 weeks — a meaningful additional benefit for people who have plateaued at 2.4mg. It is not a mandatory escalation. If you are happy with 2.4mg results, there is no clinical requirement to move to 7.2mg.

Who should consider 7.2mg — and who should not

Consider 7.2mg if: No need for 7.2mg if:
✅ You have plateaued at 2.4mg with all other factors addressed ✅ You are happy with your progress and results at 2.4mg
✅ You have been on 2.4mg for 3+ months with settled side effects ✅ You are approaching or at your target weight
✅ You still have significant weight to lose above your target ✅ Side effects at 2.4mg are already at your tolerance limit
✅ Your prescriber confirms the escalation is appropriate ✅ The additional cost of 7.2mg is not justified by your progress expectations

STEP UP trial results — what 7.2mg actually delivers

The Phase 3b STEP UP trial (NCT05646706, N=1,407, 72 weeks) found:

  • Average weight loss 20.7% at 7.2mg vs 17.5% at 2.4mg — a 3.2 percentage point additional benefit
  • 33.2% of 7.2mg participants achieved ≥25% body weight loss — a threshold previously associated only with bariatric surgery and Mounjaro 15mg
  • 91% achieved ≥5% weight loss (vs 85% at 2.4mg)
  • Discontinuation due to adverse events: 3.3% at 7.2mg — comparable to lower doses

At 18 stone (114kg) starting weight, 7.2mg’s average 20.7% loss represents approximately 23.6kg (52lbs) vs 20kg (44lbs) at 2.4mg — a genuine 8lb additional benefit. Whether that is worth the cost and dose escalation is an individual decision.

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Add Triple Magnesium and Vitamin D3+K2 separately — both essential throughout treatment.

When to progress to the next dose — and when to hold

Progress when: Hold when:
✅ Minimum 4 weeks at current dose ⛔ Less than 4 weeks at current dose
✅ Side effects have settled (typically week 3–4) ⛔ Still experiencing significant nausea or diarrhoea
✅ Protein and hydration consistently managed ⛔ Protein targets not being hit daily
✅ Active weight loss continuing — no reason to rush escalation ⛔ Weight loss stalling but all other factors not yet addressed
✅ Prescriber confirms progression is appropriate ⛔ Prescriber advises holding at current dose
✅ No major life event upcoming (surgery, holiday, illness) ⛔ Cannot tolerate side effects of the next dose level

The 1.7mg exception — the only Wegovy dose you can reduce to

Wegovy prescribing information includes an explicit instruction: if 2.4mg is not tolerated, reduce to 1.7mg for a maximum of 4 weeks then attempt re-escalation. This is the only Wegovy dose where a temporary reduction is officially recommended. If you cannot tolerate 2.4mg after two re-attempts from 1.7mg, discuss with your prescriber whether 1.7mg as permanent maintenance, or switching to a different medication, is more appropriate.

Missed a Wegovy dose — exactly what to do

⚠️ Important: Wegovy’s missed dose rule is different to Mounjaro’s. Wegovy uses a 48-hour (2-day) window; Mounjaro uses a 96-hour (4-day) window. Do not confuse them if switching between medications.
Scenario What to do
Missed dose — next scheduled dose is MORE than 2 days (48 hours) away Inject as soon as you remember. Return to your normal weekly schedule.
Missed dose — next scheduled dose is LESS than 2 days (48 hours) away Skip the missed dose entirely. Resume on your normal injection day. Never double dose.
Missed several weeks (illness, supply issue, holidays) Contact your prescriber before resuming — you may need to re-titrate from a lower dose after a gap of 2+ weeks
Re-starting after a break of more than 2 weeks Your prescriber will advise — typically need to re-start from a lower dose to avoid severe side effects

Best day and time to inject Wegovy

There is no medically optimal injection time. Side effects peak 1–3 days post-injection. Most practical strategies:

  • Friday or Saturday injection: most popular — side effects fall mainly over the weekend when work demands are lowest
  • Sunday injection: good if you want side effects peaking Monday–Tuesday when appetite is naturally lower after a weekend
  • Avoid Monday injection if your work requires full focus on Tuesday and you are still in the titration phase
  • Consistency matters most — same day, same time, every week

Side effects at each Wegovy dose — what to expect

Nausea and vomiting

Dose Nausea frequency (STEP data) Duration Management
0.25mg ~20% experience notable nausea 24–48hrs post-injection Usually minimal — manage with slow eating
0.5mg ~30–35% at dose increase Settles weeks 7–8 Eat slowly; avoid carbonation; ginger tea
1mg ~40% at first injection at this dose Weeks 9–10 worst; settles week 12 High-fat and spicy food are reliable triggers — avoid both
1.7mg ~35% at dose increase Weeks 13–14; settles with consistent slow eating Established strategies help; antiemetic if needed
2.4mg ~44% overall in STEP-1 at some point during treatment Worst at first injection; usually settled within 2–4 weeks If persistent beyond week 4, discuss with prescriber
7.2mg Similar to 2.4mg profile — STEP UP showed manageable rates First 2 weeks at new dose; settles Same strategies; only 3.3% discontinued due to AEs in STEP UP

Diarrhoea — more common with Wegovy than Mounjaro

STEP-1 data showed diarrhoea in 29% of 2.4mg participants — significantly higher than the rate seen with tirzepatide. This is one of the key side effect differences between the two medications. Management:

  • Stay hydrated — electrolytes are essential as diarrhoea depletes both fluid and electrolytes rapidly
  • Reduce high-fat food during episodes
  • Low-fibre, bland foods on difficult days (rice, plain chicken, bananas)
  • BRAT approach (banana, rice, apple sauce, toast) on severe days
  • Avoid high-fat, fried, and heavily seasoned food — these are reliable triggers
  • Contact prescriber if diarrhoea is severe, persistent beyond 5–7 days, or accompanied by blood

Constipation — also present but less dominant than with Mounjaro

24% of STEP-1 participants experienced constipation. The same management hierarchy as any GLP-1 medication applies:

  1. 2.5L still water per day — scheduled, not thirst-triggered
  2. 25–30g dietary fibre daily (oats, lentils, vegetables)
  3. Psyllium husk (1 tsp in large glass of water before bed)
  4. Probiotics — Pre+Pro 15 supports gut motility
  5. 20-minute post-meal walks directly stimulate peristalsis
  6. Macrogol (Movicol) if dietary measures insufficient — OTC, safe for regular use

Hair loss — what Wegovy studies show

STEP-1 data showed hair loss (alopecia) in 3% of Wegovy participants vs 1% on placebo. This is lower than Mounjaro’s 4.9–7.1% rate. As with all GLP-1 medications, it is telogen effluvium caused by the physiological stress of rapid weight loss, not a direct drug effect. The same interventions apply: adequate protein (1.6g/kg target weight daily), vitamin D3, iron (test first), zinc, and biotin.

Injection site reactions — more common than with Mounjaro

Wegovy has injection site reaction rates of 14–26% — substantially higher than Mounjaro’s 3–8%. Redness, bruising, swelling, and mild lumps at injection sites are all common. Reduce with: room-temperature pen, dry alcohol wipe, consistent site rotation, slow injection.

Nutrition at each Wegovy dose

Dose Typical daily intake Protein challenge Most common failure Key strategy
0.25mg 1,500–1,900 kcal ⭐ Easy Not changing anything yet Establish protein-first eating now
0.5mg 1,300–1,700 kcal ⭐⭐ Manageable Protein falling below 100g Daily protein shake from this dose
1mg 1,100–1,500 kcal ⭐⭐⭐ Moderate Food aversions causing protein drift Soft high-protein foods; tinned fish, yoghurt, cottage cheese
1.7mg 1,000–1,400 kcal ⭐⭐⭐ Significant Muscle loss from insufficient protein Two shakes daily if needed; track protein daily
2.4mg 900–1,300 kcal ⭐⭐⭐⭐ Challenging Eating feels like a chore; nutritional gaps widening Treat protein shake as medication — take it regardless of appetite
7.2mg 800–1,200 kcal ⭐⭐⭐⭐ Very challenging Same as 2.4mg but amplified Full supplement stack essential; double shakes on difficult days

Daily protein targets by body weight — non-negotiable at every dose

Target weight Protein minimum/day How to hit it
10 stone (63kg) 100g Shake (21g) + Greek yoghurt (20g) + tuna tin (26g) + 2 eggs (12g) + cottage cheese (17g) = 96g
12 stone (76kg) 120g Two shakes (42g) + salmon (33g) + Greek yoghurt (20g) + cottage cheese (17g) + 2 eggs (12g) = 124g
14 stone (89kg) 140g Two shakes (42g) + chicken breast (45g) + tuna (26g) + cottage cheese (17g) + skyr (16g) = 146g
16 stone (102kg) 160g Two shakes (42g) + salmon (33g) + chicken (45g) + yoghurt (20g) + 2 eggs (12g) + tuna (26g) = 178g

Supplements at each Wegovy dose — what to add and when

Supplement Start at Priority Why at this point
Daily Fuel (protein) Day 1 — 0.25mg ⭐⭐⭐⭐⭐ Essential Protein gap starts immediately from day 1
Electrolyte Drink Day 1 — 0.25mg ⭐⭐⭐⭐⭐ Essential Thirst suppressed from day 1; electrolytes critical
Vitamin D3+K2 Week 1 — 0.25mg ⭐⭐⭐⭐⭐ Essential Near-universal UK deficiency; hair and immune function
Triple Magnesium 0.5mg transition ⭐⭐⭐⭐⭐ Essential Sleep disruption and cortisol increase from 0.5mg+
Pre+Pro 15 (probiotics) 1mg or when diarrhoea/constipation begins ⭐⭐⭐⭐ High GI side effects — gut microbiome support. More important with Wegovy due to higher diarrhoea rate.
Biotin Plus Month 2–3 if hair loss begins ⭐⭐⭐⭐ High (if hair loss) Additional hair support alongside protein and D3
Collagen Plus 1.7mg or when skin laxity concerns appear ⭐⭐⭐ Moderate Skin elasticity support as rapid fat loss accumulates
Ashwagandha KSM-66 2.4mg–7.2mg if stress is high ⭐⭐⭐ Moderate Cortisol management; 28% reduction in trials

Wegovy vs Mounjaro — which is better?

This is the most common question for people making a treatment choice or considering switching. Here is the honest comparison:

Factor Wegovy (semaglutide) Mounjaro (tirzepatide)
Mechanism GLP-1 receptor agonist (single) Dual GLP-1 + GIP agonist
Average weight loss (standard max dose) 14.9% at 2.4mg (STEP-1) 22.5% at 15mg (SURMOUNT-1)
New high dose 7.2mg — avg 20.7% loss (STEP UP) 15mg (original max)
Nausea rate ~44% at 2.4mg ~40–45% at dose increases
Diarrhoea rate 29% (higher) ~8–12% (lower)
Constipation rate 24% 12–17% (lower)
Injection site reactions 14–26% (higher) 3–8% (lower)
NHS availability ✅ NICE approved pathway (BMI ≥35 + comorbidity) Limited (mainly T2DM specialist services)
Private cost UK (typical) ~£200–250/month ~£100–160/month
Half-life ~7 days ~5 days
Missed dose window 48 hours 96 hours
Head-to-head vs each other SURMOUNT-MMO (2024): Mounjaro produced significantly greater weight loss Winner in head-to-head efficacy comparison

The practical decision guide

  • Choose Wegovy if: you qualify for the NHS pathway (most cost-effective route), you prefer semaglutide’s longer half-life and weekly consistency, you have previously responded to semaglutide (Ozempic), or your prescriber specifically recommends it
  • Choose Mounjaro if: maximum weight loss is the priority, you are paying privately and cost matters (Mounjaro is typically £40–100 cheaper/month), you have Type 2 diabetes or insulin resistance, or you have not responded adequately to semaglutide
  • Consider switching Wegovy → 7.2mg first before switching medications entirely if you have plateaued at 2.4mg — the additional efficacy at 7.2mg is substantial

NHS access for Wegovy in the UK

Wegovy (semaglutide 2.4mg) was the first GLP-1 medication to receive NICE approval for weight management on the NHS, making it more accessible than Mounjaro for weight management specifically.

Pathway Criteria Reality in 2026
NHS primary care BMI ≥35 + at least one weight-related comorbidity (T2DM, hypertension, OSA, etc.), or BMI 30–35 in high-risk ethnic groups NICE-approved. Rolling out through specialist weight management services. Waiting lists remain in most areas.
NHS specialist weight services (Tier 3+) Same BMI criteria, referred from primary care More accessible for complex cases; dietitian and lifestyle support included
Wegovy 7.2mg — NHS Not yet available on NHS MHRA-approved January 2026. NHS health technology assessment underway. Expected NHS availability late 2026.
Private prescription BMI ≥30 (some providers ≥27 with comorbidities) Available immediately through multiple UK private services. No waiting list.

NHS Wegovy is significantly cheaper than private — standard prescription charge (~£9.90) vs £200–250/month privately. If you meet the criteria, pursuing the NHS pathway is worth the wait for most people. Ask your GP specifically about the NICE obesity treatment pathway.

What happens when you stop Wegovy

STEP-4 is the definitive trial on this question — it specifically studied what happens when semaglutide is stopped after successful treatment:

Timepoint after stopping Average weight status
Week 20 (stopping point) -10.6% from baseline
Week 28 (8 weeks post-stopping) -7.3% (partial regain)
Week 68 (48 weeks post-stopping) -5.6% (two-thirds of loss regained within a year)

The pattern mirrors SURMOUNT-4 data for Mounjaro — approximately two-thirds of lost weight returns within 12 months of stopping. This is not a failure of willpower. GLP-1 medications address the biological mechanisms of obesity — elevated ghrelin, reduced leptin, altered reward pathways — which reassert themselves when the medication is removed.

How to minimise regain if stopping is necessary

  • Discuss structured tapering with your prescriber — reducing from 2.4mg → 1.7mg → 1mg over several months may moderate the rebound appetite vs abrupt stopping
  • Before stopping, consider 7.2mg — if stopping due to insufficient results at 2.4mg, the higher dose may be the better option than discontinuation
  • Increase protein intake during and after tapering — protein is the primary hunger management tool without medication
  • Continue exercise habits built during treatment — physical activity partially substitutes for the appetite-suppressing effect
  • Continue supplement stack — Daily Fuel, Triple Magnesium, Electrolytes, and Vitamin D3+K2 remain relevant after stopping

Complete FAQ — 40+ questions answered

Getting Started

❓ When does Wegovy start working?
Appetite suppression typically begins within 1–3 days of the first injection. Meaningful weight loss requires 4–5 weeks at 0.5mg+ as steady-state plasma concentrations establish. Most people feel the medication genuinely working from 0.5mg–1mg onwards (weeks 5–12). The full therapeutic effect at 2.4mg takes approximately 16–20 weeks to reach.
❓ Why do you start Wegovy at 0.25mg?
The 0.25mg initiation dose is explicitly stated in Novo Nordisk’s prescribing information as not intended for weight loss or glycaemic control. Its sole purpose is to allow GI adaptation before higher doses are introduced. Clinical trials that skipped titration steps showed 3–4× higher discontinuation rates due to GI side effects.
❓ Can I start Wegovy at a higher dose?
No — 0.25mg is the required starting dose regardless of body weight or urgency. Starting at 0.5mg or higher would expose you to the full GI side effect profile before your gut receptors have adapted, likely causing severe nausea and vomiting and increasing dropout risk.
❓ How long does it take to reach 2.4mg Wegovy?
Minimum 16 weeks (4 months) following the standard titration: 4 weeks each at 0.25mg → 0.5mg → 1mg → 1.7mg → then 2.4mg. This is the minimum — if side effects require holding at any dose for additional weeks, the journey is longer.
❓ Is 2.4mg the maximum dose of Wegovy?
Until January 2026, yes. The MHRA approved Wegovy 7.2mg on 12 January 2026, making it the new maximum dose available in the UK. The 7.2mg dose is intended for people who have already reached and tolerated 2.4mg and want to lose more weight.

Weight Loss and Results

❓ How much weight can I lose on Wegovy?
STEP-1 trial: average 14.9% body weight at 2.4mg over 68 weeks. STEP UP trial: average 20.7% at 7.2mg over 72 weeks. At 18 stone (114kg), this is 24lbs at 2.4mg and 33lbs at 7.2mg on average. Individual results range widely — roughly one-third of people lose more than 20%, one-third lose 10–20%, and one-third lose less than 10%.
❓ How quickly do you lose weight on Wegovy?
Most people lose 2–5lbs in weeks 1–4 (primarily water weight at 0.25mg), then 0.5–1.5lbs/week from weeks 5–16 as the dose increases. The fastest absolute weekly loss typically occurs at 1mg–2.4mg. The rate then settles to 0.5–1lb/week at maintenance dose as the body adapts.
❓ Why am I not losing weight on Wegovy?
The most common causes in order: (1) TDEE decreased as weight fell — recalculate at current weight; (2) calorie intake has crept up — track honestly for 2 weeks; (3) protein insufficient — audit daily intake; (4) dose not yet at therapeutic level; (5) sleep quality poor. If all are addressed and still not progressing, discuss with prescriber.
❓ Does Wegovy work for everyone?
No. Clinical trial data shows a consistent one-third of participants lose less than 10% of body weight on 2.4mg. Predictors of lower response include Type 2 diabetes, higher insulin resistance, certain genetic variants, and insufficient lifestyle changes. If 2.4mg produces minimal response after 3–4 months, 7.2mg or switching to tirzepatide (Mounjaro) may be worth discussing with your prescriber.
❓ Is Wegovy better than Mounjaro?
For most people on the evidence: no — Mounjaro produces approximately 50% more average weight loss. However, Wegovy has a longer track record, a clearer NHS pathway, strong cardiovascular outcome data (SELECT trial), and for some individuals is better tolerated. The best medication is the one you can access, afford, and tolerate long-term.
❓ What does Wegovy 7.2mg add?
STEP UP trial data shows 7.2mg adds approximately 3–4 additional percentage points of weight loss over 2.4mg — meaning a further 3–4% of body weight at maintenance. At 18 stone (114kg), this represents approximately an additional 5–7lbs. Notably, 33% of 7.2mg participants lost ≥25% of body weight — a threshold previously associated with bariatric surgery.

Dose Progression and Schedule

❓ Can I increase Wegovy dose faster than every 4 weeks?
No — 4 weeks is the minimum interval as stated in the prescribing information. Faster escalation significantly increases nausea and vomiting risk without producing better weight loss outcomes. The titration pace is clinically determined.
❓ Can I stay on 1.7mg Wegovy permanently?
Yes — if 1.7mg produces adequate results with acceptable tolerability and you cannot tolerate 2.4mg, 1.7mg is a valid maintenance dose. Discuss with your prescriber. The prescribing information allows a temporary step down to 1.7mg from 2.4mg — it does not prohibit long-term use at 1.7mg.
❓ Can I reduce my Wegovy dose?
Yes — the only officially recommended dose reduction is from 2.4mg to 1.7mg if 2.4mg is not tolerated. Reducing below 1.7mg to manage side effects is not recommended in prescribing guidance; if tolerable management fails below 1.7mg, contact your prescriber.
❓ What happens if I skip a Wegovy injection?
If you remember within 48 hours of the missed dose (and your next dose is more than 48 hours away), take it immediately. If your next dose is less than 48 hours away, skip it and take the next dose on schedule. Never double dose. Note this is different to Mounjaro which uses a 96-hour window.
❓ Can I change my Wegovy injection day?
Yes — shift by taking your next injection on your new chosen day, as long as you maintain at least 2 days (48 hours) between injections during the transition. Then resume weekly on the new day.

Side Effects

❓ Why does Wegovy cause more diarrhoea than Mounjaro?
Wegovy (semaglutide) activates GLP-1 receptors exclusively; Mounjaro (tirzepatide) activates both GLP-1 and GIP receptors. The GIP receptor component in tirzepatide appears to partially offset the GLP-1-driven gut motility effects, resulting in a different GI side effect profile. This is one reason some people tolerate Mounjaro better than Wegovy despite it being a stronger medication.
❓ Does Wegovy nausea ever go away?
Yes — for most people, nausea at each dose level improves significantly within 2–4 weeks as plasma levels stabilise and GI receptors adapt. The worst nausea is typically in the first 72 hours after each new dose injection. People who are still experiencing significant nausea at week 6–8 at a given dose should not escalate.
❓ Why is Wegovy causing hair loss?
Hair loss on Wegovy is almost always telogen effluvium — temporary shedding caused by the physiological stress of rapid weight loss. STEP-1 data showed 3% of participants experienced hair loss. The follicles are not damaged; hair regrows as weight stabilises. Protein and vitamin D3 are the most important interventions.
❓ Can Wegovy cause muscle loss?
Yes, if protein intake is insufficient. Calorie deficit without adequate protein causes the body to break down muscle alongside fat. Target 1.6g protein per kg target body weight daily throughout treatment. Resistance training 2–3x per week significantly reduces muscle loss during the deficit phase.
❓ Does Wegovy affect sleep?
Indirectly — the medication itself does not directly disrupt sleep, but poor nutrition (particularly magnesium and B vitamin deficiency from reduced food intake) can affect sleep quality. Magnesium glycinate supplementation before bed addresses this directly and also reduces cortisol — which otherwise promotes abdominal fat storage.
❓ Is Wegovy safe long-term?
Semaglutide has been used in GLP-1 form for type 2 diabetes management since 2018. The STEP-5 two-year trial showed maintenance of weight loss with continued Wegovy treatment. The SELECT trial demonstrated cardiovascular benefit in high-risk populations. No new long-term safety signals have emerged in 5+ years of clinical use.

Practical Questions

❓ What should I eat on Wegovy?
Prioritise protein at every meal — chicken, fish, eggs, Greek yoghurt, cottage cheese, protein shakes. Eat slowly (20 minutes minimum per meal). Stop at 70–80% full. Avoid high-fat, fried, and spicy food on injection days. Target 1.6g protein per kg target weight daily. See: What to Eat on GLP-1 UK.
❓ Can I drink alcohol on Wegovy?
Yes, but effects are significantly amplified. Semaglutide slows gastric emptying — alcohol absorbs faster, producing higher blood alcohol concentration per unit. Most users find tolerance substantially lower. Nausea risk is significantly higher when drinking. Avoid alcohol in the 24–48 hours around each injection when nausea risk is highest.
❓ Can I take Wegovy while pregnant?
No — Wegovy is contraindicated during pregnancy. Stop at least 2 months before planning pregnancy. Use effective contraception throughout treatment. Note: semaglutide may reduce the effectiveness of oral contraceptives by delaying gastric emptying — discuss with your prescriber and consider non-oral contraceptive methods.
❓ Can I exercise on Wegovy?
Yes — and exercise significantly improves the quality of weight loss by preserving muscle. Walking and resistance training are the most evidence-backed additions. GLP-1 medication does not negatively interact with exercise. Start gently if new to exercise and build gradually.
❓ What is the best time to inject Wegovy?
Any time of day, same time each week. Most people choose Friday or Saturday to have side effects fall over the weekend. The injection does not need to be related to meals. What matters is consistency — the same day, same time, every week.
❓ How do I store Wegovy?
Store in refrigerator (2–8°C) before first use. Do not freeze. Once in use, store at room temperature (below 30°C) for up to 28 days. Keep out of sunlight and heat. Let the pen reach room temperature (30+ minutes) before injecting — cold injection causes more discomfort.
❓ What if Wegovy is out of stock?
Supply disruptions have occurred with semaglutide in the UK. If your pharmacy cannot supply, contact your prescriber immediately — do not simply wait. Options include: alternative pharmacy, temporary dose maintenance, or discussion about bridging to a different medication. Discuss with your prescriber before skipping more than 2 weeks.

NHS and Cost

❓ Can I get Wegovy on the NHS?
Yes — Wegovy 2.4mg has a NICE-approved NHS pathway for adults with BMI ≥35 and at least one weight-related comorbidity, or BMI 30–35 in high-risk groups. Rollout is through specialist weight management services. Waiting lists vary by area. Ask your GP specifically about the NICE obesity medication pathway.
❓ How much does Wegovy cost privately in the UK?
Approximately £200–250 per month privately in 2026. Annual cost at maintenance dose is approximately £2,400–3,000. This is significantly more expensive than Mounjaro (£100–160/month), which also produces better average weight loss. If accessing privately, compare Mounjaro as an alternative.
❓ Is Wegovy 7.2mg available on the NHS?
Not yet — the MHRA approved 7.2mg on 12 January 2026 but NHS commissioning requires a separate NICE health technology assessment. This process typically takes 6–9 months post-approval, meaning NHS availability is expected towards late 2026.
❓ What is the difference between Wegovy and Ozempic?
Both contain semaglutide. Wegovy is licensed for weight management at doses up to 2.4mg (now 7.2mg). Ozempic is licensed for type 2 diabetes at doses up to 1mg (or 2mg in extended indication). The same molecule at different approved doses and different licensed indications. Wegovy’s higher maintenance dose produces greater weight loss than Ozempic’s maximum dose.

Quick reference — Wegovy dose schedule at a glance

Dose Weeks Avg weekly loss GI side effect risk Protein difficulty Key supplement addition
0.25mg 1–4 0.25–0.75lb ⭐ Very low ⭐ Easy Daily Fuel + Electrolytes from day 1
0.5mg 5–8 0.5–1.5lb ⭐⭐ Moderate ⭐⭐ Manageable Add Triple Magnesium
1mg 9–12 1–2lb ⭐⭐⭐ Higher ⭐⭐⭐ Moderate Add Pre+Pro 15; Biotin if hair loss begins
1.7mg 13–16 1–2.5lb ⭐⭐⭐ Moderate ⭐⭐⭐ Challenging Add Collagen Plus if skin concerns
2.4mg 17+ 0.75–2lb ⭐⭐⭐ Moderate ⭐⭐⭐⭐ Very challenging Full stack essential. Two shakes daily on difficult days.
7.2mg Month 6+ Additional loss ⭐⭐⭐ Similar to 2.4mg ⭐⭐⭐⭐ Very challenging Add Ashwagandha for cortisol; full stack maintained

📋 Download the free 14-day meal plan — designed for GLP-1 users at every dose level.

Related: Mounjaro Dose Guide UK | Mounjaro vs Wegovy UK | Best Supplements on GLP-1 UK | GLP-1 Side Effects UK | Hair Loss on GLP-1 UK | How to Maximise GLP-1 Weight Loss UK

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