FDA-Approved Wegovy Dosing Schedule

The standard Wegovy titration for weight loss follows a 5-month escalation to 2.4mg weekly. This gradual progression minimizes GI side effects while allowing your body to adapt to semaglutide's appetite-suppressing effects.

What's Happening at Each Wegovy Dose

Understanding the biological mechanisms at each dose helps you know what your body is experiencing and why achieving the full 2.4mg dose produces the most dramatic weight loss.

0.25 mg (Weeks 1-4): Initiation Phase

• GLP-1 receptors: Beginning activation in brain's appetite centers
• Gastric emptying: Slowing by 15-20%
• Appetite: 5-10% reduction in hunger signals
• Weight loss: 1-3 lbs (mostly GI adaptation, not fat loss)
• Purpose: Allows digestive system to adapt before therapeutic dosing

0.5 mg (Weeks 5-8): Weight Loss Begins

• Appetite suppression: 15-25% reduction in caloric intake
• Gastric emptying: Delayed by 30-40%
• Food noise: Noticeable reduction in food-related thoughts
• Satiety: Feeling full faster and staying full longer
• Weight loss: 3-5 lbs over 4 weeks (0.75-1.25 lbs/week)
• Metabolic rate: Slight increase in energy expenditure

1 mg (Weeks 9-12): Moderate Weight Loss

• Appetite suppression: 25-35% reduction in caloric intake
• Weight loss: 5-8% total body weight by week 12
• Insulin sensitivity: Improving significantly
• Inflammatory markers: CRP and other markers declining
• Food preferences: Many patients report less interest in high-fat foods
• Energy levels: Often improving as inflammation decreases

1.7 mg (Weeks 13-16): Enhanced Effects

• Appetite suppression: 35-45% reduction in caloric intake
• Weight loss: 8-12% total body weight by week 16
• Body composition: Preferential loss of visceral (organ) fat
• Metabolic benefits: Blood pressure, lipids, liver enzymes improving
• Food noise: Dramatic reduction for most patients
• Plateau breaking: This dose often pushes past weight loss plateaus

2.4 mg (Weeks 17+): Maximum Weight Loss Dose

• Appetite suppression: Near-maximum suppression for most patients
• Weight loss: 15-20% total body weight over 12 months achievable
• Metabolic optimization: Full spectrum of metabolic health improvements
• Cardiovascular health: Significant reductions in cardiovascular risk factors
• Fat oxidation: Maximum increase in fat burning
• GI side effects: May be more pronounced, but most patients have adapted by this point
• Maintenance: Most patients stay at this dose long-term

Expected Weight Loss Timeline on Wegovy

Clinical trials provide clear benchmarks for expected weight loss at each dose level and timepoint. Individual results vary, but these averages help set realistic expectations.

Individual variation: Some patients lose significantly more (20-25% body weight), while others lose less (10-12%). Factors affecting results include starting weight, diet quality, physical activity, sleep, stress, and metabolic health.

Wegovy Pen Types and Doses

Wegovy comes in single-dose, pre-filled pens. Each pen contains one injection at a specific dose, making it impossible to accidentally inject the wrong amount.

Important: Always check the pen label before injecting to ensure you have the correct dose for your current stage of treatment.

Compounded Semaglutide for Weight Loss

Compounding pharmacies create custom semaglutide formulations that generally follow Wegovy's dosing schedule. Compounded versions cost significantly less than pharmaceutical Wegovy but lack FDA approval and the same manufacturing standards.

See our detailed comparison of semaglutide formulations to understand quality differences between pharmaceutical and compounded versions.

Wegovy vs. Mounjaro/Zepbound for Weight Loss

Both medications are FDA-approved for weight loss, but tirzepatide (Mounjaro/Zepbound) generally produces greater weight loss due to its dual GIP/GLP-1 mechanism.

Wegovy has longer safety data and proven cardiovascular benefits from the SELECT trial. Zepbound shows greater weight loss in head-to-head comparisons but has less long-term data.

See our Mounjaro/Zepbound Dosage Chart for complete tirzepatide dosing information.

Common Wegovy Dosing Questions

Do I have to reach 2.4mg?

No. While 2.4mg produces maximum weight loss, some patients achieve their goals at 1mg or 1.7mg. Your provider may keep you at a lower dose if you're hitting your targets and want to minimize side effects or costs.

Can I stay at 2.4mg indefinitely?

Yes. Wegovy is approved for long-term use. Most patients remain on 2.4mg weekly as a maintenance dose to sustain weight loss. Stopping the medication typically results in weight regain.

What if I can't tolerate 2.4mg?

If 2.4mg causes intolerable side effects, your provider may:

• Keep you at 1.7mg long-term (still highly effective)
• Temporarily drop back to 1.7mg, then retry 2.4mg after 4-8 weeks
• Implement dietary strategies to reduce GI symptoms at 2.4mg

What if I miss a dose?

Within 5 days: Take the missed dose as soon as you remember, then resume your regular weekly schedule.
More than 5 days late: Skip the missed dose and take your next dose on the regularly scheduled day. Do not double up.

How quickly will I lose weight?

Initial phase (0-12 weeks): 1-2 lbs per week average
Mid phase (12-40 weeks): 0.75-1.5 lbs per week average
Maintenance (40+ weeks): Weight stabilizes; focus shifts to maintaining loss

Weight loss is not linear—you'll experience weeks with no loss, then sudden drops. Focus on monthly trends rather than weekly weigh-ins.

Side Effects by Dose Level

GI side effects increase with dose but typically improve after 4-8 weeks at each level as your body adapts. The most challenging transitions are usually 0.5mg and 2.4mg.

Good news: Side effects are most intense during the first 1-2 weeks at each new dose, then improve significantly. By 8-12 weeks at 2.4mg, most patients have minimal symptoms.

The Bottom Line

Wegovy (semaglutide) for weight loss follows a 5-month titration from 0.25mg to 2.4mg weekly, with each dose serving a specific purpose in your weight loss journey.

Key takeaways:

• 0.25mg is initiation only—real weight loss begins at 0.5mg
• 2.4mg is the target maintenance dose for maximum weight loss (15-20% body weight)
• Gradual titration over 5 months minimizes GI side effects
• Weight loss averages 1-2 lbs/week initially, then 0.75-1.5 lbs/week
• Most patients stay on 2.4mg indefinitely to maintain weight loss
• Side effects peak during weeks 1-2 at each new dose, then improve

Ready to start Wegovy? Compare pharmaceutical-grade and compounded semaglutide options in our comprehensive provider reviews.