Wegovy Dosage Chart: Complete Titration Schedule & Guide
FDA-approved Wegovy titration schedule (0.25mg → 2.4mg), monthly dose increases, weight loss results at each dose, clinical trial data, managing side effects during titration, and when to pause dose escalation.
Quick Dosing Reference
Wegovy follows a 5-step titration schedule, increasing monthly:
- Month 1: 0.25mg weekly (starting dose)
- Month 2: 0.5mg weekly
- Month 3: 1mg weekly
- Month 4: 1.7mg weekly
- Month 5+: 2.4mg weekly (maintenance dose)
Most people reach the 2.4mg maintenance dose by week 17 (month 5).
Complete Wegovy Dosage Chart
This is the FDA-approved titration schedule for Wegovy (semaglutide for weight loss):
| Dose Level | Weekly Dose | Timeline | Average Weight Loss | Purpose |
|---|---|---|---|---|
| STARTING DOSE | 0.25mg | Weeks 1-4 | 1-3% body weight | Minimize side effects, assess tolerance |
| DOSE 2 | 0.5mg | Weeks 5-8 | 4-6% body weight | First therapeutic dose, appetite reduction begins |
| DOSE 3 | 1mg | Weeks 9-12 | 7-9% body weight | Significant appetite suppression, steady weight loss |
| DOSE 4 | 1.7mg | Weeks 13-16 | 10-13% body weight | Strong weight loss effects, approaching maintenance |
| MAINTENANCE DOSE | 2.4mg | Week 17+ | 15-18% body weight | Maximum FDA-approved dose for weight loss |
IMPORTANT NOTES:
- Monthly increases: Each dose level lasts 4 weeks before increasing
- Don't skip steps: Must go through each dose level—no jumping ahead
- Can stay longer: Okay to stay at any dose longer than 4 weeks if needed
- 2.4mg is standard: Unlike Ozempic (which goes to 2mg), Wegovy's therapeutic dose is 2.4mg
- Weight loss is cumulative: Percentages shown are total from treatment start
What to Expect at Each Dose Level
Here's what most people experience at each dose of Wegovy:
Weeks 1-4: Initial Adjustment Period
Expected Effects:
- Minimal appetite reduction (this is a very low dose)
- Slight decrease in hunger between meals
- 1-3% weight loss over first month (2-6 lbs for someone starting at 200 lbs)
- Body is adjusting to the medication
Common Side Effects:
- Mild nausea (usually days 1-2 after injection)
- Decreased appetite
- Mild bloating or gas
- Fatigue (first week or two)
WHAT TO DO:
- Start establishing good habits (protein-first meals, hydration)
- Track your food to understand current eating patterns
- Stay hydrated (80-100oz water daily)
- Note your side effects to discuss with provider
Weeks 5-8: Appetite Suppression Begins
Expected Effects:
- Noticeable appetite reduction
- Less frequent thoughts about food
- 4-6% cumulative weight loss (8-12 lbs from start for 200 lb person)
- Getting full faster during meals
Common Side Effects:
- Nausea (may increase with dose increase, then improve)
- Occasional heartburn or acid reflux
- Constipation or diarrhea
- Fatigue
- Bloating
WHAT TO DO:
- Focus on protein (aim for 80-100g daily)
- Eat 3 small meals daily even if not hungry
- Avoid high-fat, greasy foods that worsen nausea
- Consider anti-nausea strategies (ginger tea, smaller meals)
Weeks 9-12: Significant Weight Loss Phase
Expected Effects:
- Strong appetite suppression
- 7-9% cumulative weight loss (14-18 lbs from start)
- Steady weight loss of 1-2 lbs per week
- Changes in food preferences (less interest in heavy foods)
- Some people can maintain at this dose long-term
Common Side Effects:
- Nausea typically improving by now
- Constipation (increasingly common)
- Fatigue (especially if not eating enough)
- Occasional dizziness
WHAT TO DO:
- Track calories to ensure minimum 1,200-1,500 daily
- Address constipation proactively (fiber, water, magnesium)
- Consider protein shakes if struggling to eat enough
- Start or continue strength training to preserve muscle
Weeks 13-16: Approaching Maximum Dose
Expected Effects:
- Very strong appetite control
- 10-13% cumulative weight loss (20-26 lbs from start)
- May need reminders to eat
- Weight loss continues steadily
Common Side Effects:
- Most side effects have stabilized
- Constipation (requires management)
- Risk of eating too few calories
- Occasional nausea (less common than earlier doses)
DECISION POINT:
Increase to 2.4mg if: Tolerating well and want maximum weight loss results.
Stay at 1.7mg if: Achieving good results, side effects are concerning, or prefer a lower maintenance dose.
Week 17+: Maximum FDA-Approved Dose
Expected Effects:
- Maximum appetite suppression
- 15-18% average weight loss at 68 weeks (clinical trials)
- 30-36 lbs lost for someone starting at 200 lbs
- This is the standard maintenance dose for Wegovy
- Weight loss continues for 12-18 months before plateauing
Common Side Effects:
- Similar to 1.7mg (body is adjusted)
- Constipation (ongoing management needed)
- Need to be vigilant about adequate nutrition
LONG-TERM MAINTENANCE:
- Stay at 2.4mg for continued weight loss and maintenance
- Focus on building sustainable habits (nutrition, exercise)
- Monitor for nutritional deficiencies (get regular bloodwork)
- Plan to stay on medication long-term (most people regain weight if stopped)
Weight Loss Results from Clinical Trials
Data from the STEP clinical trial program (over 4,500 participants):
STEP 1 Trial: Weight Loss at 2.4mg (68 weeks)
| Outcome | Wegovy 2.4mg | Placebo |
|---|---|---|
| Average Weight Loss | 14.9% | 2.4% |
| Lost 5%+ of Body Weight | 86.4% | 31.5% |
| Lost 10%+ of Body Weight | 69.1% | 12.0% |
| Lost 15%+ of Body Weight | 50.5% | 4.9% |
| Lost 20%+ of Body Weight | 32.0% | 1.7% |
Weight Loss by Time (Average Patient)
| Time Point | Cumulative Weight Loss | Example (Starting 200 lbs) |
|---|---|---|
| Week 20 (Month 5) | ~10% body weight | 20 lbs lost (180 lbs) |
| Week 40 (Month 10) | ~13% body weight | 26 lbs lost (174 lbs) |
| Week 68 (Month 17) | ~15% body weight | 30 lbs lost (170 lbs) |
Key Clinical Findings:
- Weight loss is gradual: Most weight loss occurs in first 60 weeks
- Highly effective: 86% of people lose clinically meaningful weight (5%+)
- Individual variation: Results range from 5% to 25%+ weight loss
- Health improvements: Significant reductions in blood pressure, blood sugar, and cholesterol
- Long-term use required: Weight typically returns when medication is stopped
When to Pause Dose Escalation
Not everyone should increase on schedule. Here's when to stay at your current dose:
PAUSE INCREASING IF:
- Severe nausea or vomiting: If you can't keep down food/water for 24+ hours
- Excessive fatigue: Feeling too tired to perform daily activities
- Eating too little: Consistently below 1,000 calories daily
- Concerning symptoms: Severe abdominal pain, rapid heartbeat, severe dizziness
- Recent illness: Stomach bug, food poisoning, or other acute illness
- Significant stress: Major life events making medication management difficult
CONSIDER PAUSING IF:
- Side effects haven't improved: After 2+ weeks at current dose
- Losing weight very rapidly: More than 2-3 lbs per week consistently
- Close to goal weight: May not need higher dose if nearing target
- Planning surgery or procedure: May need to pause during recovery
- Pregnancy or breastfeeding: Stop medication immediately
OKAY TO INCREASE IF:
- You've been at current dose for 4+ weeks
- Side effects are mild or resolved
- You're tolerating the medication well
- Eating adequate calories (1,200+ daily)
- Still have significant weight to lose
- Your provider agrees it's appropriate
IMPORTANT:
It's perfectly fine to stay at 0.5mg, 1mg, or 1.7mg long-term if you're getting good results and don't want higher doses. Not everyone needs to reach 2.4mg. Work with your provider to find your optimal dose.
Managing Side Effects During Titration
Side effects are most common when starting Wegovy and with each dose increase:
Nausea (Most Common)
40-44% of people experience nausea, especially in first weeks at new dose.
Strategies That Help:
- Eat smaller, more frequent meals (5-6 mini-meals vs 3 large)
- Avoid greasy, fatty, fried, or spicy foods
- Eat bland, easy-to-digest foods (crackers, rice, bananas, toast)
- Ginger (tea, chews, supplements)
- Don't lie down for 2-3 hours after eating
- Inject at bedtime (sleep through worst nausea)
- Ask doctor about anti-nausea medication (ondansetron/Zofran)
Diarrhea or Constipation
Diarrhea affects 30%, constipation affects 24% of Wegovy users.
For Diarrhea:
- Reduce dietary fat (especially greasy/fried foods)
- Stay hydrated with electrolytes
- Eat smaller meals
- Consider probiotic supplement
For Constipation:
- Drink 80-100oz water daily (critical)
- Fiber supplement (Metamucil, start low and increase slowly)
- Stool softener (Colace) daily
- Magnesium supplement (400mg at bedtime)
- Regular physical activity
Fatigue & Low Energy
Often caused by eating too few calories or insufficient protein.
Solutions:
- Track food—ensure minimum 1,200 calories daily
- Eat 80-100g protein daily
- Take B12 supplement (500-1,000 mcg)
- Get adequate sleep (7-9 hours)
- Consider multivitamin if not eating variety of foods
WHEN TO CONTACT YOUR DOCTOR:
- Severe abdominal pain (especially upper abdomen)
- Persistent vomiting preventing food/water intake
- Signs of pancreatitis (severe pain radiating to back, fever)
- Signs of gallbladder problems (pain in upper right abdomen after eating)
- Rapid heartbeat or chest pain
- Severe allergic reaction (difficulty breathing, severe rash, swelling)
- Changes in vision
- Signs of thyroid tumor (lump in neck, hoarseness, difficulty swallowing)
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Frequently Asked Questions
Can I skip the lower doses and start at 1mg or 2.4mg?
No. The titration schedule is designed to minimize side effects and allow your body to adjust. Starting at higher doses dramatically increases risk of severe nausea, vomiting, and other side effects. You must start at 0.25mg and increase gradually.
How long do I need to stay on Wegovy?
Wegovy is intended for long-term use. Clinical trials show that most people regain 2/3 of their weight loss within one year of stopping. Plan to stay on maintenance dose indefinitely, or work with your provider on a very slow taper if you want to stop.
What if I miss a dose during titration?
If it's been less than 5 days since your missed dose, take it as soon as you remember. If more than 5 days have passed, skip that dose and take your next scheduled dose. If you've missed 2+ weeks, contact your provider—you may need to drop back to a lower dose.
Can I stay at 1mg or 1.7mg instead of going to 2.4mg?
Yes. If you're achieving good weight loss and tolerating a lower dose well, you can stay there long-term. 2.4mg is the recommended maintenance dose for maximum effect, but some people maintain excellent results at lower doses with fewer side effects.
What's the difference between Wegovy and Ozempic dosing?
Both start at 0.25mg. Ozempic (for diabetes) goes up to 2mg maximum, while Wegovy (for weight loss) goes to 2.4mg. Wegovy's titration schedule is faster (monthly vs every 4+ weeks for Ozempic). The medications are otherwise identical (both semaglutide).
Will side effects get worse with each dose increase?
Typically, side effects (especially nausea) are worst when first starting the medication and with the first dose increase. Most people find that subsequent increases are better tolerated as their body adjusts. Side effects usually improve within 1-2 weeks after each increase.
The Bottom Line
Wegovy follows a 5-dose titration schedule over 17 weeks, starting at 0.25mg and reaching the 2.4mg maintenance dose by month 5.
Key takeaways:
- Increase monthly (every 4 weeks)—don't rush the process
- Average weight loss is 15-18% of body weight at 68 weeks
- Side effects are most common in first weeks and with dose increases
- 2.4mg is the standard maintenance dose, but some people stay at lower doses
- Pause dose escalation if experiencing severe side effects
- Medication is intended for long-term use
Work with your healthcare provider to optimize your titration schedule based on your tolerance, side effects, and weight loss results.