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Complete guide to Wegovy (semaglutide) dosing including escalation schedule, maintenance doses, weight loss results by dose level, and optimal titration timeline for maximum results.
Wegovy starts at 0.25 mg weekly for 4 weeks, then increases monthly to 0.5 mg, 1 mg, 1.7 mg, and finally 2.4 mg weekly as the maintenance dose. This gradual 5-month titration minimizes side effects while delivering 15-20% average weight loss. The 2.4 mg dose is the FDA-approved maintenance level for maximum efficacy.
Clinical trials show average weight loss of 10-12% at 1.7 mg and 15-17% at the full 2.4 mg dose over 68 weeks. This makes Wegovy one of the most effective weight loss medications available.
| Month | Dose | Injection Volume | Purpose | Expected Weight Loss |
|---|---|---|---|---|
| 1 | 0.25 mg | 0.5 mL | Starting dose - body adaptation | 2-4 lbs total (0.5-1 lbs/week) |
| 2 | 0.5 mg | 0.5 mL | First escalation - build tolerance | 3-6 lbs total (0.75-1.5 lbs/week) |
| 3 | 1 mg | 0.5 mL | Therapeutic dose - noticeable results | 4-8 lbs total (1-2 lbs/week) |
| 4 | 1.7 mg | 0.75 mL | Higher therapeutic - strong effects | 6-10 lbs total (1.5-2.5 lbs/week) |
| 5+ | 2.4 mg | 0.75 mL | Maintenance dose - maximum efficacy | Continued 1.5-2.5 lbs/week until goal |
Lower Maintenance
Mid Maintenance
FDA-Approved Maintenance
Month 1
Initial dose to introduce your body to semaglutide. Very minimal side effects expected. Begin noticing slightly reduced appetite and smaller portion sizes.
Month 2
Doubling the dose. More noticeable appetite suppression. Side effects may temporarily increase but typically resolve within 1-2 weeks.
Month 3
First therapeutic dose with significant appetite suppression. Weight loss becomes more consistent. Many patients notice meaningful results.
Month 4
Strong appetite control and steady weight loss. Results become very noticeable. Some patients maintain at this dose long-term.
Month 5+
FDA-approved maintenance dose for maximum weight loss. Continued steady loss until goal weight achieved, then maintained long-term.
No, you must follow the escalation schedule starting at 0.25 mg. Jumping to 2.4 mg would cause severe nausea, vomiting, and other GI side effects that could be dangerous. The gradual 5-month titration allows your body to adapt to semaglutide while still achieving excellent weight loss results. Studies show the standard schedule delivers 15-17% weight loss - rushing doesn't improve outcomes.
Wegovy and Ozempic both contain semaglutide but have different maximum doses. Wegovy goes up to 2.4 mg for weight loss, while Ozempic maxes out at 2 mg for diabetes (though some providers prescribe 2.4 mg off-label). The escalation schedules are similar but Wegovy's is specifically optimized for weight loss. Wegovy is FDA-approved for chronic weight management, while Ozempic is approved for type 2 diabetes.
The standard protocol is 4 weeks (one month) at each dose level. This monthly escalation gives your body time to adjust and minimizes side effects. However, you can stay at any dose longer if needed - some people remain at 0.5 mg or 1 mg for 8-12 weeks if experiencing good results. Only move to the next dose when you've tolerated the current one well for at least 4 weeks and your provider approves.
While 2.4 mg delivers maximum weight loss (15-17% average), many people achieve satisfactory results at lower doses. Clinical data shows 8-10% weight loss at 1 mg and 10-13% at 1.7 mg - both excellent outcomes. If you experience good weight loss and tolerable side effects at a lower dose, you can maintain there long-term. However, most providers recommend trying to reach 2.4 mg for optimal results unless side effects prevent it.
Yes, if you experience intolerable side effects at a higher dose, you can decrease back to the previous dose level. Many people find 1.7 mg is their ideal long-term maintenance dose rather than 2.4 mg. Work with your provider to find the lowest effective dose that delivers your desired weight loss with manageable side effects. There's no requirement to stay at 2.4 mg if a lower dose works well for you.
Yes, completely different. Wegovy (semaglutide) doses range from 0.25-2.4 mg, while tirzepatide ranges from 2.5-15 mg - but you can't compare them directly because they're different medications. Wegovy escalates monthly over 5 months, while tirzepatide uses 4-week intervals over 5-6 months. Tirzepatide typically produces slightly higher weight loss (20-25% vs 15-20%) due to its dual GIP/GLP-1 mechanism versus semaglutide's single GLP-1 action.
If you miss a dose and it's been less than 2 weeks, take it as soon as you remember and continue your schedule. If it's been more than 2 weeks, don't take the missed dose - instead, take your next dose on the regularly scheduled day. If you've missed multiple doses, you may need to restart at a lower dose to avoid severe side effects. Always consult your provider about missed doses during titration.
Most people notice reduced appetite within days of their first injection and begin losing weight within 1-2 weeks. Weight loss starts slowly at 0.25-0.5 mg (0.5-1.5 lbs/week) and accelerates as you reach higher doses (1.5-2.5 lbs/week at 2.4 mg). The most rapid weight loss typically occurs during months 3-9, then continues at a slower pace. Average total weight loss is 15-17% of starting body weight over 68 weeks on the 2.4 mg maintenance dose.
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