Wegovy dose chart (full titration)
| Week | Dose | Purpose | Mean weight loss (STEP-1) |
|---|---|---|---|
| 1-4 | 0.25mg | Titration only | n/a (subtherapeutic) |
| 5-8 | 0.5mg | Maintenance option | ~5% at 68 weeks |
| 9-12 | 1mg | Common maintenance | ~10% at 68 weeks |
| 13-16 | 1.7mg | Higher response | ~14% at 68 weeks |
| 17+ | 2.4mg | Maximum maintenance | ~15% at 68 weeks |
The standard titration schedule
- Weeks 1-4: 0.25mg weekly. Subtherapeutic starter dose. Acclimates body to GLP-1 receptor activation, minimizes side effects at higher doses.
- Weeks 5-8: 0.5mg weekly. First therapeutic threshold. Mild appetite suppression begins. Some patients see 2-3% weight loss by week 8.
- Weeks 9-12: 1mg weekly. Common long-term maintenance dose for patients who achieve adequate response. Mean ~10% weight loss at 68 weeks if maintained.
- Weeks 13-16: 1.7mg weekly. Higher response for patients who need more. Mean ~14% weight loss at 68 weeks.
- Week 17+: 2.4mg weekly (maintenance). Maximum FDA-approved dose. Mean ~15% weight loss at 68 weeks. Most patients reach this dose if they tolerate the titration.
The 4-week interval between dose increases is a minimum. Many patients benefit from longer titration (extended 6-8 weeks at each level) to minimize side effects. Discuss slower titration with your prescriber if you struggle with the standard schedule.
Where to inject Wegovy
Three approved subcutaneous injection sites:
- Abdomen: At least 2 inches from the navel. Most-used site for self-administered injection because of accessibility. Rotate around the abdomen across weeks (not the same exact spot).
- Front of thigh: Mid-thigh, front-outer area. Good alternative when abdomen is irritated.
- Back of upper arm: Requires assistance from another person or a dexterity-friendly position. Less commonly used but FDA-approved.
Rotate injection sites weekly to prevent injection-site reactions. A typical rotation: week 1 right abdomen, week 2 left abdomen, week 3 right thigh, week 4 left thigh, then repeat.
How to inject Wegovy (pen format)
- Remove the pen from the refrigerator 30 minutes before injection (lets it warm to room temperature)
- Wash hands and clean the injection site with an alcohol pad
- Twist off the pen cap (do not put it back on after removing)
- Place the pen yellow-end-down flat against the chosen injection site
- Press the pen down firmly until you hear a click — this starts the auto-injection
- Hold for 6 seconds (count slowly) — you'll see the dose indicator turn yellow when complete
- Lift the pen straight up away from the skin
- Dispose of the used pen in your sharps container
- Apply mild pressure to the injection site if there's slight bleeding (rare)
What dose of Wegovy is most effective?
The STEP-1 trial (NEJM 2021) measured weight loss at the standard maintenance dose (2.4mg) over 68 weeks: mean weight reduction ~15% from baseline. The escalating-dose analysis showed:
- 0.5mg: ~5% mean weight loss at 68 weeks
- 1mg: ~10% mean weight loss at 68 weeks
- 1.7mg: ~14% mean weight loss at 68 weeks
- 2.4mg: ~15% mean weight loss at 68 weeks
The diminishing returns from 1.7mg → 2.4mg (1 percentage point for a 41% dose increase) mean some patients land at 1.7mg as their long-term maintenance dose. The right dose balances weight loss against side-effect tolerability — there is no universally optimal dose.
FAQ
What is the standard Wegovy dosing schedule?
Wegovy starts at 0.25mg weekly for 4 weeks (titration only — not therapeutic), then increases every 4 weeks: 0.5mg → 1mg → 1.7mg → 2.4mg (maintenance). Full titration to maintenance takes 17 weeks. The 2.4mg maintenance dose is the dose at which the SUSTAIN/STEP trials demonstrated maximum weight loss (~15% mean reduction at 68 weeks).
What is the highest dose of Wegovy?
The maximum FDA-approved Wegovy dose is 2.4mg weekly, reached at week 17 in the standard titration. Some patients are maintained at lower doses (1.7mg or 1mg) if they achieve adequate weight loss without escalating to 2.4mg, or if they don't tolerate the higher dose. There is no FDA-approved dose above 2.4mg for Wegovy.
At what dose does Wegovy start working?
Mild appetite suppression typically begins at the 0.5mg dose (week 5-8). Meaningful weight loss (1-3% from baseline) is typical by the 1mg dose (week 9-12). Significant weight loss accelerates at 1.7mg and 2.4mg. The full therapeutic effect requires 16-24 weeks at the 2.4mg maintenance dose. Patients expecting rapid results in the first month often miss that the early doses are titration-only.
Can I stay on a low dose of Wegovy?
Yes, if you achieve and maintain your weight-loss goals at a lower dose (1mg or 1.7mg). Some patients tolerate the lower doses better and achieve adequate response. The maintenance dose is individualized based on response and tolerability. Lower-dose maintenance often produces less weight loss than the 2.4mg dose but with fewer side effects.
Do you lose more weight on a higher dose of Wegovy?
Generally yes, with diminishing returns. SUSTAIN trial data showed mean weight loss at 68 weeks: ~10% at 1mg, ~14% at 1.7mg, ~15% at 2.4mg. The jump from 1mg to 1.7mg adds ~4 percentage points; the jump from 1.7mg to 2.4mg adds only ~1 percentage point. Many patients land at 1.7mg as their long-term maintenance dose because the additional benefit of 2.4mg doesn't justify the additional side-effect burden.
Where do I inject Wegovy?
Three approved subcutaneous injection sites: abdomen (at least 2 inches from the navel), front of thigh, or back of upper arm. Rotate sites weekly to prevent injection-site reactions. The Wegovy pen format injects subcutaneously (just under the skin) — not into muscle. The pen is single-use and disposable.
Do you lose weight on the maintenance dose of Wegovy?
Yes — the maintenance dose (2.4mg or whatever lower dose you've stabilized on) continues to support weight loss for as long as you remain on it. Mean weight loss continues for up to 68 weeks before plateauing. After plateau, the maintenance dose maintains the lost weight. Discontinuing Wegovy typically results in significant weight regain (the SELECT trial showed about 2/3 of lost weight regained within 1 year of discontinuation).
Bottom line on Wegovy dosing
Standard titration moves from 0.25mg through 2.4mg in 5 dose steps every 4 weeks. Most patients land at 1mg, 1.7mg, or 2.4mg as their long-term maintenance dose. The right dose balances weight-loss response against side-effect tolerability. Slower titration is reasonable if standard pace is too aggressive.
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