At a glance
- Wegovy has one maintenance dose: 2.4mg once weekly, reached over 16 weeks.
- The escalation is 0.25 to 0.5 to 1.0 to 1.7 to 2.4mg, each step held about 4 weeks.
- The low starting doses are for tolerance, not weight loss. They let your gut adapt.
- STEP-1 showed roughly 15% mean weight loss at 68 weeks on 2.4mg (Wilding et al. 2021).
- If 2.4mg is intolerable, the label allows a temporary drop to 1.7mg for up to 4 weeks.
Wegovy has one target dose: 2.4mg once weekly. Getting there takes about 16 weeks and four step-ups, and skipping ahead is the fastest route to a week you spend near the bathroom. The titration is not bureaucracy. It is the entire tolerability strategy.
Wegovy is the obesity brand of semaglutide (Ozempic is the same molecule approved for type 2 diabetes). For the research-compound version, see the semaglutide guide and the semaglutide dosage chart. This page covers the FDA-approved brand schedule.
The Wegovy escalation schedule
Per the FDA label, Wegovy is titrated on a fixed monthly ladder.
| Weeks | Dose (once weekly) | Purpose |
|---|---|---|
| 1 to 4 | 0.25 mg | Initiation. Not a treatment dose. |
| 5 to 8 | 0.5 mg | Escalation |
| 9 to 12 | 1.0 mg | Escalation |
| 13 to 16 | 1.7 mg | Escalation |
| 17 and on | 2.4 mg | Maintenance |
Why 16 weeks
Semaglutide slows gastric emptying, which is a large part of why it curbs appetite and also why it causes nausea. Ramping the dose slowly gives the gut time to adapt at each level before the next increase. The starting 0.25mg dose is explicitly not intended to produce weight loss. It is there to build tolerance.
Warning: Rushing the ladder does not speed up results, it just concentrates the side effects. Nausea, diarrhea, and vomiting cluster during escalation and ease at a steady dose.
What if you cannot tolerate 2.4mg
The label builds in an escape hatch. If the 2.4mg maintenance dose is not tolerated, it can be temporarily reduced to 1.7mg once weekly for up to 4 weeks, then increased back to 2.4mg. If a step during escalation is rough, delaying that step for another 4 weeks is also allowed. The point is to reach 2.4mg eventually, not on a rigid calendar.
What the trial data showed
In the STEP-1 trial, adults on semaglutide 2.4mg lost roughly 15% of body weight on average at 68 weeks, versus about 2.4% on placebo (Wilding et al. 2021). The effect depends on staying on the drug: a STEP-1 extension found participants regained about two-thirds of their lost weight in the year after stopping (Wilding et al. 2022). GLP-1 therapy is a maintenance treatment, not a course you complete.
Wegovy versus the alternatives
Wegovy (semaglutide) tops out at about 15% weight loss. Tirzepatide, sold as Zepbound, reached 16% to 22.5% in its trial, which is why many people compare the two. Cost is the other axis: brand Wegovy is expensive, and compounded semaglutide through telehealth runs far less. Our cheapest GLP-1 options and compounded semaglutide pages lay out the price ladder.
Bottom line: Wegovy is a 16-week climb to a single 2.4mg maintenance dose. Hold each step about 4 weeks, use the 1.7mg fallback if 2.4mg is rough, and expect the results to depend on staying on it. A telehealth clinician sets and adjusts your actual dose. Compare access options in our GLP-1 hub.
This article is for educational purposes only and is not medical advice. Wegovy is an FDA-approved prescription medication. The schedule above is the published label titration for reference; your clinician determines your dose. Consult a licensed provider before starting or changing any GLP-1 medication.
