There is no fixed course for Wegovy (semaglutide). The UK licence covers weight management, including weight loss and weight maintenance. [1] It sets no end date for adults. [1]
The licence sets one review point instead. If you have not lost at least 5% of your starting weight after 6 months, the licence requires a decision on whether to continue. [1] Stopping is a decision to make with your clinician: the leaflet says do not stop using this medicine without talking to your doctor. [2]
A licence is a medicine’s UK approval. Its rules sit in the Summary of Product Characteristics (SmPC), the document the regulator approves for each medicine. The regulator is the Medicines and Healthcare products Regulatory Agency (MHRA).
This article sets out what the licence says about maintenance, pausing and stopping. It also sets out what the trials show about weight after stopping, and what the NHS position adds.
What does the licence say about how long you stay on treatment?
The licence sets no maximum duration for adults. [1] Its licensed use names weight maintenance as part of treatment, alongside weight loss. [1] The only time-based decision point on continuing is the review at 6 months. [1]
Wegovy is licensed as an addition to a reduced-calorie diet and increased physical activity. [1] It is for adults with a body mass index (BMI) of 30 or more. [1] It also covers a BMI of 27 to under 30 with at least one weight-related condition. [1]
BMI is your weight against your height.
What is the 6-month review?
The rule applies if you have been unable to lose at least 5% of your initial body weight after 6 months on treatment. [1] A decision is then required on whether to continue. [1] The licence says that decision weighs the benefit and risk for you as an individual. [1]
The trial behind the rule gives some context. In the STEP 1 trial, 89.8% of people on semaglutide had lost 5% or more after about 6 months. [1] Of those who had not, 40.5% went on to lose 5% or more by week 68. [1]
Average trial results are not a prediction of individual results.
Outside that review, the leaflet says your doctor will assess your treatment on a regular basis. [2] How long you continue is a clinical decision made at those reviews.
What is a maintenance dose?
A maintenance dose is the dose you stay on once the build-up is complete. For Wegovy it is 2.4 mg once a week, reached over 16 weeks from a 0.25 mg starting dose. [1] The name describes a dose level, not a length of treatment.
The licence also allows a higher 7.2 mg weekly dose for adults with obesity if needed. [1] It comes after at least 4 weeks on 2.4 mg. [1]
The leaflet calls 7.2 mg the next maintenance dose and the maximum dose. [2] Whether you move to it is your clinician’s decision within those rules.
If gastrointestinal symptoms are significant, the licence says to consider delaying a dose increase or lowering to the previous dose until they improve. [1] The week-by-week article sets out the dose steps in full.
What does the NHS position add?
On the NHS, NICE recommends semaglutide only for a maximum of 2 years within a specialist weight management service. [3] NICE is the National Institute for Health and Care Excellence, whose recommendations the NHS must fund. The 2-year limit is an NHS funding and service condition, not part of the licence. [3] [1]
NICE’s criteria are narrower than the licence. They require at least one weight-related condition and a BMI of 35 or more. [3] A BMI of 30 to 34.9 qualifies where the NHS referral criteria are met, with lower thresholds for some family backgrounds. [3]
NICE also says to consider stopping if less than 5% of the initial weight has been lost after 6 months of treatment. [3] That is the same threshold as the licence’s review. [1] For private treatment, the licence and your clinician’s regular review apply. [1] [2]
What do the longest trials show about continued treatment?
In the longest trials, weight loss levelled off after 65 to 68 weeks and was sustained for up to 4 years. [1] [4] In the 2-year STEP 5 trial, mean weight fell through week 68 and then reached a plateau. [1] At 104 weeks mean weight was down 15.2% on semaglutide and 2.6% on placebo, counting everyone randomised. [1]
A placebo is an injection with no active medicine. Counting everyone randomised means the figure includes people who stopped the trial treatment early.
The SELECT trial followed 17,604 adults with established cardiovascular disease for a median of 41.8 months. [1] That means a prior heart attack, a stroke or peripheral arterial disease (narrowed arteries in the legs). [1] Weight loss continued over 65 weeks and was sustained for up to 4 years. [4]
It was 72% men, all aged 45 or over. [1] At 208 weeks mean weight was down 10.2% on semaglutide and 1.5% on placebo, counting everyone randomised. [4] That population had cardiovascular disease and no diabetes, so it is not the general weight-management population. [4]
Average trial results are not a prediction of individual results.
What happens to your weight when you stop?
In the trials, most of the lost weight returned within a year of stopping. [5] [6] [7] In the STEP 4 trial, people who switched to placebo regained 6.9% of their body weight over 48 weeks. [5] In the STEP 1 extension, people regained about two thirds of their loss in the year after treatment ended. [6]
A 2026 review of 37 studies put regain after semaglutide or tirzepatide (Mounjaro) at about 0.8 kg a month. [7] Results varied widely between people. [6] [7]
| Study | Design | After stopping |
|---|---|---|
| STEP 4 (2021) | 803 people continued or switched to placebo after 20 weeks on semaglutide; diet and activity support continued in both groups. [5] | The placebo group regained 6.9% of body weight over 48 weeks, counting everyone randomised. The continued group lost a further 7.9%. [1] [5] |
| STEP 1 extension (2022) | 327 people followed for a year after 68 weeks of semaglutide or placebo; the medicine and the lifestyle support both stopped. [6] | Semaglutide arm (228 people): about two thirds of a 17.3% loss regained. Net loss 5.6% of starting weight at week 120. [6] |
| BMJ review (2026) | 37 studies, 9,341 participants, several weight-management medicines. [7] | 0.8 kg a month after semaglutide or tirzepatide. Projected return to starting weight at about 1.5 years. [7] |
What the STEP 4 trial found
STEP 4 was designed to answer this question: all 902 participants took semaglutide for 20 weeks. [5] The 803 who reached 2.4 mg had lost a mean of 10.6%. [5] They were randomised: 535 continued and 268 switched to placebo. [5]
Both groups kept the diet and physical activity programme. [5] Over the next 48 weeks the continued group lost a further 7.9%. [5] The placebo group regained 6.9% of its body weight, counting everyone randomised. [1] [5]
Even so, the placebo group’s observed mean weight at week 68 was still below its level at the start of the trial. [1] The trial was 79% women. [5]
What happened a year after a longer course
The STEP 1 extension followed 327 people for a year after 68 weeks of treatment ended. [6] Diet and activity support stopped at the same time. [6] On semaglutide, mean loss at week 68 was 17.3%. [6]
By week 120 the group had regained 11.6 percentage points, a net loss of 5.6% from the start. [6] A percentage point is the gap between two percentages: 17.3% lost minus 11.6 points regained leaves 5.6%.
Blood pressure returned to its starting level. [6] Most other cardiometabolic measures moved back towards where they began. [6] Cardiometabolic measures are markers such as blood pressure, blood sugar and cholesterol.
Results varied. At week 120, 48.2% of the semaglutide group were still 5% or more below their starting weight. [6] People who had lost 20% or more during treatment regained the most, but kept the most: a net 12.1% below their starting weight. [6]
The extension group was 67% women. [6] The extension was exploratory. It reported the weights actually observed and ran no formal statistical tests. [6]
The manufacturer employed some of the authors and funded its medical writing. [6]
What a 2026 review of 37 studies found
A systematic review pools the results of many trials. One appeared in the medical journal the BMJ in January 2026. It pooled 37 studies with 9,341 participants across weight-management medicines. [7]
After semaglutide or tirzepatide, regain ran at 0.8 kg a month. [7] The review estimated 9.9 kg regained in the first year. [7]
The authors projected a return to starting weight about 1.5 years after stopping. [7] Across all the medicines pooled, they projected cardiometabolic markers to return to their starting levels within 1.4 years. [7] Data were insufficient to analyse those markers after semaglutide or tirzepatide. [7]
They also noted that the figures are averages and that a small proportion of people kept their weight off. [7]
The review had only eight studies of the newer medicines, with at most 12 months of follow-up after stopping. [7] The longer figures are projections, not observations. [7]
What happens in the body after the last dose?
Semaglutide remains in the circulation for approximately 7 weeks after the last 2.4 mg dose. [1] Its half-life is around 1 week. [1] A half-life is the time for the blood level to fall by half.
Semaglutide is similar to glucagon-like peptide-1 (GLP-1), a natural hormone released from the gut after a meal. [2] GLP-1 is a physiological regulator of appetite and calorie intake, with receptors in several areas of the brain. [1] The leaflet says the medicine makes you feel fuller and less hungry. [2]
The BMJ review found that stopping weight-management medicines was followed by what its authors call rapid weight regain. [7] Its authors say these medicines work by reducing hunger and increasing satiety, so conscious diet and activity effort is the only recourse after stopping. [7] They describe obesity as a chronic and relapsing condition. [7]
Do diet and exercise changes stop the weight coming back?
Not on average, in the trials so far. In STEP 4 the placebo group kept its diet and activity programme throughout and still regained 6.9% of its body weight. [1] [5] The BMJ review found no evidence that behavioural support after stopping changed the rate of regain. [7]
The review also found that people who lost more during treatment tended to regain faster. [7] It did not find that more support during treatment slowed regain afterwards. [7]
What one exercise trial found
One Danish trial points the other way, with limits. After an 8-week diet that cut a mean of 13.1 kg, people were allocated to one of four groups for a year. [8]
- a different GLP-1 medicine
- supervised exercise
- both together
- placebo
Treatment and exercise then stopped for a year. [8] Regain over that year was 6.0 kg larger after the medicine alone than after supervised exercise. [8] People who had done both ended 5.1 kg lower than the medicine-alone group. [8]
The limits matter. Only 109 people attended the follow-up, and they had responded better than those who did not attend. [8] The exercise was four monitored sessions a week, two of them supervised vigorous group sessions. [8]
The combination group’s advantage did not meet the trial’s pre-set statistical threshold. [8] The trial used a different medicine, so the finding does not transfer directly to semaglutide. Average trial results are not a prediction of individual results.
So structured exercise may blunt regain. [8] It has not been shown to prevent it. The plateau article covers what helps when weight loss stalls.
Can you pause treatment and restart later?
The licence covers missed doses, not planned breaks. A missed dose is taken within 5 days. [1] [2] After 5 days it is skipped and the next dose is taken on the usual day. [1] [2]
Never take a double dose to make up for a missed one. [2] If more doses are missed, the licence says a lower starting dose should be considered when restarting. [1] It gives no number of missed doses for that rule. [1]
The licence also allows the injection day to change, as long as at least 3 days have passed since the last dose. [1]
No trial in this article tested planned breaks. The BMJ review lists intermittent treatment as a question for further research, not a finding. [7] The MHRA says to talk to your prescriber before making any change to your treatment. [9]
Whether a pause is right for you is a decision for your clinician. So is how you restart.
Do you have to stop before surgery or sedation?
Not as a rule. The licence does not instruct stopping before a procedure. [1]
The medicine delays stomach emptying. [1] So the licence says to consider the increased risk of food or drink remaining in the stomach before general anaesthesia or deep sedation. [1]
Cases of pulmonary aspiration have been reported in people on GLP-1 receptor agonists under general anaesthesia or deep sedation. [1] A GLP-1 receptor agonist is a medicine that acts like GLP-1, the gut hormone described above. Aspiration means stomach contents entering the airways and lungs. [9]
The leaflet says to tell your doctor if you are due to have surgery under anaesthesia. [2] The MHRA says to inform your healthcare team and the anaesthetist before the procedure. [9] Pre-procedure instructions and the anaesthetic technique may need to change. [9]
The MHRA’s advice is to continue your prescribed medicine as usual and not to stop without first discussing it with your doctor. [9]
When does the licence say treatment must stop?
For men, the licence names two situations where semaglutide is stopped: suspected pancreatitis and a confirmed eye condition called NAION. If pancreatitis is suspected, semaglutide is discontinued. [1] If the diagnosis is confirmed, it is not restarted. [1]
Pancreatitis is inflammation of the pancreas. The leaflet says to stop the medicine and seek urgent help for severe and persistent pain in the stomach area. [2] That can be a sign of acute pancreatitis. [2]
Sudden loss of vision needs urgent referral for an eye examination. [1] That includes partial loss of vision. [1]
Treatment is discontinued if a condition called NAION is confirmed. [1] NAION stands for non-arteritic anterior ischaemic optic neuropathy, a condition of the optic nerve.
These are safety rules set by the licence. Everything else about stopping is a decision between you and your clinician. [2]
How does HeMed fit in?
HeMed starts with a blood test. We measure 10 metabolic markers across four systems from a needle-free blood test at home.
A clinician reviews your blood test first. If they approve treatment, we deliver it the next working day, discreetly packaged, with delivery included in your plan.
Your dose moves on how you are doing, not on a calendar. If side effects are still settling on a lower dose, your clinician can hold that dose before any increase, as the licence allows. [1] No step comes sooner than the licence minimum of 4 weeks. [1]
A weekly in-app check-in, reviewed by clinicians, so your plan can be adjusted when it needs to be. A retest every 6 months shows what’s actually changing.
Wegovy is a prescription medicine for weight management. Whether it’s right for you is a clinical decision, made from your health information and your baseline blood test.
Frequently asked questions
Is there a maximum time you can stay on treatment?
The licence sets no maximum duration for adults. It requires a decision on whether to continue if you have not lost at least 5% of your starting weight after 6 months.
On the NHS, NICE limits semaglutide to a maximum of 2 years within a specialist weight management service. That is a funding condition, not part of the licence.
How much weight comes back after stopping?
In the STEP 1 extension, people regained about two thirds of their lost weight in the year after treatment ended. In the STEP 4 trial the group that switched to placebo regained 6.9% of its body weight over 48 weeks, counting everyone randomised. Diet and activity support continued throughout.
Results vary widely. In the STEP 1 extension, 48.2% of the semaglutide group were still 5% or more below their starting weight a year after stopping. Average trial results are not a prediction of individual results.
Can you take a break and restart later?
A missed dose is taken within 5 days. After 5 days it is skipped. If more doses are missed, a lower starting dose should be considered when restarting.
No trial in this article tested planned breaks. Talk to your clinician before any change to your treatment.
Do you have to stop before an operation?
The licence does not say to stop. It says the risk of food or drink remaining in the stomach should be considered before general anaesthesia or deep sedation.
Tell your healthcare team and the anaesthetist that you take the medicine. The MHRA’s advice is to continue as prescribed and not to stop without first discussing it with your doctor.
Does exercise stop the weight coming back?
Not in the trials on average. In STEP 4 the placebo group kept its diet and activity programme and still regained weight. A 2026 review found no evidence that support after stopping slowed regain.
One Danish trial of a different GLP-1 medicine found less regain after supervised exercise. It was small, and the combination group’s advantage did not meet the pre-set statistical threshold.
Does the dose change once you reach maintenance?
The maintenance dose is 2.4 mg once a week, reached over 16 weeks from a 0.25 mg starting dose.
A 7.2 mg dose exists for adults with obesity if needed. It comes after at least 4 weeks on 2.4 mg. The leaflet calls it the next maintenance dose and the maximum dose.
Should you stop once you reach your target weight?
The licence sets no weight at which treatment ends. Its licensed use names weight maintenance alongside weight loss.
In the trials, weight regain followed stopping on average whether diet and activity support continued or stopped. Results varied between people. What happens next is a decision to make with your clinician at your regular review.
HeMed provides clinician-led weight management. Treatment is prescription-only and is prescribed only where a clinician decides it is suitable. This page is general health information, not medical advice. If you are worried about symptoms, speak to your GP, or use NHS 111.
Next step: see what the HeMed blood test measures.
Sources (9)
- Novo Nordisk, Wegovy FlexTouch (semaglutide) Summary of Product Characteristics, sections 4.1, 4.2, 4.4, 5.1 and 5.2 (text revised September 2026). electronic medicines compendium. medicines.org.uk/emc/product/13800/smpc. Accessed 23 October 2026.
- Novo Nordisk, Wegovy FlexTouch Patient Information Leaflet, sections 1 to 4 (last revised August 2026). electronic medicines compendium. medicines.org.uk/emc/product/13800/pil. Accessed 23 October 2026.
- NICE, “Semaglutide for managing overweight and obesity”, technology appraisal guidance TA875, section 1 Recommendations (published 8 March 2023, last updated 4 September 2023). nice.org.uk/guidance/ta875. Accessed 23 October 2026.
- Ryan DH et al., “Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial”, Nature Medicine 2024;30(7):2049 to 2057. doi.org/10.1038/s41591-024-02996-7. Accessed 23 October 2026.
- Rubino D et al., “Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial”, JAMA 2021;325(14):1414 to 1425 (abstract; full text paywalled). doi.org/10.1001/jama.2021.3224. Accessed 23 October 2026.
- Wilding JPH et al., “Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension”, Diabetes, Obesity and Metabolism 2022;24(8):1553 to 1564. doi.org/10.1111/dom.14725. Accessed 23 October 2026.
- West S et al., “Weight regain after cessation of medication for weight management: systematic review and meta-analysis”, BMJ 2026;392:e085304 (published 7 January 2026). doi.org/10.1136/bmj-2025-085304. Accessed 23 October 2026.
- Jensen SBK et al., “Healthy weight loss maintenance with exercise, GLP-1 receptor agonist, or both combined followed by one year without treatment: a post-treatment analysis of a randomised placebo-controlled trial”, EClinicalMedicine 2024;69:102475. doi.org/10.1016/j.eclinm.2024.102475. Accessed 23 October 2026.
- MHRA, “GLP-1 medicines for weight loss and diabetes: what you need to know”, updated 5 February 2026. gov.uk/government/publications. Accessed 23 October 2026.
Numbered markers in the page text link to these entries. Statistics describe populations, not any one person’s results.