Wegovy injection for men: what to expect week by week, from the starting dose to maintenance

Wegovy (semaglutide) starts at 0.25 mg once a week. The dose rises every 4 weeks through 0.5 mg, 1 mg and 1.7 mg. It reaches the 2.4 mg maintenance dose from week 17. [1]

Side effects are most common while the dose is rising and usually ease with time. That pattern is expected. A higher 7.2 mg maintenance dose exists for adults with obesity who need it. The earliest point is week 21. [1]

This article sets out what the UK licence, the STEP trials and the medicines regulator say about each stage. It is a reference for men starting the injection, so you can read your own experience against what the evidence calls normal. For the results at each stage, see our companion article on Wegovy results for men at each dose stage.

How does the Wegovy dose build up?

Over 16 weeks, in four steps. The licence says the dose is escalated over a 16-week period to reduce the likelihood of digestive symptoms. [1]

Stepping the dose up in stages is called titration. The table shows the schedule from the UK Summary of Product Characteristics (the licence document for the medicine) and the patient leaflet. [1] [2]

Stage	Dose	What the licence says
Weeks 1 to 4	0.25 mg once weekly	The starting dose
Weeks 5 to 8	0.5 mg once weekly	First escalation step
Weeks 9 to 12	1 mg once weekly	Second escalation step
Weeks 13 to 16	1.7 mg once weekly	Third escalation step
From week 17	2.4 mg once weekly	The maintenance dose
From week 21, if needed	7.2 mg once weekly	A higher maintenance dose for adults with obesity only, after at least 4 weeks on 2.4 mg

The pause and the review point

The licence allows a pause or a step back. For significant digestive symptoms, it tells clinicians to consider delaying the next step or lowering to the previous dose until symptoms have improved. [1]

The licence also sets a review point. If you have lost less than 5% of your starting weight after 6 months on treatment, your clinician reviews whether to continue. [1]

How do you take it?

Once a week, at any time of day. Food makes no difference. [1] It is injected under the skin of the abdomen, thigh or upper arm. The site can be changed. [1]

• You can change your injection day if needed. Keep at least 3 days between two doses. [1]
• If you miss a dose, take it within 5 days. If more than 5 days have passed, skip it and take the next dose on your usual day. [1]
• Never take a double dose to make up for a missed one. [2]
• If you miss several doses, the licence says restarting at a lower dose should be considered. Speak to your clinician before you restart. [1]

What happens in weeks 1 to 4 on 0.25 mg?

The first 4 weeks are about tolerability. The 0.25 mg dose is the starting dose, not the maintenance dose. [1]

Semaglutide is a GLP-1 receptor agonist. GLP-1 (glucagon-like peptide-1) is a hormone that regulates appetite and calorie intake. A receptor agonist is a medicine that acts on the same receptors as the hormone. [1]

The GLP-1 receptor is present in several areas of the brain involved in appetite regulation. [1] The patient leaflet puts it plainly: the medicine makes you feel fuller and less hungry, with less craving for food. [2] Reduced appetite is the mechanism, not a side effect.

Side effects in the first weeks

Digestive side effects are the most common. In the trials these were very common, which means more than 1 in 10 people, and mainly seen during dose escalation: [1]

• nausea
• vomiting
• diarrhoea
• constipation
• abdominal pain

Headache and fatigue were also very common and mainly seen during dose escalation. Dizziness was common, mainly in the same period. [1]

The patient leaflet says these effects usually go away over time. [2] They can still cause dehydration. Drink plenty of fluids throughout treatment. [1] [7]

What changes in weeks 5 to 16 as the dose rises?

Three steps follow: 0.5 mg from week 5, 1 mg from week 9 and 1.7 mg from week 13. [1] Each step can bring the digestive effects back for a while. In the trials, they were most frequently reported during dose escalation. [1]

The licence reports the rates over the full 68-week trials on the 2.4 mg dose, against a placebo, an inactive comparison injection. [1]

• Nausea: 43.9% on semaglutide, 16.1% on placebo.
• Diarrhoea: 29.7% against 15.9%.
• Vomiting: 24.5% against 6.3%.
• Constipation: 24.2% against 11.1%, and of longer duration than the others.

Most events were mild to moderate and short in duration. [1] The regulator notes they can persist for several days. [7] In the trials, 4.3% of people stopped treatment because of a digestive event. [1]

If a step is hard going, the licence allows a delay or a step back to the previous dose. [1] Tell your clinician rather than pushing through.

What does maintenance on 2.4 mg look like from week 17?

From week 17 the dose is 2.4 mg once weekly, the maintenance dose for every indication. [1] Semaglutide has a half-life of around one week, the time for the blood level to fall by half. [1]

What the main trial found

STEP 1 followed 1,961 adults without diabetes for 68 weeks, including the 16-week escalation. [3] [1] Weight loss occurred early and continued throughout the trial. [1]

• By about 6 months (week 28), 89.8% of people on semaglutide had lost 5% or more of their starting weight. [1]
• Mean weight loss at 68 weeks, counting everyone randomised: 14.9% on semaglutide and 2.4% on placebo. [1] [3]
• A second estimate, assuming everyone stayed on treatment: 16.9% and 2.4%. [1]
• Waist circumference fell by 13.5 cm against 4.1 cm. [1]

Average trial results are not a prediction of individual results.

In a 2-year trial, weight fell through week 68 and then reached a plateau. [1] The licence states that weight loss was demonstrated regardless of sex, and publishes no male-only figure. [1] The published results are end-of-trial figures, so this article gives no week-by-week weight curve.

What is the 7.2 mg dose, and who is it for?

A higher maintenance dose, licensed in the UK for adults with obesity only. The regulator approved it on 6 January 2026 as three 2.4 mg injections, and a single 7.2 mg pen on 14 April 2026. [5] [6]

The licence limits it to a BMI of 30 or more. BMI is body mass index, your weight against your height. It is not for people with a BMI of 27 to 30 or for the heart-risk indication. [1] [5]

The move can be made only after at least 4 weeks on 2.4 mg, if needed. [1]

Whether to move is a clinical decision. The licence calls 7.2 mg a maintenance dose, not a step everyone takes. [1]

What the STEP UP trial found

STEP UP followed 1,407 adults with a BMI of 30 or more and no diabetes for 72 weeks. Dose escalation ran over the first 20 weeks. [4] [1]

• Mean weight loss at 72 weeks, counting everyone randomised: 18.7% on 7.2 mg, 15.6% on 2.4 mg and 3.9% on placebo. [4]
• A second estimate, assuming everyone stayed on treatment: 20.7%, 17.5% and 2.4%. [1]
• Altered skin sensation, such as tingling or burning: 21.6% on 7.2 mg against 0.3% on placebo, and 2.1% on 2.4 mg in the earlier trials. Most cases were mild to moderate and recovered on treatment. [1]
• Hair loss: 5.3% on 7.2 mg against 2.5% on 2.4 mg and 1.0% on placebo. It was more frequent with larger weight loss. [1]
• Digestive effects were most frequent during the 20-week escalation. Nausea affected 38.9% on 7.2 mg, and 3.2% stopped because of a digestive event. [1]

Average trial results are not a prediction of individual results. Only 26.3% of the STEP UP participants were men. [1]

When should you contact your clinician?

Seek urgent medical attention for severe, persistent abdominal pain that may spread to your back. This can be a sign of acute pancreatitis. [8] Seek urgent help too for any sudden loss of vision, including partial loss. [1]

Contact your clinician promptly for:

• vomiting or diarrhoea that stops you keeping fluids down, because dehydration can harm the kidneys [1]
• signs of low blood sugar, if you have type 2 diabetes and also take insulin or a sulfonylurea (a type of diabetes tablet) [1]
• any planned operation or procedure under general anaesthetic or deep sedation, so the team knows you take semaglutide [1]
• several missed doses, before you restart [1]
• any new or unusual symptom that worries you

Only use medicine from a registered prescriber and an authorised pharmacy. The regulator warns against unregulated sellers and reports falsified medicines. [7] [9]

Is Wegovy available on the NHS?

Only within specialist weight management services. NICE, the National Institute for Health and Care Excellence, recommends semaglutide for NHS use for a maximum of 2 years and only in those services. [10]

The criteria are at least one weight-related condition plus a BMI of at least 35. A BMI of 30 to 34.9 qualifies with the criteria for referral to a specialist service. NICE sets lower BMI thresholds, usually 2.5 lower, for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean backgrounds. [10] The NICE guidance predates the 7.2 mg licence and does not address it. [10]

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

When do appetite changes start?

No source gives a start week. Appetite regulation is how the medicine works. In a small early study, people on 2.4 mg ate 35% less at a test meal after 20 weeks of dosing. They reported more fullness, less hunger and fewer cravings.

In the main trial, weight loss began early and continued throughout. By week 28, 89.8% of people on semaglutide had lost 5% or more. No verified week-by-week weight curve is published.

When do side effects settle?

Digestive effects were most frequently reported during dose escalation and were mostly mild to moderate and short in duration. The patient leaflet says they usually go away over time, and the regulator says they can persist for several days. Constipation lasted longer than the other effects in the trials.

What if I miss a dose?

Take it within 5 days of the missed dose. If more than 5 days have passed, skip it and take the next dose on your usual day.

Never take a double dose. If you have missed several doses, speak to your clinician before restarting.

Can I stay on a lower dose than 2.4 mg?

The licence names 2.4 mg as the maintenance dose. It also allows your clinician to delay a step or lower the dose to the previous level when digestive symptoms are significant. How long you stay on a lower dose is a clinical decision.

Who can move to the 7.2 mg dose?

Adults with a BMI of 30 or more, after at least 4 weeks on 2.4 mg, if needed. The licence excludes people with a BMI of 27 to 30 and the heart-risk indication.

Altered skin sensation affected 21.6% of people on 7.2 mg in its trial, so your clinician will weigh that with you. Whether to move is a clinical decision.

Does Wegovy make you tired?

Fatigue is a very common side effect, which means more than 1 in 10 people, and it is mainly seen during dose escalation. No primary source gives its cause or shows that the medicine improves energy. If fatigue is persistent or severe, tell your clinician.

What does NICE say about NHS access?

NICE recommends semaglutide on the NHS only within specialist weight management services and for up to 2 years. The criteria are at least one weight-related condition plus a BMI of at least 35. A BMI of 30 to 34.9 qualifies with the criteria for referral to a specialist service.

NICE also says to consider stopping if less than 5% of starting weight has been lost after 6 months. Its guidance predates the 7.2 mg licence and does not address it.

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 (10)

1. Novo Nordisk, Wegovy FlexTouch (semaglutide) Summary of Product Characteristics, sections 4.1, 4.2, 4.4, 4.5, 4.7, 4.8, 5.1 and 5.2 (text revised September 2026). electronic medicines compendium. medicines.org.uk/emc/product/13800/smpc. Accessed 13 October 2026.
2. Novo Nordisk, Wegovy FlexTouch Patient Information Leaflet, sections 1, 3 and 4 (last revised August 2026). electronic medicines compendium. medicines.org.uk/emc/product/13800/pil. Accessed 13 October 2026.
3. Wilding JPH, Batterham RL, Calanna S and colleagues. "Once-Weekly Semaglutide in Adults with Overweight or Obesity" (STEP 1). New England Journal of Medicine 2021;384(11):989 to 1002. doi.org/10.1056/NEJMoa2032183. Accessed 13 October 2026.
4. Wharton S, Freitas P, Hjelmesæth J and colleagues. "Once-weekly semaglutide 7.2 mg in adults with obesity" (STEP UP). The Lancet Diabetes & Endocrinology 2025;13(11):949 to 963. doi.org/10.1016/S2213-8587(25)00226-8. Accessed 13 October 2026.
5. MHRA, "Medicines regulator approves up to 7.2mg dose of semaglutide (Wegovy) for patients with obesity only", 16 January 2026 (approval dated 6 January 2026). gov.uk/government/news. Accessed 13 October 2026.
6. MHRA, "Single-dose 7.2mg semaglutide (Wegovy) pen approved to treat adult patients with obesity", 14 April 2026. gov.uk/government/news. Accessed 13 October 2026.
7. MHRA Drug Safety Update, "GLP-1 receptor agonists: reminder of the potential side effects and to be aware of the potential for misuse", 24 October 2024. gov.uk/drug-safety-update. Accessed 13 October 2026.
8. MHRA Drug Safety Update, "GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists: strengthened warnings on acute pancreatitis, including necrotising and fatal cases", 29 January 2026. gov.uk/drug-safety-update. Accessed 13 October 2026.
9. MHRA, "GLP-1 medicines for weight loss and diabetes: what you need to know", updated 5 February 2026. gov.uk/government/publications. Accessed 13 October 2026.
10. NICE, "Semaglutide for managing overweight and obesity", technology appraisal guidance TA875, recommendations 1.1 and 1.2 (8 March 2023, updated 4 September 2023). nice.org.uk/guidance/ta875. Accessed 13 October 2026.

Numbered markers in the page text link to these entries. Statistics describe populations, not any one person’s results.