How long do you take Wegovy for weight loss?

How long do you take Wegovy (semaglutide) for weight loss? The GLP-1 medication is intended for long-term use. It takes 3–4 months to reach a maintenance dosage, with weight loss occurring gradually. Read on to learn more.  

Wegovy is usually intended for long-term use, as it takes at least 3–4 months to reach a maintenance dosage, depending on the form you’re taking (i.e. oral vs. injectable). 

In clinical trials of the Wegovy injection, people taking 2.4 mg weekly lost nearly 15% of their body weight in 68 weeks. Here’s a general timeline of weight loss based on the research: 

• 2% weight loss in the first month

• 4% weight loss in the first two months

• 6% weight loss in the first three months 

• 15% weight loss in 68 weeks (about a year and four months)

In clinical trials of the Wegovy pill, people taking 25 mg daily lost nearly 14% of their body weight in 64 weeks. Here’s a general timeline of weight loss based on the research:

• 2% weight loss in the first month

• 4% weight loss in the first two months

• 6% weight loss in the first three months

• 13.6% weight loss in 64 weeks (about a year and 3 months)

There are a few factors that can affect how quickly you lose weight on Wegovy, says Supriya Rao, MD, DABOM, a quadruple board-certified physician specializing in obesity medicine and lifestyle medicine. These include:

• The lifestyle changes you make. “Medications like Wegovy work best alongside lifestyle changes, such as diet and exercise,” Dr. Rao says.

• The dosage prescribed. People taking the higher 2.4 mg maintenance dose of Wegovy lose more weight than those taking the 1.7 mg dose. There is only one maintenance dosage of the Wegovy pill (25 mg). However, clinical studies have shown that higher dosages of 50 mg may lead to more weight loss.

• Other health conditions you have. People with type 2 diabetes tend to lose less weight than those without diabetes: about 2% less at three months and 5% less at six months of taking the injection. 

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*The Wegovy pill dosage increases in 30-day increments, while the Wegovy pen dosage increases in four-week increments. To keep things simple, we’ve used a monthly timeline in the table above. 

Both the Wegovy injection and Wegovy pill follow a dose titration schedule, where you start at a low dose and gradually increase to the maintenance dosage over a period of months. This gradual dose escalation allows your body to get used to the medication and its side effects. 

The maintenance dosage for the Wegovy pill is:

• 25 mg daily

• Reached at day 91 (start of week 13) 

The maintenance dosage for the Wegovy injection is:

• 1.7 mg or 2.4 mg weekly, depending on how your body responds to the medication

• Reached at weeks 13 (1.7 mg) or 17 (2.4 mg)

Because the Wegovy pen is injected weekly, dose increases occur every four weeks. The Wegovy pill is taken daily and comes in a supply of 30 pills, so dose increases occur every 30 days. 

“Most people start noticing weight loss within the first four weeks of taking Wegovy,” Dr. Rao says. Appetite reduction can occur even sooner — within a week — says registered dietitian Gabby Zeagler, MS, RD, CDN, CDCES.

Here’s a month-by-month overview of the average weight loss people experience on the Wegovy injection, according to research:

• Month 1 (4 weeks): 2% average weight loss

• Month 3 (12 weeks): 6% average weight loss

• Month 6 (24 weeks): 11% average weight loss

• Month 16 (68 weeks): 15% average weight loss

And here’s an overview of average weight loss on the Wegovy pill, based on clinical trials:

• Month 1 (4 weeks): 2% average weight loss

• Month 3 (12 weeks): 6% average weight loss

• Month 6 (24 weeks): 10% average weight loss

• Month 15 (64 weeks): 13.6% average weight loss

For someone starting at 200 pounds, this means they would lose about 4 pounds in the first month on either the injection or the pill. By week 68, they could lose up to 30 pounds on injectable Wegovy (up to 27 pounds on oral Wegovy). 

Most people lost at least 5% of their body weight by the 20-week mark of taking injectable Wegovy. But about 15% of people lose less than that. These so-called “non-responders” end up losing less weight on Wegovy than average, but they still lose significant weight: about 6.4% in 68 weeks (compared with 19.7% for “responders”).

The “right” Wegovy dosage differs from person to person, depending on your response to the medication and tolerance for common side effects, which can include nausea, diarrhea, vomiting, headache, and fatigue. Before you reach your right maintenance dosage of Wegovy, you’ll likely spend at least a few weeks or months at the lower doses. 

Typical dosage schedule for the Wegovy injection:

• Weeks 1–4: Starting dose of 0.25 mg weekly 

• Weeks 5–8: Dose increase to 0.5 mg weekly 

• Weeks 9–12: Dose increase to 1 mg weekly 

• Weeks 13–16: Dose increase to 1.7 mg weekly

• Weeks 17+: Stay at 1.7 mg or increase to 2.4 mg weekly 

Typical dosage schedule for the Wegovy pill:

• Days 1–30: Starting dose of 1.5 mg daily

• Days 31–60: Dose increase to 4 mg daily

• Days 61–90: Dose increase to 19 mg daily

• Days 91+: Dose increase to 25 mg daily

It’s generally recommended that people start injectable Wegovy at 0.25 mg weekly. This starting dose helps your body get used to the medication and its side effects, Dr. Rao says. 

Then, your healthcare provider will gradually increase your dosage — usually every four weeks, but it may be faster or slower depending on your response — until you reach the maximum dosage of Wegovy that is right for you. 

The titration process is similar for the Wegovy pill, which starts at 1.5 mg daily and increases every 30 days (instead of every four weeks, as with the injection).

The Wegovy pill has a single maintenance dosage (25 mg daily), but there are two maintenance dosage options for the Wegovy pen: 1.7 mg and 2.4 mg. 

The 2.4 mg dosage of Wegovy has been shown to deliver the greatest weight loss, but it’s not right for everyone. Some people may tolerate the side effects of Wegovy better at the 1.7 mg dosage, and that will be the right dosage for them. Both 1.7 mg and 2.4 mg are effective maintenance doses of Wegovy.

While the recommended maintenance dosage of the Wegovy pill is 25 mg daily, some studies have found that higher doses of 50 mg may lead to more weight loss: 15.1% weight loss at 68 weeks vs. the 13.6% weight loss at 64 weeks on 25 mg. But 25 mg daily is the highest approved dose of the Wegovy pill.

Beyond the initial weight loss, Dr. Rao says there are other benefits to staying on Wegovy long-term, such as: 

• Weight maintenance

• Improved cardiovascular health markers (e.g. lower blood sugar, lower cholesterol levels)

• Reduced risk of obesity-related conditions

When people stay on Wegovy long-term, they typically experience “decreased ‘food noise,’ better control of appetite, and improvements in insulin sensitivity and blood sugar,” says Emily Villaseca, RD, owner and lead dietitian at Pass the Chia.

Clinical trials have found that when people stop taking Wegovy, they can regain as much as two-thirds of the weight lost in one year. Other health improvements may also return to baseline levels, including blood pressure, cholesterol, and blood sugar. 

On the other hand, when people continue taking Wegovy, they tend to maintain the weight loss — and experience fewer adverse health outcomes than those taking a placebo. For example, they have a 20% lower risk of experiencing a serious cardiovascular event, such as heart attack, stroke, or death. 

One study found that weight loss tends to plateau after about one year on the Wegovy injection, but the drug sustains weight loss for at least four years. To maintain weight loss on Wegovy, it’s important to keep up with the diet, exercise, and other healthy lifestyle changes you’ve made during your Wegovy treatment.

The main cons of staying on Wegovy in the long term are related to its side effects and cost, Dr. Rao says. 

Side effects

When you start taking Wegovy, the drug’s gastrointestinal side effects — including nausea, vomiting, diarrhea, and constipation — can be frequent and intense. 

Making changes to what you eat and how you eat can make a big difference, such as eating smaller portions to reduce nausea and drinking plenty of water to relieve constipation. For some people, increasing their fiber intake, either naturally through their diet or with a supplement, can also help.

Villaseca also recommends strength training along with cardio exercises to build muscle, boost heart health, and maximize weight loss on Wegovy. 

“Muscles use more energy, so they increase your metabolism and fat-burning ability,” she says. “You can start with bodyweight exercises at home.”

Cost considerations

With a list price of over $1,349.02, sticker stock is possible with Wegovy. But that doesn’t mean you have to shell out thousands if you’re paying out-of-pocket. 

Through Ro, Wegovy is also available for as little as $149 per month for the pill and $199 per month for the injection. The exact cash price depends on the version prescribed and the dose.

• Wegovy pill: $149–$299 per month, depending on the dose 

• Wegovy pen: $199–$349 per month, depending on the dose 

You can also save on the cost using Wegovy pharmacy coupons (many of which are free to download online). 

Unfortunately, as a weight loss medication, Wegovy is not likely to be covered by health insurance. But if you do have insurance and it includes coverage of Wegovy, you may qualify for the manufacturer’s savings program. This offer can lower the cost of Wegovy to $25 per month. 

All that’s to say, Wegovy isn’t available for free. So, like pretty much everything else in life, the costs can add up. And this can be a con for some people, even if they pay with cash or are eligible for savings.  

The “best” time to stop Wegovy depends on the person taking the medication and their specific situation. 

There are a number of reasons why you might need to stop Wegovy. Some people cannot tolerate the side effects and need to switch to another weight loss medication. Others may start trying to conceive or become pregnant. (Ideally, Wegovy should be stopped at least two months before a planned pregnancy due to the drug’s long half-life.) 

One of the common reasons people stop Wegovy is due to a lack of insurance coverage and the drug’s out-of-pocket cost, according to Zeagler. 

“Stopping Wegovy or similar medications cold turkey, often due to insurance reasons, has not led to the best outcomes in my experience,” she says. “When clients abruptly discontinue the medication, their cravings tend to return twice as strong, often leading to rapid weight regain at an exponential rate.”

And then there are those who stop taking Wegovy because they’ve achieved their weight loss goals and can maintain them through lifestyle changes. 

“You and your healthcare provider should agree that it’s safe and sustainable to stop, and you should have a solid plan to maintain your progress without the medication,” Dr. Rao says. This plan may include:

• Following a healthy, balanced diet

• Regularly exercising (particularly by doing  a mix of aerobic and resistance workouts)

• Meeting with your healthcare provider and getting annual bloodwork

• Working with other professionals, such as a dietitian, nutritionist, or personal trainer

Staying on Wegovy for weight loss maintenance is generally recommended since research has shown that stopping it can result in weight regain — just like what you might expect if a person stops a particular diet plan or exercise regimen.

People can lose up to 15% of their body weight after a year and a half of taking Wegovy, according to clinical trials. 

Wegovy injection: On average, people lost nearly 15% of their body weight in 68 weeks. (If you weigh 250 pounds, that’s an average weight loss of about 37 pounds.) Not only that, but 86% lost at least 5% of their body weight, 69% lost at least 10% of their body weight, and just over half of people lost 15% or more.

Wegovy pill: On average, people lost nearly 14% of their body weight in 64 weeks. (If you weigh 250 pounds, that’s an average weight loss of 34 pounds). At 64 weeks, 79% of people lost at least 5% of their body weight, 63% lost at least 10% of their body weight, half (50%) lost 15% or more, and 30% lost 20% or more. 

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How long you take Wegovy depends on your weight loss goals, response to the medication, and tolerance for side effects. While many people see weight loss results within the first few months, long-term use may be necessary to sustain weight loss and improve overall health. 

• You should see results within three months. If Wegovy is effective, most people lose at least 5% of their body weight by the 20-week mark on the injection. And average weight loss at three months on the Wegovy pill is about 6%.

• It can take several months to reach the right dosage of Wegovy. Usually, maintenance doses are 25 mg daily (pill) or 1.7 mg or 2.4 mg weekly (injection). Side effects like nausea and constipation may affect your ability to stay on the higher dose.

• Stopping Wegovy may lead to weight regain. Studies show that people who discontinue Wegovy injection tend to regain about two-thirds of the weight lost within a year. 

• Long-term use of Wegovy has its pros and cons. While continued use can help maintain weight loss and reduce cardiovascular risks, potential side effects and cost can be downsides. (Though, you can get Wegovy for as little as $149 per month through Ro. Just saying…).