Wegovy for Weight Loss: How Long It Takes and What Results You Can Expect

Wegovy® (semaglutide) is a prescription medication approved by the FDA for chronic weight management in adults and children aged 12 years and older with obesity, as well as adults with overweight who also have at least one weight-related medical condition. It is administered as a once-weekly injection. Wegovy works by mimicking a hormone called glucagon-like peptide-1 (GLP-1), which helps to regulate appetite and food intake. It can reduce your appetite which may help you eat less and lead to weight loss. This article explores the duration of Wegovy treatment, what kind of results you can expect, and what happens if you stop using it.

How Wegovy Works

Wegovy is classified as a glucagon-like peptide-1 (GLP-1) receptor agonist. It contains the active ingredient semaglutide. Semaglutide works by acting like a hormone in your body that signals brain receptors involved in your appetite and food intake. It can reduce your appetite which may help you eat less and lead to weight loss. Another way Wegovy aids in weight loss is by slowing down the rate at which the stomach empties food into the intestine. Semaglutide also affects the way the body regulates blood sugar levels. It promotes the release of insulin, a hormone that lowers blood sugar levels, and decreases the release of glucagon, a hormone that raises blood sugar levels.

Starting Wegovy Treatment

When starting a Wegovy prescription, patients start at the lowest dose (0.25 mg weekly) and gradually increase every 4 weeks to a maximum dose (2.4 mg weekly) as long as the medication is well tolerated. The recommended starting dose for Wegovy is 0.25 milligrams (mg). You’ll need to take 0.25 mg once per week for the first 4 weeks of treatment. Starting at this dosage reduces the risk of side effects from Wegovy. If you tolerate the initial dose, your doctor may gradually increase the dosage as follows:

Weeks 5 through 8: 0.5 mg
Weeks 9 through 12: 1 mg
Weeks 13 through 16: 1.7 mg

For some patients, there isn’t much of an effect at the lower dose, and weight loss may not start until they reach a higher dose of the medication.

How Long Does Wegovy Take to Work?

The time it takes for Wegovy® (semaglutide) to work for weight loss can vary. Wegovy takes time to work, but you may see some weight loss results in the first month (4 weeks) of treatment.

After 4 weeks: Some weight loss is typically seen within the first 4 weeks of starting semaglutide, but the amount can vary widely between individuals. A 2021 study found that, on average, people lost more than 2% of their body weight in the first 4 weeks of using semaglutide. For example, if a person weighs 200 pounds (lb), a 2% reduction in body weight means they would lose 5 lb.
After 12 weeks: One study showed that on average people lost ~6% of their starting body weight by 12 weeks.
After 20 weeks: One study showed that on average people lost ~10% of their starting body weight by 20 weeks. Many people don’t start seeing visible weight loss with Wegovy until the 20-week mark.
After 12 months: Individuals can expect to lose approximately 15 to 17% of their baseline body weight on average after one year of treatment with the 2.4mg once-weekly semaglutide injection when combined with lifestyle interventions. One study showed that on average people lost ~15% at the one-year mark.
At week 68: In adolescents 12 years of age and older, Wegovy led to a 16.1% decrease in body mass index (BMI) at week 68, compared to a 0.6% BMI decrease with placebo. In addition, 77% of patients in the Wegovy group had a BMI reduction of at least 5%.
Long-term results: A long-term study published in 2024, involving 17,604 adults, found that weight loss with semaglutide continued for 65 weeks, and participants sustained their weight loss for up to 4 years. At 104 weeks, 67.8% of participants using semaglutide had lost 5% of their body weight or more, and 44.2% had lost 10% or more. A smaller percentage of participants using semaglutide had lost 15% to 25% of their weight or more at this point in the trial.

Note that patients in the study used Wegovy in combination with healthy nutrition and physical activity.

How Long Should You Take Wegovy?

Although Wegovy will start working for weight loss within the first few months of taking the medication, your weight loss efforts will be most successful if you continue taking Wegovy as you reach your weight loss goals and beyond. Continuing Wegovy after reaching your goal weight is recommended to maintain your achievement.

The duration of semaglutide treatment for weight loss can vary, but many healthcare providers recommend a minimum of 12 to 24 months for chronic weight management. You can use Wegovy (semaglutide) as long as you need it for weight loss and weight management. You can continue taking Wegovy if you and your doctor determine that Wegovy is safe for you and you can tolerate its side effects. Wegovy is currently approved for use for up to 2 years.

Wegovy’s Maintenance Dosage

The typical maintenance (long-term) dosage of Wegovy can be up to 2.4 mg once per week. Your doctor will prescribe a maintenance regimen at the dose that helped you reach your goal weight. For some people, the maintenance dosage may be 2.4 mg once per week. For others, it may be 1.7 mg once per week. Your doctor will determine the best dosage for you after you hit your weight loss goal. The maintenance dose of Wegovy is up to 2.4 mg once per week. You can stay on your maintenance dose for several months as long as the drug is effective and you can tolerate its side effects. If you are unable to tolerate the side effects, your doctor may decrease your Wegovy dose to 1.7mg once per week.

Factors Affecting Weight Loss on Wegovy

Several factors can influence the effectiveness of Wegovy for weight loss:

Individual Response: The amount of weight you lose with Wegovy and how fast you lose it varies from person to person. The rate of weight loss depends on various factors, including your metabolism and overall health picture.
Adherence to Treatment Plan: It’s important to ensure adherence to the recommended treatment plan, including dietary and lifestyle modifications, alongside medication therapy. The first few months of your Wegovy treatment are a chance to get used to the treatment and start incorporating healthier habits into your lifestyle. Wegovy patients tend to lose around 4% body weight after two months, 6% after three months, and 8% after four months. After 17 months you can expect to lose around 17% of your starting body weight.
Lifestyle Changes: Wegovy and Ozempic are not prescribed alone. When providers prescribe semaglutide, they also advise healthy lifestyle changes like regular exercise and a healthy diet. Clinical trials show that semaglutide is most effective for weight loss when patients get at least 150 minutes of moderate-intensity aerobic exercise each week. That’s equal to about 21 minutes a day or 30 minutes a day, 5 times per week. Aerobic exercise can be brisk walking, swimming, dancing, cycling, weight lifting, or jogging. Even yard work counts!

What If You're Not Losing Weight?

You may not be hitting your weight loss goals while taking semaglutide injections for several reasons. If you’re finding your medication is more bothersome than you can bear, especially if it is interfering with your daily life and activities, let your health care team know. Your prescribing provider might be able to adjust the medication dosage to reduce your symptoms.

Possible reasons you may not be losing weight while using Wegovy include:

Needing to give it more time: Significant weight loss with Wegovy is gradual. It can take more than a year to lose almost 15% of your weight with the highest dosage.
Reaching a plateau: After an initial weight loss, a plateau may occur at roughly 60 weeks (1 year and 2 months) of treatment. For most people, the weight loss achieved with semaglutide starts to plateau around 9 to 12 months of treatment if the individual adheres to the medication and lifestyle recommendations.
Taking other medications: Other medications, such as beta-blockers, some diabetes drugs, and antipsychotics, may cause weight gain.
Underlying health conditions: If you’re not losing weight on Wegovy or Ozempic, it might not be due to anything you are or aren’t doing. It may be that an underlying medical condition is to blame. Conditions like hypothyroidism can make it hard to lose weight. Additionally, certain medications, like antipsychotics and some blood pressure medicines, may cause weight gain. They may also slow weight loss.

If you have been maintaining healthy habits while taking Wegovy or Ozempic and are not losing weight, talk to your provider. They may screen you for other health conditions. Before starting treatment with semaglutide, tell your provider about your medical history and any medicines you are taking. This will reduce your risk of harmful drug interaction side effects. It will also give your provider a fuller picture of your health and potential barriers to weight loss.

If you’re using Wegovy and not losing weight, you can talk with your doctor about factors that could be preventing weight loss. In some cases, your doctor may suggest changing your Wegovy dosage or taking a different weight loss drug, such as tirzepatide (Zepbound).

Ways to Increase Weight Loss with Wegovy

Here are five possible ways to increase weight loss while using Wegovy:

Reduce your calorie intake: Reducing your calorie intake by 500 kilocalories per day may support weight loss.
Increase your physical activity: Aiming for at least 150 minutes of moderate intensity exercise per week can help increase weight loss.
Eat nutrient-dense foods: Nutrient-dense foods provide important vitamins and minerals and are lower in added sugars, saturated fats, and salt. Nutrient-dense foods help provide your body with the nutrients it needs without excess calories.
Manage stress: Stress can change food intake and fat storage, potentially leading to weight gain. Finding healthy ways to manage stress may support weight loss.
Get quality sleep: Inadequate sleep may increase the risk of obesity and increase energy intake. Getting 7 to 9 hours of sleep may help with weight loss.

What Happens When You Stop Taking Wegovy?

Wegovy is a long-term treatment that you may use to maintain weight loss until you can manage its side effects. If you stop using Wegovy, you may regain the weight that you lost. If you had preexisting cardiovascular or metabolic conditions, these may also return.

A 2022 study found that 1 year after stopping semaglutide, participants had regained two-thirds of the weight they had lost by using the drug and making lifestyle changes. If you want to stop using Wegovy, it is important to continue any other lifestyle changes you’ve made to support weight loss, such as eating a low calorie diet and increasing your physical activity. You can talk with your doctor about how to stop Wegovy safely while avoiding weight regain and preventing health conditions from returning.

Important Considerations

Side Effects: Be aware that all medications come with the potential for side effects. Some people don’t experience any side effects whereas others might find them to be overwhelming. Stomach side effects are most common when starting treatment but decrease over time in most people.
Injection Challenges: Many weight-loss medications require that you inject yourself with the medication. You may face challenges such as needle phobia or have difficulty with proper injection techniques. Injection site reactions such as redness, swelling or itching can also be a deterrent. While these reactions are usually mild and transient, they can still be uncomfortable. Contact your provider to ensure you have thorough training on proper injection techniques to ensure a confident, accurate and comfortable self-injection. A different type of needle also may help reduce discomfort during injections.
Cost and Insurance: Weight-loss medications can be costly, and they’re not always paid for by insurance or covered long-term. You might consider exploring financial assistance programs as some pharmaceutical companies offer patient assistance programs or co-pay assistance programs to help reduce the cost of the medications.
Changes in Health Conditions: It may be necessary to stop the medication if you have a change in health conditions. That’s why it’s important to have ongoing conversations with your health care team to assess your medication.

Precautions

Wegovy® may cause certain side effects, and it is important to consult your healthcare provider if you experience any of the following:

Possible thyroid tumors, including cancer.
Inflammation of your pancreas (pancreatitis).
Gallbladder problems, including gallstones.
Increased risk of low blood sugar (hypoglycemia), especially those who also take medicines for diabetes such as insulin or sulfonylureas.
Dehydration leading to kidney problems.
Severe stomach problems.
Increased heart rate.
Depression or thoughts of suicide.
Food or liquid getting into the lungs during surgery or other procedures that use anesthesia or deep sleepiness (deep sedation).

Wegovy® may harm your unborn baby, so it is not recommended if you are pregnant or plan to become pregnant. It is also not recommended if you are breastfeeding or plan to breastfeed.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements, as Wegovy® may affect the way some medicines work and some medicines may affect the way Wegovy® works.

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