Wegovy Side Effects

The Wegovy titration schedule

• Weeks 1–4: 0.25 mg / week
• Weeks 5–8: 0.5 mg / week
• Weeks 9–12: 1.0 mg / week
• Weeks 13–16: 1.7 mg / week
• Weeks 17+: 2.4 mg / week (maintenance)

Each dose step lasts 4 weeks. Full titration takes 16–20 weeks. If you can't tolerate a step-up, your clinician can hold or step down.

Weeks 1–4 (0.25 mg)

Common: Mild nausea for a few days after injection, subtle appetite drop by day 3, occasional fatigue, mild constipation. Some people feel nothing.

What helps: Smaller meals, lots of water, walk daily, protein at every meal.

Weeks 5–8 (0.5 mg)

Common: Noticeable appetite drop. Nausea can return for 1–3 days after the first 0.5 mg dose, then fade. Constipation is common by week 6. Early weight loss (usually 2–5 lb) starts to show.

What helps: Add a magnesium citrate supplement (200–400 mg at bedtime) for constipation. Prioritize fiber.

Weeks 9–12 (1.0 mg)

Common: Bigger appetite drop, sometimes dramatic. Reflux and burping can appear. Fatigue is common in the first few days after the dose bump. Weight loss typically hits 5–10% by end of week 12.

What helps: Cut greasy foods after each injection. Avoid lying down for 2 hours after meals.

Weeks 13–16 (1.7 mg)

Common: Symptoms similar to previous step-ups but often milder as your body has adapted. Some patients experience early "food aversion" — favorites suddenly don't appeal. Weight loss continues at ~1 lb/week average.

What helps: Lean into the changing food preferences rather than fighting them. Meal-prep to ensure protein is hit.

Weeks 17+ (2.4 mg maintenance)

Common: The transition to max dose is often the roughest step for GI symptoms. If you can't tolerate 2.4 mg, most clinicians will maintain you at 1.7 mg — and outcomes are still very good.

What helps: Give it 3 full weeks before deciding a dose is intolerable. If nausea persists, slow the titration or hold.

Months 4–12

Side effects usually settle into a mild background awareness — maybe some burping, occasional reflux, and slow digestion. Weight loss plateaus around month 12–15 for most patients as the body reaches a new equilibrium.

Warning signs at any stage

• Severe abdominal pain, especially radiating to the back — potential pancreatitis, go to ER
• Right-upper-quadrant pain, especially after fatty meals — potential gallstones
• Yellowing of skin/eyes — liver or gallbladder issue
• Persistent vomiting or inability to keep fluids down over 24 hours — dehydration risk
• Any lump or hoarseness — thyroid check

When to slow down

Your titration schedule is a recommendation, not a mandate. Any of these are reasons to ask your clinician to hold or extend a dose step:

• Nausea that hasn't faded by week 3 of a step
• Unable to hit 1,200 calories or 60 g protein consistently
• Losing weight faster than 2 lb/week for more than a few weeks
• Constipation not responsive to fiber, water, magnesium

FAQ