In trials, semaglutide was given once a week at doses from 0.5 to 7.2 mg, and every higher dose gave a greater weight loss. The 2.4 mg dose cut body weight by 14.9 percent after 68 weeks in STEP 1. The 7.2 mg dose gave 18.7 percent after 72 weeks in STEP UP. In type 2 diabetes lower doses were used: 0.5, 1 and 2 mg. Below we compare all the doses from seven trials and what each of them achieved.
How is the semaglutide dose increased?
Semaglutide is started at a small dose and raised every four weeks, so that the body gets used to its effect on the stomach. The label of the medicine Wegovy starts at 0.25 mg a week. The dose then rises to 0.5 mg, 1 mg and 1.7 mg. From week 17 the maintenance dose is 2.4 mg or 1.7 mg.
In STEP 1 the whole dose-escalation period lasted 16 weeks. In STEP 4, after those 16 weeks and four more, 89.0 percent of participants had reached the 2.4 mg dose. The label allows the next step to be delayed by four weeks when a dose is poorly tolerated. How many vials the whole scheme uses is calculated in the guide on how long a GLP-1 vial lasts.
What did the 2.4 mg dose achieve in people without diabetes?
The 2.4 mg dose is the best-studied dose of semaglutide in obesity. STEP 1 included 1961 adults without diabetes and lasted 68 weeks. The results were published in 2021 in the New England Journal of Medicine.
| STEP 1, after 68 weeks | Semaglutide 2.4 mg | Placebo |
|---|---|---|
| Average weight loss | 14.9 percent, or 15.3 kg | 2.4 percent, or 2.6 kg |
| Loss of at least 5 percent | 86.4 percent of people | 31.5 percent of people |
| Loss of at least 10 percent | 69.1 percent of people | 12.0 percent of people |
| Loss of at least 15 percent | 50.5 percent of people | 4.9 percent of people |
Every second person on 2.4 mg lost at least 15 percent of their body weight. Participants also reported better physical functioning and had better cardiovascular risk factors than on placebo.
What did the 7.2 mg dose achieve?
The 7.2 mg dose gave a weight loss 3.1 percentage points greater than 2.4 mg. This was tested in STEP UP, published in 2025 in The Lancet Diabetes and Endocrinology. It included 1407 adults with obesity and without diabetes, with an average weight of 113.0 kg.
| STEP UP, after 72 weeks | 7.2 mg | 2.4 mg | Placebo |
|---|---|---|---|
| Average weight loss | 18.7 percent | 15.6 percent | 3.9 percent |
| Gastrointestinal complaints | 70.8 percent of people | 61.2 percent of people | 42.8 percent of people |
| Unusual skin sensations | 22.9 percent of people | 6.0 percent of people | 0.5 percent of people |
At 7.2 mg the chance of losing at least 20 percent was almost twice as high as at 2.4 mg. Waist circumference fell by 11.7 cm more than on placebo. The price was more frequent dysaesthesia, tingling or oversensitive skin, reported by almost one person in four.
Which doses were used in type 2 diabetes?
In type 2 diabetes semaglutide was studied mainly at 0.5, 1 and 2 mg a week. These are the doses of the medicine Ozempic, which has a different indication from Wegovy. The table collects three trials with different doses.
| Trial | Dose | HbA1c fall | Weight loss |
|---|---|---|---|
| SUSTAIN 1, 30 weeks | 0.5 mg | 1.45 points | 3.73 kg |
| SUSTAIN 1, 30 weeks | 1 mg | 1.55 points | 4.53 kg |
| SUSTAIN FORTE, 40 weeks | 1 mg | 1.9 points | 6.0 kg |
| SUSTAIN FORTE, 40 weeks | 2 mg | 2.2 points | 6.9 kg |
In SUSTAIN FORTE the 2 mg dose lowered glycated haemoglobin by 0.23 points more than 1 mg. Glycated haemoglobin is the average blood sugar over recent months. Stomach complaints were reported by 34 percent of people at 2 mg and 31 percent at 1 mg, almost the same.
Does a higher dose help with weight loss in diabetes?
Yes, although people with diabetes lose weight on semaglutide more slowly than people without it. STEP 2 compared 2.4 mg and 1 mg in 1210 people with type 2 diabetes and overweight. After 68 weeks body weight fell by 9.6 percent at 2.4 mg and by 3.4 percent on placebo.
STEP UP T2D tested 7.2 mg in 512 people with obesity and diabetes. After 72 weeks weight fell by 13.2 percent, against 3.9 percent on placebo. Glycated haemoglobin fell by 1.5 points more than on placebo. The risk of significant falls in blood sugar was low and similar at both doses and on placebo.
How did the dose affect tolerability?
Gastrointestinal complaints were the most common side effect at every dose. In STEP 1 nausea and diarrhoea were usually temporary and mild or moderate. 4.5 percent of people on semaglutide and 0.8 percent on placebo stopped treatment because of them.
- 0.5 and 1 mg: in SUSTAIN 1 nausea affected 20 and 24 percent of people, against 8 percent on placebo.
- 1 and 2 mg: in SUSTAIN FORTE stomach complaints affected 31 and 34 percent of people.
- 2.4 mg: in STEP 2 stomach complaints affected 63.5 percent of people, against 34.3 percent on placebo.
- 7.2 mg: in STEP UP stomach complaints affected 70.8 percent of people.
How much does a week cost at successive doses?
A 3 mg vial of semaglutide costs 90 EUR in the shop, so 30 EUR per milligram. The cost of a week rises with the dose, because each step uses more milligrams. The table converts the Wegovy label doses into the cost of a week.
| Weekly dose | Cost per week | How many weeks a 3 mg vial lasts |
|---|---|---|
| 0.25 mg | 7.50 EUR | 12 weeks |
| 0.5 mg | 15 EUR | 6 weeks |
| 1 mg | 30 EUR | 3 weeks |
| 1.7 mg | 51 EUR | almost 2 weeks |
| 2.4 mg | 72 EUR | a week and 2 days |
At the start of the scheme one vial lasts a long time, because the doses are small. Only at 1.7 and 2.4 mg does a 3 mg vial run out in under two weeks.
Where to buy semaglutide?
The shop offers semaglutide 3 mg Bio-Peptide for 90 EUR, in stock. All information about the molecule is on the semaglutide page. The course of weight loss over the months is described in the guide on semaglutide results.
The doses described above come from medicine labels and clinical trials. They are not a recommendation for research material, and choosing a dose for a person is a matter for a doctor. The difference between a medicine and research material is explained in the guide on why semaglutide and tirzepatide are prescription-only. How to convert milligrams into syringe marks is shown in the guide on converting a peptide dose to syringe units.
Frequently asked questions
What dose is semaglutide started at?
The Wegovy label starts at 0.25 mg once a week for four weeks. The dose then rises to 0.5, 1 and 1.7 mg, and from week 17 it is 2.4 mg.
How much weight can you lose on 2.4 mg?
In STEP 1 the average weight loss after 68 weeks was 14.9 percent, or 15.3 kg. Every second person lost at least 15 percent of their weight.
Does the 7.2 mg dose work better than 2.4 mg?
Yes, in STEP UP it gave an 18.7 percent weight loss after 72 weeks, against 15.6 percent at 2.4 mg. It did, however, cause unusual skin sensations more often.
Which semaglutide doses are used in diabetes?
The SUSTAIN trials used 0.5, 1 and 2 mg a week. The 2 mg dose lowered glycated haemoglobin by 2.2 points in 40 weeks.
How much does a week of semaglutide cost at 2.4 mg?
With a 3 mg vial at 90 EUR, a week at 2.4 mg costs 72 EUR. The vial then lasts a week and two days.
Sources
- Wilding JPH, Batterham RL, Calanna S et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 2021, 384(11): 989-1002. https://doi.org/10.1056/NEJMoa2032183
- Davies M, Færch L, Jeppesen OK et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2). The Lancet, 2021, 397(10278): 971-984. https://doi.org/10.1016/S0140-6736(21)00213-0
- Rubino D, Abrahamsson N, Davies M 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): 1414-1425. https://doi.org/10.1001/jama.2021.3224
- Wharton S, Freitas P, Hjelmesæth J et al. Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP). The Lancet Diabetes and Endocrinology, 2025, 13(11): 949-963. https://doi.org/10.1016/S2213-8587(25)00226-8
- Lingvay I, Bergenheim SJ, Buse JB et al. Once-weekly semaglutide 7.2 mg in adults with obesity and type 2 diabetes (STEP UP T2D). The Lancet Diabetes and Endocrinology, 2025, 13(11): 935-948. https://doi.org/10.1016/S2213-8587(25)00225-6
- Sorli C, Harashima SI, Tsoukas GM et al. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1). The Lancet Diabetes and Endocrinology, 2017, 5(4): 251-260. https://doi.org/10.1016/S2213-8587(17)30013-X
- Frías JP, Auerbach P, Bajaj HS et al. Efficacy and safety of once-weekly semaglutide 2.0 mg versus 1.0 mg in patients with type 2 diabetes (SUSTAIN FORTE). The Lancet Diabetes and Endocrinology, 2021, 9(9): 563-574. https://doi.org/10.1016/S2213-8587(21)00174-1
- U.S. Food and Drug Administration. Wegovy (semaglutide) injection, prescribing information, 215256s011. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf