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This page is for patients currently receiving treatment through The Virtual Slimming Clinic. The information here reflects the UK Summary of Product Characteristics and published clinical trial data. It is not a substitute for advice from your clinician.
A higher-strength dose of Wegovy (semaglutide) is now licensed in the UK. If you're currently on Wegovy, you may have seen coverage of the 7.2mg dose and wondered what it means for your treatment. This guide covers what the dose is, what the clinical trials actually showed, who it may — and may not — be suitable for, and how a dose change works at our clinic.
The short version: 7.2mg is an additional maintenance option, not a replacement for the 2.4mg dose most patients are on. Whether it's right for you is a clinical decision made with your clinician, based on your progress, your tolerance, and your health history.
What is Wegovy 7.2mg?
Wegovy 7.2mg is a higher weekly maintenance dose of semaglutide, the same medicine you're already taking. It was approved by the MHRA in January 2026 and is licensed for weight management in adults with obesity, alongside a reduced-calorie diet and increased physical activity [1].
Nothing about the medicine itself has changed — it's the same GLP-1 receptor agonist, working the same way on the areas of the brain involved in appetite regulation [1]. What's new is the licensed ceiling: previously the highest maintenance dose was 2.4mg once weekly; the licence now allows an increase to 7.2mg once weekly for adult patients with obesity where clinically appropriate [1].
Two points worth being clear on from the outset:
It is not a starting dose. Everyone still begins at 0.25mg and titrates through the standard 16-week escalation to 2.4mg. Under the SmPC, the dose can only be increased to 7.2mg after a minimum of four weeks on the 2.4mg dose [1].
2.4mg remains the standard maintenance dose. For many patients, 2.4mg continues to be the right long-term dose. The 7.2mg option exists for a specific group — and staying at 2.4mg is not a lesser version of treatment.
What the STEP UP trial showed
The evidence for the 7.2mg dose comes primarily from STEP UP, a phase 3b randomised, double-blind, placebo-controlled trial published in The Lancet Diabetes & Endocrinology in 2025 [2]. It enrolled 1,407 adults with a BMI of 30 or above (without diabetes) across 11 countries, who received once-weekly semaglutide 7.2mg, semaglutide 2.4mg, or placebo for 72 weeks, all alongside a lifestyle intervention [2, 3].
The headline results, using the trial's primary analysis (which includes all participants regardless of whether they stayed on treatment):
- Average weight reduction at 72 weeks was 18.7% with 7.2mg, compared with 15.6% on 2.4mg and 3.9% with placebo [2, 4]
- Among participants who remained adherent to treatment throughout, average reduction was 20.7% with 7.2mg versus 17.5% with 2.4mg [4]
- 33.2% of those on 7.2mg lost 25% or more of their starting body weight, compared with 16.7% on 2.4mg [4]
- Waist circumference reduced by an estimated 11.7cm more than placebo [5]
A second trial, STEP UP T2D, studied the dose in people with type 2 diabetes and was published alongside it [5].
You'll notice we've led with the 18.7% figure rather than the 20.7% you may have seen elsewhere. The higher number reflects only participants who stayed fully on treatment; the lower one reflects everyone who started the trial, which is closer to real-world experience. Both are accurate — but we'd rather you plan around the more conservative picture. And as with every figure on this page: trial averages describe groups, not individuals. Your own response depends on your physiology, your starting point, and factors no trial can predict for you.
Who the 7.2mg dose may suit
Under the UK licence, the increase to 7.2mg is an option for adults with obesity where additional support is needed [1]. In practice, your clinician may consider it if you:
- have completed the full titration and been established on 2.4mg for at least four weeks [1]
- have tolerated your current dose well, with manageable or minimal side effects
- have seen your progress slow or plateau despite good adherence to your treatment plan
A word on plateaus, because they carry more emotional weight than they deserve: a plateau is a normal, well-documented part of how the body responds to weight loss. It is not evidence that you've failed, or that the treatment has stopped working for you. It's one clinical signal among several that your clinician weighs when reviewing your dose — and sometimes the right response to a plateau isn't a dose change at all.
Who it isn't for
The 7.2mg dose is not appropriate for everyone, and there are groups for whom it's specifically not recommended:
- Anyone not yet established on 2.4mg — the escalation pathway is a licensing requirement, not a formality. It exists because gradual titration substantially reduces gastrointestinal side effects [1].
- Patients under 18 — for adolescents, weekly doses higher than 2.4mg are not recommended under the licence [1].
- Patients planning pregnancy, pregnant, or breastfeeding — semaglutide should not be used during pregnancy or breastfeeding, and should be stopped at least two months before a planned pregnancy [1]. If this applies to you, speak to your clinician before any dose decision.
- Patients experiencing significant side effects at their current dose — the SmPC is explicit that where gastrointestinal symptoms are significant, escalation should be delayed or the dose lowered until symptoms improve [1].
If you have existing health conditions — including thyroid conditions, PCOS, a history of pancreatitis, or diabetes managed with insulin or sulfonylureas — none of these automatically rules the dose out, but they are exactly the kind of factors your clinician will work through with you individually. This is why the dose change sits behind a clinical review rather than a request button.
What to expect from side effects
The safety profile of 7.2mg in STEP UP was broadly consistent with what's already known about semaglutide, with gastrointestinal effects remaining the most common [1, 2]. Being specific, because you deserve the actual numbers rather than a vague reassurance — over 72 weeks in the STEP UP trials:
- Nausea affected 38.9% of patients on 7.2mg (versus 12.6% on placebo)
- Diarrhoea 24.2%, vomiting 22.1%, constipation 20.4% [1]
Most of these events were mild to moderate, of short duration, and concentrated in the dose-escalation period.
If you move to 7.2mg and experience anything on this list — or anything not on it — you don't need to wait for a scheduled check-in. Message our clinical team through your account. Persistent, severe abdominal pain in particular needs immediate medical attention, as it can be a symptom of pancreatitis, a rare but serious effect of this class of medicine [1].
The pen is different
If you and your clinician agree to move to 7.2mg, the device changes. The 7.2mg dose comes as a single-dose, pre-filled pen — different from the multi-dose pen with an attachable needle you've used for doses up to 2.4mg [1].
With the single-dose pen, you press it firmly against the skin until the yellow bar stops moving; the injection takes around five to ten seconds [1]. The injection sites are the same — abdomen, thigh, or upper arm, rotated as usual — and it remains once weekly, any time of day, with or without food [1]. Your clinician will walk you through the new device before your first dose, and the instructions for use come in the pack.
If you miss a dose, the same rule applies as now: take it as soon as possible within five days; if more than five days have passed, skip it and take your next dose on your usual day [1].
How a dose change works at our clinic
Moving to 7.2mg is a prescribing decision, so it follows the same clinical governance as every other change to your treatment:
- Request a clinical review through your account. Tell us you'd like to discuss the higher dose — or simply that your progress has slowed and you'd like a review.
- Your clinician assesses your case. They'll look at your progress, how you've tolerated 2.4mg, your health history, and whether the licensing criteria are met.
- You decide together. If it's appropriate, your prescription is updated and your medication is dispatched by our GPhC-registered pharmacy partner, with guidance on the new pen. If it isn't the right step now, your clinician will explain why and what the alternatives are.
Whatever the outcome, your regular check-ins continue — and if you do move to 7.2mg, we'll be monitoring how you respond, particularly in the early weeks.
Frequently asked questions
Do I have to move to 7.2mg?
No. 2.4mg remains a fully licensed maintenance dose, and for many patients it remains the right one. This is an additional option, not a new default.
Will it work faster?
The trial measured outcomes at 72 weeks — this is long-term treatment, not an accelerant. In STEP UP, the difference between doses built gradually over the full trial period [2].
What if I try it and the side effects are worse?
The dose can be lowered. The SmPC explicitly provides for returning to the previous dose until symptoms improve [1] — moving up is not a one-way door.
If you're unsure whether any of this applies to you, the simplest next step is a message to our clinical team through your account. That's what we're here for.
References
- Novo Nordisk Limited. Wegovy 7.2 mg solution for injection in pre-filled pen — Summary of Product Characteristics. electronic medicines compendium (emc). Last updated April 2026. Available at: medicines.org.uk/emc/product/102093/smpc
- Wharton S, Freitas P, Hjelmesaeth J, et al.; STEP UP trial group. Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. Lancet Diabetes Endocrinol. 2025;13(11):949–963. doi:10.1016/S2213-8587(25)00226-8
- ClinicalTrials.gov. A Research Study to See How Semaglutide Helps People With Excess Weight Lose Weight (STEP UP). Identifier: NCT05646706.
- Novo Nordisk / American Diabetes Association 85th Scientific Sessions (2025). STEP UP detailed results presentation (Wharton S).
- Lingvay I, et al. STEP UP T2D: once-weekly semaglutide 7.2 mg in adults with obesity and type 2 diabetes. Lancet Diabetes Endocrinol. 2025. (Published alongside STEP UP.)
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