Starting Wegovy: what to expect in weeks 1-4

Week 1: 0.25 mg — the "starter" dose

The starting dose is intentionally small. It's not meant to cause weight loss yet — it's a ramp-up to help your body get used to semaglutide. Most people feel mild nausea, fullness, or a "quieter" appetite within the first few days.

What helps: sip water constantly, eat small protein-rich meals, avoid greasy or fried foods, and keep something bland (crackers, plain toast) nearby.

Weeks 2-3: settling in

Side effects usually peak in the first 3-4 days after a dose and then ease off. Your "food noise" — the constant mental chatter about eating — may start quieting down. This is when a lot of people feel their first real shift.

Watch for: mild constipation (fiber + water fix this), fatigue if you're under-eating, and shrunken thirst — set water reminders.

Week 5: 0.5 mg — the first bump

Around week 5 your prescriber steps you up to 0.5 mg. Expect a mini-repeat of week 1 side effects for a few days. This is normal. Log how you feel — patterns emerge quickly.

The full ramp

The FDA-approved Wegovy titration is 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg, stepping up every 4 weeks. Some people stay at a lower dose if it's working; some ramp faster or slower depending on tolerability. Always follow your prescriber.

What to eat

• Protein first, every meal — 60-80g/day minimum to protect muscle
• Small meals every 3-4 hours — a big plate feels overwhelming now
• Cooked vegetables digest easier than raw
• Skip: fried food, alcohol, carbonated drinks, huge portions
• Electrolytes daily — dehydration makes every side effect worse

When to call your prescriber

Persistent vomiting, severe stomach pain, signs of pancreatitis, or dehydration are not "just" side effects — reach out. Your doctor may pause the ramp or drop back a dose.