What is Wegovy (Semaglutide)?

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Wegovy is a prescription medication approved in the UK for adults who are living with obesity, or who are overweight with at least one weight-related health condition such as type 2 diabetes, high blood pressure, or high cholesterol. It belongs to a class of drugs called GLP-1 receptor agonists, which work by mimicking appetite-regulating hormones. This helps reduce hunger and supports weight management. Wegovy is administered as a weekly injection, starting at a dose of 0.25 mg.

Read our in-depth guide on what Wegovy is and how it works.

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How to set realistic first month expectations

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In the first month, weight loss is generally modest. Most people experience gradual changes, often around 0.5-2kg (or 1–5 pounds) depending on individual factors. The initial 0.25 mg dose is primarily an introduction, and the first month focuses on adjustment rather than maximum weight loss. Everyone responds differently, so it’s important to focus on small, steady progress rather than immediate results.

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What to expect in your first box of Wegovy

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Your first box of Wegovy contains one pen, providing four weekly injections at the starting 0.25 mg dose. It is important to follow the weekly injection schedule, rotate injection sites, and ensure correct injection technique (watch our video to learn more).

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How your body loses weight in the first month on Wegovy

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When starting a GLP-1 medication, changes in weight often happen slowly and for some people, there may be little or no change at first. In the first couple of weeks, most of the weight you see lost is water, not fat. This happens because your body uses stored carbohydrates (called glycogen) for energy, and each gram of glycogen is stored with water.

Actual fat loss usually starts after 2–3 weeks, once your body begins using stored fat for energy. Even before the scale shows big changes, you may notice your waistline shrinking. These early changes are a healthy and normal part of how your body responds to the medication.

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How your appetite and hunger cravings changes

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As your body adjusts, you may notice gradual appetite suppression and changes in hunger and fullness cues. Many people experience reduced interest in high-calorie foods and fewer cravings for sugar. These effects often continue to increase as the dose is escalated.

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Common side effects when starting Wegovy and how to manage them

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During the first month on Wegovy, some people may notice side effects as their body adjusts to the medication. Nausea or vomiting can occur, especially during the first few weeks. You might also experience fatigue, digestive changes such as constipation or diarrhoea, headaches, dizziness, or minor reactions at the injection site.

These effects are usually temporary and tend to improve as your body becomes accustomed to the medication. To help manage side effects, drink plenty of water, eat small, bland meals if you feel nauseous, and avoid high fat or spicy foods when feeling unwell. Take your injection at a time of day that fits your routine to minimise disruption.

It’s important to contact Phlo Clinic if side effects are severe, persistent, or worrying. We can offer guidance on coping strategies or adjust your treatment if needed.

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Monitoring progress beyond the scale

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Weight is only one measure of progress. Pay attention to changes in how your clothes fit, energy levels, blood glucose stability, mood and sleep quality. These indicators often improve even before significant scale changes are visible.

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4 tips to get the most out of your first month on Wegovy

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1. Adjust Your diet

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During the first month, aim to eat three balanced meals a day, with snacks in between if hungry. Drink 2–3 litres of water daily to support digestion and hydration. If nausea occurs, stick to bland foods such as plain rice, toast, boiled potatoes, or bananas, and avoid foods high in fat or spicy meals. Even if portions are smaller than usual, ensure each meal contains protein, complex carbohydrates, vegetables, and a small amount of healthy fats.

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2. Include gentle exercise in your routine

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Introduce or continue gentle physical activity, focusing on consistency rather than intensity. Low-impact activities such as walking, stretching, or light resistance exercises are often well-tolerated while your body adjusts. Plan workouts around injection days if you find energy levels fluctuate.

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3. Track weight loss and diet changes along the way

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Documenting changes can help you and your healthcare provider evaluate progress. Keep baseline measurements and photos, note energy levels, mood, and appetite, and use digital tools or apps if helpful.

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4. Plan ahead for follow-up appointments and your next Wegovy dose

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After the first four weeks, when you re-order your medication, you can choose to continue with the same dose or increase your dose. A Phlo Clinic Pharmacist will review your progress, including weight changes and how well you have tolerated any side effects, to determine which dose is most suitable for you. Report any side effects accurately to support safe and effective treatment.

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References

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Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., … & Kushner, R. F. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 384(11), 989–1002. https://doi.org/10.1056/NEJMoa2032183

Blundell, J., Finlayson, G., Axelsen, M., Flint, A., Gibbons, C., Kvist, T., … & Wilding, J. P. H. (2021). Effects of once-weekly semaglutide on appetite, energy intake, control of eating, and body weight in subjects with obesity. Diabetes, Obesity and Metabolism, 23(6), 1128–1139. https://doi.org/10.1111/dom.14355

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