A Wegovy programme, run by an obesity physician - not a website.

Wegovy pen prices vary by dose and by pharmacy - UK supply has improved through 2025 after the 2023 to 2024 global shortage. NICE TA875 caps NHS specialist weight-management use at two years private care carries no such cap, but a long-term maintenance plan is essential.

1. 01

   Before

   You send us your height, weight and history

   A short, confidential form. BMI, comorbidities (T2DM, hypertension, OSA, NAFLD, cardiovascular disease), previous weight-loss attempts, and any thyroid or pancreas history.

2. 02

   Before

   We come back with a recommendation

   Within one working day: whether Wegovy fits, whether Mounjaro (tirzepatide) is a better call, or whether a bariatric pathway makes more sense. Indicative annual cost.

3. 03

   Before

   Specialist consultation and baseline bloods

   A 45 to 60 minute consultation. Baseline TFT, HbA1c, lipids, LFT, U&E, amylase and pregnancy test. Contraindications are ruled out before a pen is prescribed.

4. 04

   Starting

   First dose and injection teaching

   You start at 0.25 mg subcutaneous once weekly, into abdomen or thigh. A nurse teaches the pen, rotation of sites, and how to manage early nausea.

5. 05

   Starting

   Monthly dose escalation

   0.25 to 0.5 to 1.0 to 1.7 to 2.4 mg, one step per month. Escalation is slowed or held if side effects are intolerable. The target is the highest tolerated dose, not the highest dose.

6. 06

   On programme

   Monthly medical reviews

   Weight, blood pressure, side effect check, dietitian and exercise coaching. Bloods repeated at 3 and 12 months. A conversation about long-term maintenance from month 6.

7. 07

   On programme

   Long-term maintenance planning

   The STEP trials show weight regain when the drug is stopped. From month 12 we plan continued therapy, tapered doses, or a structured off-drug maintenance protocol with close review.

Escalation: 5 months. Full response by: 68 weeks. Maintenance conversation: month 12.

• BMI 35 or above with one weight-related comorbidity

  Type 2 diabetes, hypertension, obstructive sleep apnoea, non-alcoholic fatty liver disease, or dyslipidaemia. This is the core NICE TA875 eligibility group.

• BMI 30 or above with established cardiovascular disease

  Post SELECT trial, obese non-diabetic adults with prior MI, stroke or PAD qualify - a roughly 20% relative reduction in major adverse cardiovascular events.

• Type 2 diabetes with poor glycaemic control

  Where lifestyle plus first-line agents have not brought HbA1c to target, and weight loss would help both glucose and cardiovascular risk together.

• Pre-bariatric-surgery optimisation

  Selected patients use 6 to 9 months of Wegovy to reduce liver volume and operative risk before sleeve gastrectomy or gastric bypass.

• Weight regain after bariatric surgery

  Regain 3 to 5 years after sleeve or bypass is common. Wegovy is an evidence-based option, done alongside the bariatric team, not instead of them.

• Obesity with obstructive sleep apnoea

  10 to 15% weight loss meaningfully reduces AHI and CPAP dependence. We coordinate with the sleep physician so CPAP is retitrated as you lose weight.

• HFpEF with obesity phenotype

  The STEP HFpEF trial showed symptom, quality-of-life and exercise capacity gains. Discussed with your cardiologist before starting.

• Red flag: MTC, MEN2 or active pancreatitis

  Personal or family history of medullary thyroid cancer or MEN2, active pancreatitis, type 1 diabetes, pregnancy or breastfeeding - Wegovy is not for you.

• Nausea in the first weeks

  60 to 80% of patients get nausea in the escalation phase. It usually settles within 2 to 4 weeks at each step. Smaller meals, low-fat, avoiding alcohol - and slowing the escalation if needed.

• Constipation and reflux

  Common through escalation. Managed with fibre, hydration, movement, and short-term laxatives or PPI. Not a reason to abandon the programme.

• Vomiting and injection-site reactions

  Less common than nausea, mostly mild. Injection sites are rotated between abdomen and thigh. Persistent vomiting is a reason to hold the dose and review.

• Rare: pancreatitis and gallstones

  Acute pancreatitis is rare but reported. Gallstones are commoner during rapid weight loss with any modality. Persistent abdominal pain radiating to the back needs same-day review.

• Gastroparesis and delayed gastric emptying

  Semaglutide slows gastric emptying by design. This matters before a general anaesthetic - stop the drug at least 3 weeks before elective GA, per current UK anaesthesia guidance.

• Thyroid C-cell signal

  Contraindicated in personal or family history of medullary thyroid carcinoma (MTC) or MEN2 - based on rodent data. We screen for this before you start.

• Mood and suicidal ideation

  A regulator-reviewed signal that has not been confirmed. We ask about mood at every review and stop the drug if new low mood or suicidal thoughts appear.

• Realistic weight-loss expectations

  Average 12 to 15% total body weight loss over 68 weeks in STEP 1. Around 65% achieve 10% or more. Response varies - a small minority lose little.

• What happens if you stop

  STEP 4 showed roughly two-thirds of lost weight is regained within a year of stopping. Long-term therapy or an intensive maintenance plan is the honest conversation.