Wegovy First Month Results: What to Expect Week by Week

During your first month on Wegovy (semaglutide 2.4 mg), expect modest weight loss of around 2% of body weight, which translates to roughly 3 to 5 pounds for most people.

Clinical trial data from the STEP 1 study shows that participants lost just over 2% of their body weight by week 5. The first month is primarily about letting your body adjust to the medication rather than achieving dramatic results.

If you’re starting Wegovy and wondering what the first few weeks will look like, here’s a realistic week by week breakdown of what to expect.

Understanding the First Month Dose

Wegovy uses a gradual dose escalation schedule to minimize side effects. During month one, you’re on the lowest dose: 0.25 mg weekly. This starter dose isn’t designed for significant weight loss. Its purpose is to help your body adapt to semaglutide before moving to higher, more effective doses.

The full dosing schedule looks like this:

• Month 1: 0.25 mg
• Month 2: 0.5 mg
• Month 3: 1.0 mg
• Month 4: 1.7 mg
• Month 5 onward: 2.4 mg (maintenance dose)

Real weight loss typically accelerates once you reach 0.5 mg and continues improving through the higher doses.

Week 1: Getting Started

What happens: You’ll take your first injection and begin adjusting to having semaglutide in your system. Most people don’t notice dramatic changes during the first week.

Appetite changes: Some people notice slightly reduced hunger, but many feel no different yet. The medication needs time to build up in your system.

Side effects: Gastrointestinal effects like mild nausea can appear within the first few days. Eating smaller meals and avoiding fatty foods helps. Some people experience no side effects at all during week one.

Weight changes: Don’t expect noticeable scale movement yet. Any early weight loss is typically water weight fluctuation rather than fat loss.

Week 2: Building Steady State

What happens: Semaglutide levels in your body are increasing but haven’t reached steady state yet. The medication takes about 4 to 5 weeks to reach consistent levels.

Appetite changes: You might start noticing subtle differences in how hungry you feel between meals. Some people report feeling satisfied with slightly smaller portions.

Side effects: If you’re going to experience nausea or digestive discomfort, it often appears or intensifies during week two. Staying hydrated and eating slowly can help. Sulfur burps are another common experience some users report.

Weight changes: Still minimal. A pound or two is possible, but many people see no change yet.

Week 3: Signs of Progress

What happens: Your body is adapting to the medication. Semaglutide levels are becoming more stable.

Appetite changes: More consistent appetite suppression typically emerges. You might notice:

• Feeling full faster during meals
• Less interest in snacking
• Reduced cravings for certain foods
• The ability to stop eating when satisfied

Side effects: For most people, initial side effects begin improving by week three as the body adjusts. If nausea persists, it’s usually mild.

Weight changes: Some people see their first noticeable weight loss during week three, typically 1 to 3 pounds total from baseline.

Week 4: Completing Month One

What happens: You’ve completed your first full month and are preparing to increase to the 0.5 mg dose.

Appetite changes: The appetite suppressing effects should feel more consistent now. Many people describe feeling more “neutral” about food, with less obsessive thinking about meals and snacks.

Side effects: Most initial side effects have subsided. However, be prepared for a potential return of nausea when you increase to 0.5 mg in week five.

Weight changes: By the end of month one, expect around 2% weight loss from your starting point. For someone starting at 220 pounds, that’s about 4 to 5 pounds. For someone at 180 pounds, it might be 3 to 4 pounds.

What “Normal” Looks Like in Month One

Here’s what clinical data tells us about first month results:

These numbers might seem modest compared to the dramatic transformations you see online. Remember: those results represent many months of treatment, not the first four weeks.

Signs Wegovy Is Working (Even If the Scale Doesn’t Move Much)

Weight loss isn’t the only indicator that semaglutide is doing its job. Look for these positive signs:

Reduced appetite is the clearest signal. If you’re naturally eating less without feeling deprived, the medication is working.

Quieter “food noise” means less mental chatter about eating. Many people describe this as the most noticeable early change.

Feeling satisfied sooner during meals indicates the medication is affecting your hunger signals properly.

Fewer cravings for specific foods, especially sweets or fatty foods, suggests the medication is influencing your food preferences.

If you’re experiencing these changes, you’re likely on track for meaningful results in the months ahead.

Managing Common First Month Challenges

Nausea: The most common side effect. Eat smaller, more frequent meals. Avoid lying down right after eating. Bland foods are easier to tolerate than rich or fatty options.

Constipation: Stay hydrated and include fiber in your diet. Gentle movement helps keep things moving.

Fatigue: Some people feel tired during the adjustment period, possibly from reduced calorie intake. Ensure adequate protein and hydration.

Injection site reactions: Rotate injection sites between your abdomen, thigh, and upper arm. Mild redness or itching usually resolves quickly.

What Comes After Month One

The real results begin emerging in months two and three. Here’s what typical progression looks like:

• Month 2 (0.5 mg): Weight loss accelerates to around 4% total
• Month 3 (1.0 mg): Approximately 6% total weight loss
• Month 4 (1.7 mg): Around 8% total weight loss
• Months 5 to 12 (2.4 mg): Continued progress toward 14% to 15% average

By month six, most people have lost 10% to 12% of their starting weight. The transformation that seems impossible in month one becomes undeniable by month six.

When to Be Concerned

While modest first month results are normal, certain situations warrant discussing with your provider:

• Severe nausea that prevents eating or drinking
• Vomiting that doesn’t improve after the first week
• Signs of dehydration
• Severe abdominal pain
• No appetite changes at all by week four

Most people tolerate Wegovy well, but your provider can help troubleshoot if issues arise.

Getting Started With Semaglutide

If you’re considering Wegovy or compounded semaglutide for weight loss, TrimRx offers telehealth consultations to help you understand your options. Compounded semaglutide provides the same active ingredient at more affordable prices.

You can take the intake quiz to see if you qualify and learn about getting started.

The Bottom Line

Your first month on Wegovy sets the foundation for what comes next. Expect modest weight loss of around 2% (3 to 5 pounds), gradual appetite changes, and some adjustment as your body gets used to the medication.

The real transformation unfolds over the following months as you progress to higher doses. Month one is about patience and adjustment. Trust the process, manage side effects proactively, and know that the results you’re hoping for are coming.

This information is for educational purposes and is not medical advice. Consult with a healthcare provider before starting any medication. Individual results may vary.