What to expect during your first week on Wegovy

You've done all the hard work already — read the research, attended the consults, listened to advice, and ordered your supplies.

Now that it's time to actually start your Wegovy weight loss journey, it's normal to be wondering what to expect over the next few weeks and months.

So let's explore together! Beginning a new medication or making lifestyle changes can sometimes feel overwhelming, but starting Wegovy doesn't have to be daunting. Knowing what to expect ahead of time can help you feel prepared, and make it easier to stay on track with your treatment goals.

First, let's have a bit of a refresher on how Wegovy actually works.

How does Wegovy affect the body?

Wegovy (also known by its official name, semaglutide) is a weight loss medication designed to help people with weight management and weight-related health conditions.

It works by targeting the areas of your brain that affect your appetite — reducing your hunger level and limiting cravings for high-fat foods [1].

Wegovy belongs to a group of medicines called GLP-1 agonists. What this means is that Wegovy mimics a hormone in the body called GLP-1 [2].

GLP-1 gets released in our body after eating — it helps regulate insulin and blood sugar levels and slows down food digestion. All of this helps to increase feelings of fullness and reduces appetite between meals [3].

If people don't have enough GLP-1 or it's not working as it should, they can be more likely to eat more during meals or snack in between meals [3]. In a nutshell, taking Wegovy helps people feel full for longe — which leads to reduced food intake and weight loss [2].

Who can take Wegovy?

As of 2023, Wegovy is now available for anyone living with obesity or other weight-related health concerns.

The guidelines recommend Wegovy for people with a body mass index (BMI) of 30 or over, or people with a BMI of 27 or over who have another weight-related condition like high blood pressure, high cholesterol, or pre-diabetes [1].

You shouldn't take Wegovy if you have certain health conditions, or a history (including family history) of certain conditions, such as:

• Thyroid cancer, especially a type of thyroid cancer called medullary thyroid carcinoma (MTC)
• An endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• Problems with your pancreas or kidneys
• Type 2 diabetes and/or a history of diabetic retinopathy

It's also not recommended to take Wegovy if you're pregnant or plan to get pregnant, or if you're breastfeeding or planning to breastfeed [4].

Clinical trials for Wegovy showed that people lost around 15% of their body weight when combined with healthy diet and exercise changes [1]. So what happens when you start taking it for the first time?

What can you expect during your first week on Wegovy?

Getting assessed for Wegovy

If there's one thing we want you to remember, it's this: healthy weight loss is a marathon, not a sprint. You probably won't notice weight loss on your first week of taking Wegovy, and that's normal [5].

Before you get started on Wegovy, your doctor or healthcare provider will do an assessment to make sure it's the right medication for you, take your medical history, and help you figure out your weight loss goals [2].

They'll ask about things like if you have any pre-existing health conditions, how much weight you should be aiming to lose, and how Wegovy will fit into your treatment plan [2].

They'll usually record your starting weight so you can track your weight loss progress, and discuss any side effects to look out for. Then, they'll discuss your dose and how to administer your medication for the first time [5].

Want to make it even easier to get started? Juniper’s Weight Reset Programme has everything you need in one place.

That includes health coaches, medical experts, dietitians, and a whole community to support you on your weight loss journey. Not to mention, the medication (discreetly) shows up on your doorstep thanks to our accessible prescribers.

Getting the right dose

Wegovy is taken as a once-weekly injection — it's injected underneath your skin, usually in your upper arm, stomach, or thigh. It should be taken on the same day each week, but it can be taken any time of day before or after food [5].

The starting dosage of Wegovy is 0.25mg, taken once a week for the first 4 weeks.

After starting on this dose, you'll gradually work your way up to a higher dosage (usually either 1.7 mg or 2.4mg a week). This higher dose is called your maintenance dose [5].

Starting at a smaller dose gives your body a chance to adapt to how the medication works, and can reduce any negative side effects [5].

Taking your first dose

When it's time for your first injection, it's important to follow your doctor or healthcare provider's instructions as well as read the instruction leaflet that comes with your medication.

If you're feeling nervous about injecting yourself, that's okay — make sure you reach out to a healthcare professional and they can talk you through it [5].

Pick a day of the week that suits you to take your first shot, and that will be the day you take your injection each week.

If you need to change the day of the week you take Wegovy you can, as long as your last injection was 2 or more days before [6]. Some people find it helpful to keep a log of when they've taken their dose and set reminders for their next dose [7].

After the first dose

As your body adjusts to Wegovy, you might notice some of its effects immediately after the first dose. This could include changes to your appetite, or feeling fuller than you normally do.

Because you've only just started Wegovy, this full stomach feeling might wear off after the first few days instead of lasting the whole week [5] [8].

You might also notice a lot of the cravings or 'food noise' are gone, meaning you're not constantly thinking about what or when to eat next. This can make it much easier to eat a balanced diet [5][8].

This early stage is also a great time to start introducing healthy lifestyle changes you want to make — like doing more physical activity, trying new healthy foods, or keeping a journal of all the things motivating you to lose excess weight [9].

Getting these habits locked in during the first few weeks can lead to more sustainable weight loss, but can also help you have more weight loss success [9].

What side effects can I expect?

Though most people experience minimal side effects after their first Wegovy dose, you might notice some popping up.

The most common side effects people experience are nausea, constipation, diarrhoea, stomach pain, gas or bloating, fatigue, headaches, and heartburn — but these usually don't last long [5].

Other potential side effects that can be more serious include:

• Severe stomach pain (with or without vomiting)
• Problems with your pancreas
• Gallbladder problems
• Increased risk of low blood sugar (especially if you have diabetes and take certain medicines)
• Increased heart rate
• Changes in your vision
• Kidney problems
• Allergic reaction to semaglutide
• Depression, mood changes, or suicidal thoughts [5].

It's really important that if you notice any of these side effects, you seek medical attention immediately. Checking in with your healthcare provider regularly can help you know what to look out for, and when to get help [5].

If you're experiencing some of the more common side effects, like nausea, you can try a few easy tweaks to help you manage until it passes. Try to:

• Eat your food more slowly
• Eat bland or easy-to-digest foods like toast, rice, or plain crackers
• Get outside for some fresh air
• Eat foods that contain water, like soup or jelly [5].

When does weight loss typically start?

The number one question on everyone's mind: how long does it take to lose weight on Wegovy?

Everyone's body will process Wegovy differently — there's no set standard for how quickly people lose weight, or how much body weight you should lose [4].

Like most weight loss treatments, Wegovy reaches its full effect when you're at your final maintenance dose. This can take up to 4 months, as the drug's levels reach a steady state in your body.

Why go this slowly? You're much less likely to experience negative side effects by following the recommended dosage plan [5][8].

This doesn't mean you won't start losing weight sooner than the 4-month mark. Some people notice positive weight loss results at 8-12 weeks, or even sooner in some studies. According to the research, most people lose at least 5% of their body weight in the first 3 months of treatment [5][8].

All of this can also depend on any other weight loss strategies you've been implementing, like diet and exercise. If you're not losing weight after 3 months, it doesn't mean it's time to give up — it could just be that your treatment plan needs changing up a bit [5][8].

And if we could sum up all the advice we have, it'd be: stay in touch with your treatment team and be gentle with yourself in this new phase. Reaching your goals is much closer than you think.

Image credit: Pexels / Pavel Danilyuk