Semaglutide has two once-weekly injection schedules in the United States and they end in different places. Ozempic, licensed for type 2 diabetes, stops at 2 mg. Wegovy, licensed for chronic weight management, maintains at 2.4 mg, with a 7.2 mg version approved in March 2026 for adults who have already tolerated 2.4 mg for at least four weeks.
That ceiling is why percentages do not transfer between the two brands. STEP 1's much-quoted -14.9% over 68 weeks was semaglutide 2.4 mg in adults without diabetes (PMID 33567185), a dose no Ozempic pen delivers. Ozempic's own ceiling was tested in SUSTAIN FORTE, where 2.0 mg produced a mean weight change of -6.9 kg over 40 weeks in 961 adults with type 2 diabetes (PMID 34293304). One chart, two ladders, and the numbers belong to whichever ladder they were measured on.
- Both brands are the same molecule and both start at 0.25 mg once weekly, then climb in four-week steps.
- Ozempic's ladder is 0.25, 0.5, 1 and 2 mg. Wegovy's is 0.25, 0.5, 1, 1.7 and 2.4 mg, reaching maintenance at week 17.
- Ozempic's 0.5 mg, 1 mg and 2 mg are all licensed maintenance doses for diabetes. Wegovy's intermediate doses are steps, not destinations.
- SUSTAIN FORTE found that doubling 1.0 mg to 2.0 mg in type 2 diabetes changed weight by 0.9 kg over 40 weeks, so the ceiling matters less than the population does.
The semaglutide dosage chart, both brands side by side
Put the two schedules in one table and the shape of the difference is obvious. They are identical for the first 12 weeks and diverge only at the top.
| Week | Ozempic (type 2 diabetes) | Wegovy (weight management) |
|---|---|---|
| 1 to 4 | 0.25 mg | 0.25 mg |
| 5 to 8 | 0.5 mg | 0.5 mg |
| 9 to 12 | 1 mg | 1 mg |
| 13 to 16 | 1 mg, or 2 mg after at least 4 weeks on 1 mg | 1.7 mg |
| 17 onward | 2 mg maximum | 2.4 mg maintenance |
| After 4 weeks at 2.4 mg | No higher labelled dose | 7.2 mg available since March 2026 |
The asymmetry in the week 13 to 16 row is the part most charts flatten. On the diabetes label, 0.5 mg, 1 mg and 2 mg are all maintenance doses, and moving up is a response to glucose control rather than a fixed calendar, so plenty of people stay at 0.5 mg or 1 mg indefinitely. On the weight-management label, 0.25 mg, 0.5 mg, 1 mg and 1.7 mg are escalation steps and 2.4 mg is the dose the schedule is aiming at.
Neither ladder has to be climbed on time. Both labels allow a step to be held for another four weeks if the current dose is not tolerated, which is the main reason a real dose history rarely matches a chart.
What each ceiling was actually tested at
Four trials cover the four doses people search for. Each row names the dose, the population, the duration and the figure, because a semaglutide percentage without all four is not comparable to anything.
| Dose | Trial | Population | Duration | Mean weight change |
|---|---|---|---|---|
| 1.0 mg | SUSTAIN FORTE (PMID 34293304) | Type 2 diabetes on metformin | 40 weeks | -6.0 kg |
| 2.0 mg | SUSTAIN FORTE (PMID 34293304) | Type 2 diabetes on metformin | 40 weeks | -6.9 kg |
| 2.4 mg | STEP 2 (PMID 33667417) | Overweight or obesity with type 2 diabetes | 68 weeks | -9.6% |
| 2.4 mg | STEP 1 (PMID 33567185) | Overweight or obesity, no diabetes | 68 weeks | -14.9% |
| 7.2 mg | STEP UP (PMID 40961952) | Obesity, no diabetes | 72 weeks | -18.7% |
SUSTAIN FORTE is the only one of these that compared two semaglutide doses head to head in the same people, and the result is worth holding on to. Doubling the weekly dose from 1.0 mg to 2.0 mg moved HbA1c by 0.23 percentage points and body weight by 0.93 kg over 40 weeks, on a trial-product estimand. Mean BMI at baseline was 34.6, so these were not people with little to lose.
Compare that with the gap between STEP 1 and STEP 2, which used the identical 2.4 mg dose for the identical 68 weeks and recorded -14.9% and -9.6%. The population changed the answer by about a third. The dose step at the top of the diabetes ladder changed it by under a kilogram. A dosage chart is a much weaker predictor of weight outcome than most of the pages built around one imply.
The 7.2 mg dose
STEP UP randomly assigned 1407 adults with obesity and no diabetes to semaglutide 7.2 mg, 2.4 mg or placebo for 72 weeks, and reported -18.7%, -15.6% and -3.9% (PMID 40961952). The higher dose is licensed in the United States for people who have tolerated 2.4 mg for at least four weeks and need further weight reduction, which makes it an extension of the Wegovy ladder rather than a new starting point. Our article on how much weight you can lose on Wegovy goes through that trial in more detail.
Turn the chart into your own numbers
The percentages in that table are trial averages. See what they work out to in pounds from your starting weight.
Why there are 16 weeks before the maintenance dose
The escalation exists for tolerability, not for effect. A pooled analysis of STEP 1 to 3 found that the cumulative incidence of a first gastrointestinal adverse event plateaued after week 20, which is to say that almost everyone who was going to feel sick had already felt sick by the time the dose stopped rising (PMID 34514682). In the STEP 4 run-in, 11.0% of participants did not reach the 2.4 mg target dose at all.
That is the practical reading of the left-hand column of any semaglutide chart: the first four months are spent buying tolerance to the dose that the trials measured, not producing the trial result. We set out what those trials logged in semaglutide side effects.
What this chart does not cover
- Oral semaglutide. The tablets are a separate product with their own milligram numbers, and those numbers do not map onto the weekly injection ladder. A 14 mg tablet is not five and a half times a 2.4 mg injection.
- Compounded semaglutide. Compounded vials are not covered by either label, and their concentration varies by supplier, which is why a dose expressed in syringe units cannot be copied between vials. The arithmetic is in our mg to units explainer.
- Tirzepatide. A different molecule on a different ladder, six strengths from 2.5 mg to 15 mg. We charted it in the tirzepatide dosage chart.
FAQ
What is the maximum dose of semaglutide?
It depends which label you are on. Ozempic's maximum is 2 mg once weekly. Wegovy maintains at 2.4 mg, and since March 2026 a 7.2 mg version is licensed in the United States for adults who have tolerated 2.4 mg for at least four weeks.
Is 2 mg of Ozempic the same as 2.4 mg of Wegovy?
It is the same molecule but not the same dose, and the trials behind each figure differ in population and duration too. SUSTAIN FORTE tested 2.0 mg in type 2 diabetes for 40 weeks and recorded -6.9 kg. STEP 1 tested 2.4 mg in adults without diabetes for 68 weeks and recorded -14.9%.
How long does it take to reach 2.4 mg?
Sixteen weeks on the Wegovy schedule, because each of the four steps below it lasts at least four weeks, so 2.4 mg begins at week 17. A step can be held longer if it is not tolerated, which pushes the date back.
What is the 1.7 mg dose for?
It is the last escalation step before Wegovy's 2.4 mg maintenance dose, and it is not intended as a long-term dose. It does appear as a maximum tolerated dose in trials: SURMOUNT-5 randomised participants to the maximum tolerated dose of semaglutide, defined as either 1.7 mg or 2.4 mg.
Does a higher semaglutide dose mean more weight loss?
Within one trial, more often than not, but by less than the chart suggests. SUSTAIN FORTE doubled the dose from 1.0 mg to 2.0 mg and moved mean weight by 0.93 kg over 40 weeks. STEP UP tripled 2.4 mg to 7.2 mg and moved it by 3.1 percentage points over 72 weeks.
What dose of semaglutide is used for weight loss?
The licensed weight-management maintenance dose is 2.4 mg once weekly, and that is the dose every headline STEP weight-loss percentage comes from. The 7.2 mg dose is licensed as a step above it rather than as a starting point.
This article describes what the semaglutide labels and the published trials say. It is not medical advice and not a dosing instruction. Starting, changing, splitting or stopping a dose is a decision for your prescriber.
Sources
- Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). <em>N Engl J Med</em>. 2021;384(11):989-1002. PMID: 33567185
- Davies M, Færch L, Jeppesen OK, et al. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2). <em>Lancet</em>. 2021;397(10278):971-984. PMID: 33667417
- Frias JP, Auerbach P, Bajaj HS, et al. Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE). <em>Lancet Diabetes Endocrinol</em>. 2021;9(9):563-574. PMID: 34293304
- Wharton S, Davies M, Lingvay I, et al. Once-weekly semaglutide 7·2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. <em>Lancet Diabetes Endocrinol</em>. 2025;13(11):949-963. PMID: 40961952
- Wharton S, Calanna S, Davies M, et al. Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity. <em>Diabetes Obes Metab</em>. 2022;24(1):94-105. PMID: 34514682
- Ozempic (semaglutide) and Wegovy (semaglutide) United States prescribing information, Novo Nordisk, for the escalation steps, the four-week interval, the 2 mg and 2.4 mg ceilings and the 7.2 mg dose.