GLP-1s like Wegovy have become some of the most well-known medications out there — whether or not you are taking them, you probably have a solid idea of what they do. Yes, they suppress your appetite. And yes, you can lose significant weight with them. But as much as you may know about GLP-1s, there’s probably a good amount you probably don’t know. Exhibit A: How long does Wegovy stay in your system? Knowing that answer can help you see why weekly doses are needed both while you’re losing and while you're maintaining weight.
What is Wegovy used for?
Wegovy is a brand name for the drug semaglutide, which is a synthetic version of a naturally occurring hormone in the body called glucagon-like peptide-1, or GLP-1. “GLP-1 has many roles that include increasing your body’s ability to release insulin to manage blood sugar, slowing the release of food from your stomach, and reducing appetite,” says Dr. Robert Kushner, M.D., professor of medicine and medical education at Northwestern University Feinberg School of Medicine in Chicago.
GLP-1s work in a number of ways to bring on weight loss, but “their effect on reducing appetite is the major benefit of semaglutide when treating obesity,” Kushner says. While the FDA has approved Wegovy for weight loss, there is another version of semaglutide prescribed under the brand name Ozempic which is FDA-approved for type 2 diabetes.
Do higher doses of Wegovy work better?
First, a little background: Doctors typically start patients on Wegovy at 0.25mg (the amount recommended by the manufacturer). They then slowly scale up in dosage over the course of several months.
Higher doses do seem to work better. One study published in JAMA Network Open followed people taking different dosages of semaglutide and found that, after six months, those taking 1.7mg or 2.4mg doses had an average weight loss of 12.1% of their starting weight while those taking lower doses of 1mg or less lost an average of 9.2% of their weight.
So why not just go with the highest dose off the bat? For one, the higher the dosage, the more at risk you are for the most common Wegovy side effects, which include nausea, constipation, and vomiting. And increasing the dosage too quickly can trigger more side effects, too, since your body doesn’t have time to adjust.
Plus, the highest dose just might not be necessary. “We reserve the higher doses in case we need them,” says Dr. Charlie Seltzer, M.D., an obesity specialist based in Philadelphia. “If someone's losing a pound or two pounds a week [on a lower dose] and they feel like their appetite is controlled, then we'll keep them on that dose for as long as it works.”
How long does Wegovy stay in your body?
Semaglutide can stay in the body for about four to five weeks after you inject it, says Kushner, but that doesn’t necessarily mean its effects will last that long. After all, “semaglutide is used as a once weekly self-injectable medication, which means that it must be taken weekly for its therapeutic effect,” he says. In other words, after about a week, it will stop having the same impact on your appetite. “People start to get hungry around a week after their last injection,” Seltzer says.
Does Wegovy build up in your system?
No, there’s no cumulative effect from Wegovy. You could be on semaglutide for years and, once you stop taking it, stop feeling the impact of the weight-loss medication on your hunger levels. Your body doesn’t stockpile the drug to maintain its appetite-suppressant effects. That’s one reason why people are likely to regain some of the weight they lose after they stop taking Wegovy. One study found that after people took semaglutide for 20 weeks and then stopped, they gained back almost 7% of their body weight within a year.
Can you skip a week of Wegovy?
Yes, if needed you can skip a week of Wegovy. For instance, Seltzer says, your doctor might ask you to stop using Wegovy the week before a medical procedure because semaglutide delays how quickly your stomach empties, which can interfere with anesthesia. Or maybe there’s a shortage and you can’t get a refill in time.
If you do skip a week, you will probably notice that your appetite has gotten bigger. In fact, Seltzer has found anecdotally that patients feel more hungry after the effects of semaglutide wear off than they were pre-Wegovy. Skipping a week is also not ideal in terms of the side effects. In some cases, “people will adjust to the side effects — and when you skip the week, sometimes the side effects come back,” Seltzer says.
How long can you stay on 0.25mg Wegovy?
Most people start their GLP-1 program at 0.25mg, which is the minimum dose. The only exception, says Seltzer, is if you’re taking it for a medical reason, like for a heart condition, and your cardiologist wants you to start at a higher dose for that purpose. (In addition to being used for weight loss, Wegovy also has FDA approval to help prevent another heart attack and stroke in patients who’ve already had one.)
You can stay at a weekly 0.25mg dose indefinitely if you’re seeing results. “If a person responds to a lower dose with good weight loss, further dose escalation may not be needed,” says Kushner. If you aren’t losing weight at the desired speed, your provider will slowly escalate it every month until you reach the maximum dosage of 2.4mg — again, only going up that high if it’s needed. The exact dosage you land on can be whatever your sweet spot is between maximum weight loss and minimal side effects. “Dose escalation can be slowed down if troubling side effects are being experienced,” Kushner says.
The bottom line
So, how long does Wegovy stay in your system? It’s about four to five weeks, but after a week the medication becomes less effective at reducing your appetite. That’s why those taking GLP-1s like Wegovy for weight loss should expect to stay on the medication long-term if you want to maintain your results.
FAQs
It takes roughly four to five weeks for Wegovy to completely leave your body, although its weight-management benefits may slow down sooner than that — in fact, you might feel your appetite return after about a week.
While it isn’t a guarantee, people who lose weight with Wegovy and then stop taking it are likely to regain at least some of the weight they lost. There have been multiple studies showing that people regained one-half to two-thirds of the weight that they lost on the medication within a year of stopping it. This is one reason why it’s so important to pair weight-loss medications with healthy habits you can stick with in the long run (and why the WeightWatchers GLP-1 Program, which helps you focus on nutrition and activity, is so great for people taking Wegovy).
This content is for informational purposes only and does not constitute medical advice, diagnosis or treatment. It should not be regarded as a substitute for guidance from your healthcare provider.