When you start a GLP-1 medication, you don't begin at the full dose. You start low and move up gradually over several months. This process is called dose titration, and it exists for a good reason: it gives your body time to adapt and dramatically reduces the chance of side effects.
Why Do GLP-1 Doses Start Low?
Your gut is not used to slower stomach emptying. Your brain is not used to the changed appetite signals. Starting at a low dose lets your body adjust to both of those changes a little at a time. Most people tolerate the starting dose well, even if the first week feels different.
Skipping ahead to a higher dose almost always means more side effects - not faster results. Manufacturers built titration schedules from large clinical trials. The 4-week intervals are not arbitrary. They reflect the typical time it takes for nausea and early side effects to settle down.
What Do Typical Titration Schedules Look Like?
Each medication follows its own schedule. Here are the standard progressions:
- Semaglutide (Wegovy): 0.25 mg weekly for 4 weeks, then 0.5 mg, 1 mg, 1.7 mg, and finally 2.4 mg.
- Tirzepatide (Zepbound, Mounjaro): 2.5 mg weekly for 4 weeks, then 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg.
- Liraglutide (Saxenda): 0.6 mg daily for 1 week, then increasing by 0.6 mg per week up to 3 mg.
| 📝 Note: Your provider may adjust the schedule based on how you're tolerating each dose. Going slower than the printed schedule is a completely normal and reasonable choice. |
When Should You Slow Down or Hold Your Dose?
Plan to stay at each dose for at least the printed interval before moving up. If you are still experiencing nausea, constipation, or fatigue at the end of that window, hold the current dose for another 1 to 4 weeks.
The next step will land much more gently when your body is already comfortable at the current level. If a dose increase makes things noticeably worse, your provider may step you back down. There's no benefit to pushing through a dose that isn't working for your body.
| ⚠️ Warning: Never adjust your dose on your own. Any changes to your titration schedule should be made in conversation with your healthcare provider. |
Do You Have to Reach the Highest Dose?
No. Many people plateau at a middle dose with results they're happy with. The goal is the right dose for your body and your goals - not the highest available dose.
Once your weight has stabilized, your provider may keep you at a maintenance dose indefinitely or trial a step back down. Long-term dosing decisions are individual and depend on your goals, tolerance, and medical history.
| ✅ Success: If you're feeling satisfied between meals, losing weight at a steady pace, and tolerating your current dose well, you may already be at the right level for you. |
Sources
- FDA Prescribing Information for Wegovy, Saxenda, and Zepbound. Wegovy | Saxenda | Zepbound
- Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 2021. https://doi.org/10.1056/NEJMoa2032183
- Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine, 2022. https://doi.org/10.1056/NEJMoa2206038
- The FITIV Support Team