Missing a weekly Wegovy (semaglutide) injection is a common concern for patients using this GLP-1 receptor agonist for weight management. Skipping a week of Wegovy can disrupt steady-state drug levels and temporarily reduce appetite suppression, though a single missed dose rarely causes lasting harm. The MHRA-approved guidance provides clear instructions: take the missed dose if fewer than five days have passed, or skip it entirely and resume your regular schedule if more time has elapsed. Understanding how to manage missed doses, minimise side effects upon resumption, and maintain weight loss during treatment gaps is essential for successful long-term outcomes with this once-weekly subcutaneous medication.

What Happens If You Skip a Week of Wegovy

Wegovy (semaglutide 2.4 mg) is a once-weekly subcutaneous injection licensed in the UK for weight management in adults with obesity or overweight with weight-related comorbidities, and in adolescents aged 12 years and older with obesity. Missing a single dose can disrupt the steady-state concentration of semaglutide in your system, though the clinical impact depends on how long you've been on treatment and your current dose level.

Semaglutide has a half-life of approximately one week, meaning it takes around five weeks to reach steady-state levels in your body. When you skip a week, blood levels begin to decline, which may reduce the medication's appetite-suppressing effects. You may notice increased appetite and reduced feeling of fullness as the drug's action on GLP-1 receptors in the brain and gastrointestinal tract diminishes.

According to the MHRA-approved prescribing information, if fewer than five days have passed since your missed dose, you should take it as soon as you remember. If more than five days have elapsed, skip the missed dose entirely and resume your regular schedule with the next planned injection. If you wish to change your weekly injection day, ensure there are at least 3 days between doses. Taking two doses too close together increases the risk of gastrointestinal side effects such as nausea, vomiting, and diarrhoea.

There is no evidence that missing a single dose causes permanent harm or significantly compromises long-term weight loss outcomes, provided you resume treatment promptly. However, repeated interruptions may reduce overall efficacy and make it harder to maintain the metabolic benefits achieved during consistent treatment. If you anticipate missing doses due to travel, illness, or medication supply issues, discuss contingency planning with your prescriber in advance.

How to Resume Wegovy After Missing a Dose

The approach to resuming Wegovy depends on how long treatment has been interrupted. For a single missed dose where fewer than five days have passed, administer the injection as soon as possible, then return to your regular weekly schedule. For example, if your usual injection day is Monday and you remember on Thursday, take the dose immediately and resume the following Monday.

If more than five days have elapsed since your scheduled dose, do not take the missed injection. Instead, wait until your next scheduled day and continue as normal. This prevents overlapping doses and reduces the likelihood of dose-dependent adverse effects, particularly gastrointestinal symptoms which are the most common reason for treatment discontinuation. Remember that if you need to change your weekly injection day, ensure there are at least 3 days between doses.

For interruptions lasting two weeks or longer, seek advice from your prescriber. They may advise restarting at a lower dose to re-establish tolerance. Patients who have been off treatment for several weeks may experience renewed or intensified side effects when resuming at their previous maintenance dose, particularly nausea and abdominal discomfort. Do not change your dose or restart the escalation schedule without clinical guidance.

Practical tips for resuming treatment include:

• Set multiple reminders on your phone for injection days

• Keep your Wegovy pen in a visible location (whilst maintaining proper refrigeration)

• Use a medication tracking app to log each dose

• Inform your prescriber immediately if supply issues or side effects cause treatment gaps

If you've missed multiple doses due to side effects, do not restart without medical review, as dose adjustment or alternative management strategies may be appropriate.

Side Effects and Risks of Skipping Wegovy

The primary risks associated with skipping Wegovy relate to loss of therapeutic effect rather than acute withdrawal symptoms. Unlike some medications, semaglutide does not cause a recognised withdrawal syndrome when discontinued. However, the physiological changes that support weight loss—including delayed gastric emptying, reduced appetite, and improved glycaemic control—begin to reverse as drug levels decline.

Changes in appetite regulation may occur after treatment interruptions. You may notice increased appetite, faster return of hunger between meals, and loss of the early satiety that characterises successful Wegovy treatment. Some individuals report feeling hungrier than before starting treatment, though this typically represents a return to baseline appetite regulation.

Weight regain is a significant concern during treatment gaps. Clinical trial data demonstrate that discontinuation of semaglutide leads to gradual weight regain in most patients, with studies showing approximately two-thirds of lost weight returning within one year of stopping treatment. Even short interruptions may lead to some weight increase, particularly if dietary and activity habits revert to pre-treatment patterns.

Metabolic effects also warrant consideration. For patients with type 2 diabetes or non-diabetic hyperglycaemia (prediabetes), missing doses may lead to deterioration in glycaemic control, with rising HbA1c and fasting glucose levels. Blood pressure and lipid profiles may similarly worsen during extended treatment gaps.

Resuming treatment after interruption carries its own risks, particularly recurrence of dose-dependent side effects. Nausea, vomiting, diarrhoea, constipation, and abdominal pain may return with similar or greater intensity, especially if restarting at a higher dose without re-titration. Rare but serious adverse effects including pancreatitis, gallbladder disease, and acute kidney injury (usually secondary to dehydration from vomiting) remain possible.

Seek urgent medical attention if you experience:

• Severe or persistent abdominal pain, especially if radiating to your back

• Repeated vomiting preventing fluid intake

• Signs of dehydration (dark urine, dizziness, reduced urination)

Contact your GP or prescriber routinely if you experience:

• Ongoing digestive symptoms affecting your quality of life

• Significant, persistent weight regain

• Concerns about resuming treatment

If you experience any suspected side effects, you can report them via the MHRA Yellow Card scheme.

Maintaining Weight Loss During Treatment Interruptions

Preserving weight loss during a treatment gap requires proactive behavioural strategies, as the pharmacological support for appetite control and satiety will diminish. The principles align with NICE guidance on multicomponent weight management interventions, emphasising that medication should always complement—not replace—lifestyle modification.

Dietary strategies become paramount during interruptions. Focus on maintaining the eating patterns established during treatment: regular meal timing, adequate protein intake spread across meals, high fibre consumption (aiming for 30 g daily), and controlled portion sizes. Many patients find that structured meal planning helps compensate for loss of medication-induced appetite suppression. Consider keeping a food diary to maintain awareness of intake, as mindless eating often increases when pharmacological satiety signals fade.

Physical activity plays a crucial role in minimising weight regain. Current UK Chief Medical Officers' guidelines recommend at least 150 minutes of moderate-intensity activity weekly, with additional strength training on two or more days. During treatment gaps, consider increasing activity levels slightly to create a modest energy deficit. However, avoid extreme exercise increases that may be unsustainable long-term.

Behavioural techniques proven effective in weight maintenance include:

• Daily self-weighing to detect early regain (weight fluctuations of 1–2 kg are normal)

• Identifying and managing emotional or stress-related eating triggers

• Maintaining social support through weight management groups or healthcare contacts

• Planning for high-risk situations (social events, holidays, stressful periods)

Sleep and stress management also influence weight regulation. Aim for 7–9 hours of quality sleep nightly, as sleep deprivation increases hunger hormones (ghrelin) and reduces satiety signals (leptin). Chronic stress elevates cortisol, promoting central adiposity and food-seeking behaviour.

If treatment interruption extends beyond four weeks, arrange a review with your prescriber or weight management service. They can assess whether additional support is needed, such as referral to a dietitian, psychological intervention for eating behaviours, or consideration of alternative pharmacological options. Remember that weight management is a long-term endeavour, and temporary setbacks do not negate previous progress. The goal is sustainable behaviour change that persists regardless of medication status.

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