WeighWeekly / Expected loss by weight
Wegovy at 300 lbs: what the STEP 1 trial average shows
Short answer: at 300 lbs, the STEP 1 average works out to about 19 lbs by month 3 (281 lbs), 32 lbs by month 6 (269 lbs), and 45 lbs by week 68 (255 lbs, or 14.9% of your starting weight) on semaglutide.
Wegovy at 300 lbs, week by week
| Point | % lost | Lbs lost | Weight |
|---|---|---|---|
| Week 4 (~mo 1) | 2.0% | 6.0 lbs | 294.0 lbs |
| Week 13 (~mo 3) | 6.3% | 19.0 lbs | 281.0 lbs |
| Week 26 (~mo 6) | 10.5% | 31.5 lbs | 268.5 lbs |
| Week 39 (~mo 9) | 13.3% | 39.8 lbs | 260.2 lbs |
| Week 52 (~1 yr) | 14.5% | 43.5 lbs | 256.5 lbs |
| Week 68 (~mo 16) | 14.9% | 44.7 lbs | 255.3 lbs |
Applied to a 300 lb starting weight from the mean curve in STEP 1 (1,961 adults without diabetes, 68 weeks).
Why month 1 looks broken
At 300 lbs the first four weeks average only 6.0 lbs — about 2.0% of your weight. That is not the drug failing. The starter dose is a tolerance ramp, and the steep part of the curve does not arrive until you are on a full treatment dose. Here is the schedule the trial used:
- 0.25 mg (weeks 1-4, starter dose - not a treatment dose)
- 0.5 mg (weeks 5-8)
- 1.0 mg (weeks 9-12)
- 1.7 mg (weeks 13-16)
- 2.4 mg (week 17 onward)
Wegovy is semaglutide, the same molecule sold as Ozempic for type 2 diabetes, but dosed higher (2.4 mg vs 1.0-2.0 mg).
What this would cost
Wegovy without insurance: $349 a month for the 1 mg to 2.4 mg pens through NovoCare Pharmacy ($399 at 7.2 mg); the Wegovy pill $149–299 a month. With commercial coverage and the savings card, as little as $25 a month. Price checked Oct 27, 2026 · novocare.com; Last known price, Oct 7, 2026 — may have changed · confirm on LillyDirect
Compounded semaglutide, which has no FDA approval: from $49/mo on a one-year plan, up to $299 a month on a month-to-month plan. Compounded semaglutide price → Price checked Oct 27, 2026 · joinem.co; Oct 27, 2026 · medgm.org
Same starting weight, other drugs
| Drug | Week 52 weight | Total lost |
|---|---|---|
| Wegovy (this page) | 256.5 lbs | 43.5 lbs (14.5%) |
| Zepbound at 300 lbs | 241.5 lbs | 58.5 lbs (19.5%) |
Other starting weights on Wegovy
250 lbs 275 lbs 325 lbs 350 lbs see all
Questions people actually ask
How much weight will I lose in the first month on Wegovy at 300 lbs?
About 6.0 lbs, taking 300 lbs to roughly 294 lbs. Month 1 is the flattest stretch of the whole curve because you are still on the starter dose, which exists to let your gut adjust, not to drive loss. Anything from almost nothing up to about 10 lbs sits inside the normal spread for month 1.
Is 45 lbs guaranteed?
No. These are trial averages. In STEP 1 the spread was wide: a large minority lost far more than average, and a real share of people lost under 5% of their weight. Dose, how long you stay on it, and whether you hit a protein target all move your own number.
What is the fastest part of the curve?
Roughly months three to eight, once you are on a full treatment dose. In this scenario the average runs near 0.50% of body weight per week through the early titration and then steepens before flattening out toward week 68.
What to do with this number
- Compare a stall against the trial curve — most "plateaus" are the curve flattening on schedule.
- Protein target — 1.2-1.6 g per kg of goal weight (about 0.55-0.7 g per lb) is what protects muscle while you lose.
- Weekly tracker — weigh on the same day, same conditions, and read the trend not the day.
- What it costs and where to get it.
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Educational only, not medical advice. Numbers are published trial averages, not a prediction for any individual. Dosing decisions belong with your prescriber.