Does the injection site need to be rotated, and how often?

Yes — rotate every week. You can stay within the same general area (e.g., abdomen) but move at least a finger-width or two from the previous spot to protect skin and reduce local reactions. Note sites on a phone or card if it helps you keep track.

Why rotation is important

Wegovy (semaglutide) is injected under the skin, into the fatty layer known as the subcutaneous tissue. Repeatedly using the same spot increases the risk of local skin changes such as lipohypertrophy — thickened or lumpy tissue caused by repeated injections. This issue is well documented in insulin therapy, and the same principles apply here. NICE TA875 and MHRA product guidance both highlight rotation as a way to protect the skin and ensure reliable medicine delivery. NHS weight management services routinely teach this as part of starting treatment.

Protecting the skin and comfort

Rotating sites also reduces pain, bruising, or irritation. Injecting too often into one area makes the skin tender and more likely to react. By moving the site each week, you give the previous area time to recover. The abdomen is usually the most convenient site, but even within that area you should move at least a couple of centimetres each time. The thighs and upper arms offer useful alternatives, especially if the abdomen becomes sore. NHS clinicians remind patients that comfort matters: better technique reduces anxiety and helps people stick with weekly injections.

Ensuring consistent absorption

One of the most important reasons for site rotation is to keep the medicine working predictably. When tissue thickens or scars from repeated injections, drug absorption becomes irregular. In diabetes, this has been shown to cause unstable glucose control. For Wegovy, unpredictable absorption could mean appetite control is weaker or side effects more noticeable. NICE guidance and NHS training materials stress that rotating sites is a simple step that protects both skin health and treatment effectiveness over the long term.

Guidance from trials and regulators

The STEP clinical trials and the SELECT cardiovascular trial standardised injection practice to the abdomen, thigh, and upper arm. Participants were instructed to rotate sites, ensuring fair and consistent results across thousands of people. This protocol underpins the MHRA licence and NICE TA875 approval. Because the evidence base rests on these injection practices, NHS prescribing guidance makes rotation part of routine care. Using the same spot repeatedly, or using non-approved sites, was not tested and is not considered safe practice.

Practical ways to keep track

Patients often find it easy to forget where they injected last. Simple tools can help: marking sites on a card, using a diary, or setting reminders on a phone. Some NHS teams provide printed site maps for the abdomen and thighs, where patients can mark each injection point. Others suggest dividing areas into quadrants and rotating around them in order. These methods prevent returning to the same spot too quickly and make rotation effortless. Families or carers supporting injections can also help by noting sites used.

What to do if a site feels sore

Mild redness, swelling, or small lumps are common after injections and usually settle in a few days. If the area feels sore, it is best to avoid it for a few weeks and use an alternative site. NHS advice is that severe, spreading redness or pain, especially if combined with fever, should be reviewed promptly by a clinician. In the STEP programme, injection site reactions were rare and generally mild, but they were most likely when people injected repeatedly in the same place. Rotation remains the best prevention.

Training and ongoing support

NHS weight management services usually provide training before starting Wegovy. Nurses demonstrate safe injection techniques and explain the importance of rotation. Many clinics check technique again at follow-up visits, helping patients refine their routine. The MHRA encourages healthcare professionals to report any recurring injection-site issues via the Yellow Card scheme, supporting national monitoring. This joined-up approach ensures that problems are spotted early and guidance stays up to date. Patients are reassured that support is always available if injection sites become problematic.

Broader lessons from diabetes care

Much of what we know about injection-site management comes from decades of insulin use in diabetes. Research has shown that lipohypertrophy develops in up to half of insulin users who do not rotate sites properly, leading to pain and unstable blood sugar control. The parallels with Wegovy are clear: without rotation, local tissue changes can reduce both comfort and consistency. NHS clinicians borrow these lessons, applying them directly to GLP-1 injections like semaglutide, so that patients benefit from proven safe practices.

The essential point

Rotating your Wegovy injection site every week is not a minor detail — it is an essential part of treatment. Moving the injection point by at least a finger-width or two protects the skin, reduces discomfort, and ensures steady absorption. This advice is grounded in NICE guidance, NHS training, MHRA licensing, and evidence from major trials. The essential point is that by adopting this simple habit and keeping track of sites, patients can protect their skin and get the best results from long-term Wegovy treatment.