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Some patients benefit from microdose protocols (0.10.2 mg) or off-label dose adjustments based on biomarker response

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If dose escalation is not tolerated due to side effects (eg, nausea, vomiting, diarrhea, constipation), the increase in dose can be delayed by another four weeks

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GLP-1 receptor agonists and GLP-1 and glucose-dependent insulinotropic peptide agonists have several mechanisms of action, including reduction of gastric emptying, inhibition of glucagon secretion, beneficial changes in the intestinal microbiome, and direct effects on hypothalamic nuclei to enhance satiety (which promotes weight loss)