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In the Phase 2 retatrutide trial ( Jastreboff et al., NEJM 2023 ), body-composition imaging showed fat mass falling substantially more than lean mass, meaning the majority of the weight lost was fat

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Effective management (slower dose escalation, dietary modifications like eating smaller meals and avoiding greasy foods, staying upright after eating) can make the difference between success and discontinuation

What to Expect When Switching: First 2-4 Weeks: Side effects may recur even if you tolerated the first medication well Nausea and GI symptoms are common during transition Appetite changes may feel different Weight loss may slow temporarily Weeks 4-12: Body adjusts to new medication Side effects typically improve Appetite suppression becomes consistent Weight loss resumes or accelerates (especially switching to tirzepatide) After 3 Months: Full effects of new medication apparent Can assess if switch was beneficial May adjust dose based on results and tolerance Switching Success Rates: Most patients successfully transition between medications