Week Zero — Why Weight-Loss Drugs Start Low
Lowest dose tier limits nausea while the gut adapts.
- 2.5 mg: Starting dose (lowest available tier)
- 4 wks: Duration (before first step-up)
- ~8%: GI risk (mild nausea, low incidence)
- ~0%: Weight loss (adaptation phase)
Starting low reduces early GI intolerance
Short placeholder: low starting dose limits nausea onset.
Gradual receptor adaptation lowers dropout risk early on.
First Step-Up — Advancing to the Next Tier
Dose doubles roughly every four weeks if tolerated.
- 5.0 mg: New dose (second tier)
- 4 wks: Step interval (standard schedule)
- ~14%: GI risk (mild uptick post-step)
- ~2%: Weight loss (early trend emerging)
Each step slightly raises transient GI risk
Short placeholder: side effects spike briefly after each increase.
Risk fades as the body re-adapts before next step.
Continued Titration Toward the Effective Range
Successive steps climb the dose ladder every few weeks.
- 7.5–10 mg: Dose range (tiers 3–4)
- 8–12: Cumulative weeks (since start)
- ~17%: GI risk (peaks near step points)
- ~6%: Weight loss (accelerating progress)
Repeated steps compound tolerability and efficacy
Short placeholder: cumulative titration builds tolerance over time.
Weight loss accelerates as effective dose approaches.
Maintenance Dose — Weeks 16 to 20
Full target dose reached; side effects largely plateau.
- 12.5 mg: Maintenance dose (top tier)
- Wk 16–20: Reached by (depending on schedule)
- ~12%: GI risk (stabilized, declining)
- ~11%: Weight loss (steady ongoing trend)
Plateauing side effects at steady-state dose
Short placeholder: body reaches steady state at maintenance.
GI symptoms taper while weight loss keeps progressing.
Slow vs Fast Titration — The Tolerability Trade-off
Slow titration trims side-effect spikes at a time cost.
- ~9%: Slow-titration GI peak (6-week steps)
- ~38%: Fast-titration GI peak (2-week steps)
- 20–30 wks: Time to maintenance (slow vs fast range)
- ~15%: Final weight loss (similar across schedules)
Slower ramps trade time for tolerability
Short placeholder: slow schedules cut side effects substantially.
Fast schedules reach maintenance sooner but spike GI events.
Short placeholder: pick titration speed based on patient tolerance.