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Weeks 1-4: Initiation Phase • Starting dose is low to minimize GI side effects • Most patients notice reduced appetite within the first 1-2 weeks • Mild nausea is common and typically improves within days • Weight loss: 2-5 pounds (mostly water and initial caloric reduction) • Key focus: Establish protein intake targets and begin resistance training if not already active • Baseline DEXA scan and comprehensive bloodwork completed Months 2-3: Dose Escalation • Dose increases every 4 weeks toward therapeutic range • Appetite suppression becomes more consistent • GI side effects may temporarily recur with each dose increase • Weight loss: 1-2 pounds per week typical • Patients often report improved energy, better sleep, reduced cravings • Follow-up bloodwork to check metabolic markers Months 4-6: Therapeutic Phase • Most patients have reached their maintenance dose • Steady, consistent weight loss of 1-2 pounds per week • Visible changes in body composition and clothing fit • Metabolic markers (fasting glucose, triglycerides, HbA1c) typically improving • Follow-up DEXA scan to verify fat loss vs

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