How it works
Mimics GLP-1 to enhance glucose-dependent insulin secretion, suppress glucagon, slow gastric emptying and act on hypothalamic appetite centres. Fatty-acid acylation extends its half-life to once-weekly dosing.
Structure: GLP-1 analogue, 94% homology to human GLP-1
Reported benefits
- ~15% mean body-weight reduction over 68 weeks in STEP-1
- Improved HbA1c and cardiovascular outcomes
- Marked reduction in appetite and food noise
Practical considerations
- Muscle loss can account for a meaningful share of weight lost — resistance training and protein intake matter
- GI side effects are dose-dependent; titrate slowly
- Weight regain is common after stopping
Side effects and risks
- Nausea and vomiting
- Constipation or diarrhoea
- Gallbladder issues
- Contraindicated with medullary thyroid carcinoma history
Dosing overview
Label titration from 0.25 mg weekly up to 2.4 mg over 16+ weeks
This describes doses reported in published literature and community protocols. It is not a recommendation, and it is not a substitute for clinical supervision.
Research references
- Wilding et al., 2021 — STEP 1 trial, NEJM
- SELECT trial, 2023 — cardiovascular outcomes