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Moreover, there have been reports of excessive off-label prescribing and misuse [28,29,30,31,32,33], and the GLP-1 RAs have become popular as a cosmetic weight loss drug by celebrities and are widely promoted on social media [34,35,36,37,38,39]
Some patients find that injecting in the evening minimizes daytime nausea
Weeks 5-8: Dose Escalation Begins Weight Loss: 6-8% cumulative (15-20 pounds total) Dose: 4mg weekly (weeks 5-8) Primary Focus: Managing increasing side effects Weight loss accelerates as the dose doubles
Guidelines have evolved considerably from routine medication cessation in 2023 to GLP-1 RA continuation with individualised risk assessment in 20242025, illustrating increasing acknowledgment that certain theoretical risks may be underestimated
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