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Then we order labs: HbA1c and fasting glucose - to identify prediabetes or type 2 diabetes Comprehensive metabolic panel - kidney and liver function Lipid panel - cardiovascular risk picture TSH - thyroid disease can drive weight changes and is often missed Additional markers based on history (insulin, vitamin D, B12, iron studies as indicated) We also screen for sleep apnea, mood disorders, and medication-related weight effects (some psychiatric and antidiabetic medications drive weight gain that's worth identifying before adding another medication on top)
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The titration regimen described in the NEJM 2023 obesity trial (Jastreboff et al.) progressed as follows: Weeks 14 : 2 mg once weekly Weeks 58 : 4 mg once weekly Weeks 912 : 8 mg once weekly Week 12 onwards : Up to 12 mg once weekly (in higher-dose cohorts) This regimen was used exclusively within a regulated clinical trial setting and does not constitute an approved dosing schedule
By embracing a holistic approach that addresses these key factors, you can create a solid foundation for a healthier, happier, and more fulfilling life
But dont race to ask your doctor for a dual prescription just yet, she says
We aim to find the cause quickly and safely
