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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