Microdosing GLP-1s May Still Aid in Weight Loss

Recent research indicates that individuals may experience weight loss while remaining on the lowest starting doses of GLP-1 medications, such as Wegovy and Zepbound, for extended periods. A study published in *Biology Methods & Protocols* on August 31 explored this phenomenon, suggesting that prolonged use of lower doses could be beneficial for some patients.

The practice of microdosing, which has gained popularity on social media and among celebrities, refers to taking smaller doses of medication than typically prescribed. Although the study did not confirm that participants were intentionally microdosing, it raises questions about the potential benefits of using such medications outside their usual dosing guidelines. It is important to note that these practices are not sanctioned by the FDA or the manufacturers of the drugs.

The study analyzed electronic health records from 814 individuals using sustained low-dose semaglutide (brands like Ozempic and Wegovy) and 1,016 individuals using sustained low-dose tirzepatide (brands like Mounjaro and Zepbound). Those on low-dose tirzepatide for one year lost an average of 5.5% of their body weight, while those on low-dose semaglutide lost about 2.2%.

Comparisons between low and high doses of semaglutide revealed significant differences in weight loss outcomes. Participants on low doses lost roughly 1.7% of their weight after matching for age, sex, BMI, and type 2 diabetes status, whereas those on higher doses experienced around 12% weight loss.

Venky Soundararajan, PhD, co-founder and chief scientific officer for nference and co-author of the study, highlighted the implications of these findings. He emphasized the potential for microdosing to offer a viable treatment strategy that balances weight loss with fewer side effects compared to higher doses. Mir Ali, MD, medical director of the MemorialCare Surgical Weight Loss Center, also noted that patients often see meaningful results even at lower doses, though some may eventually need to increase their dosage for continued weight loss.

The study also observed that weight reductions continued to be evident through a 15-month follow-up, suggesting that lower doses might serve as a long-term maintenance strategy rather than just a temporary starting point. However, Ali cautioned that while some patients may achieve satisfactory results on low doses, many will still require dose escalation to reach their weight loss goals.

GLP-1 medications like Wegovy and Zepbound are typically prescribed in specific dosing schedules. Wegovy starts at a weekly dose of 0.25 mg, increasing to a maintenance dose of 2.4 mg, while Zepbound begins at 2.5 mg, with a maximum dose of 15 mg. Adjustments to dosing schedules should be made in consultation with healthcare providers.

When it comes to side effects, microdosing may be associated with fewer adverse events for some, but this is not guaranteed for everyone. Common side effects of GLP-1 medications include nausea, vomiting, and gastrointestinal disturbances. Soundararajan noted that low-dose tirzepatide resulted in slightly greater weight loss, but also indicated that low-dose semaglutide was linked to lower rates of adverse effects, making it a potentially better option for those prioritizing tolerability.

Overall, the findings reinforce that GLP-1 medications can still promote weight loss, even at lower doses, although the extent of weight