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This approach exists for a specific reason: starting at a higher dose produces stronger side effects, particularly nausea and digestive discomfort, that make treatment difficult to tolerate and sustain
Although I do not routinely measure longitudinal change in body composition or bone mass in people taking GLP-1s, mostly because of the cost of DXA scans, significant muscle or bone loss are two objective manifestations of excessive weight loss that should lead to stopping or slowing treatment
This low and slow approach gives your gut microbiome and your colons motility patterns time to adjust to the presence of the medication
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