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Gradual weight reduction: Data from the phase 2 randomised controlled trial (Jastreboff et al., New England Journal of Medicine , 2023) showed meaningful reductions in body weight beginning within the first four to eight weeks of treatment, in line with the trial's dose-escalation protocol

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Split dosing may help if: single morning dose produces effects that fade by afternoon, you are using higher doses (450-500mcg) where sustained levels may help, or evening administration fits your schedule better than early morning

2.4% placebo GI side-effect risk / Elevated transiently during the switch

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