Abstract Introduction Semaglutide, the only glucagon-like peptide-1 receptor agonist (GLP-1 RA) available in subcutaneous and oral formulation for treatment of type 2 diabetes (T2D), has demonstrated clinically significant improvements in glycaemic control and weight in clinical trials
Similarly, semaglutide for weight management is typically provided within specialist weight management services and usually for up to 2 years, in accordance with NICE TA875

Highlights Understanding weight as a whole health ecosystem, not a willpower issue Ashleys journey and how generational experiences shape weight health The main weight-health hormones and how they influence the body GLP-1 medications: who they help, who they may harm, and what practitioners must screen for Understanding these medications system-wide effects as a practitioner Microdosing vs low-dose GLP-1 and why individualized dosing is critical A multifactorial framework for assessing weight-health hormone function Supporting long COVID, MCAS, endometriosis, autoimmune issues, and chronic pain How GLP-1 agonists may influence gut, immune, and receptor-level functioning Peptides, protein diversity, and their impact on pain and metabolic health Differences between short-acting and long-acting GLP-1 medications How to approach weaning off GLP-1s Examining internalized bias, ableism, and beauty standards in weight-related decisions Connect with Ashley Koff, RD The Better Nutrition Program GLP-1 Assessment Ashley Koffs Book | Your Best Shot: The Personalized System for Optimal Weight HealthGLP-1 Shot or Not Ashley Koff on Instagram @ashleykoffapproved About Ashley Koff, RD Ashley Koff, RD, is the founder of The Better Nutrition Program (BNP), the Nutrition Course Director for UC Irvines Susan Samueli Integrative Health Institutes Integrative and Functional Medicine Fellowship, and a faculty member at the Integrative and Functional Nutrition Academy (IFNA), where she teaches An Integrative and Functional Nutrition Approach to Obesity and Weight Management. She is also the author of the upcoming book, Your Best Shot (Harper One, January 6, 2026)

However, the field is not staying still, and recently published data from the high-dose semaglutide STEP Phase 3 trials (44) and the SURPASS Phase 3 trials of the GLP-1/glucose-dependent insulinotropic peptide (GIP) co-agonist tirzepatide (90) have set the efficacy bar high in terms of weight loss and glycaemic improvement
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