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When in doubt, throw it out

Published GLP-1 clinical research - including a real-world study published in Advances in Therapy (2025) covering nearly 10,000 patients - documented mean weight loss of 14.1% for semaglutide 2.4 mg and 16.5% for tirzepatide over one year

MC4R receptors are expressed in the hypothalamus, which houses the body's master clock (suprachiasmatic nucleus) and regulates sleep-wake transitions

Mounjaro starts at 2.5 mg weekly for four weeks, then moves to 5 mg

The primary concern involves cardiovascular effects, as phentermine can increase heart rate and blood pressure while semaglutide may affect heart rate variability through vagal mechanisms