While promoting a potent pulsatile release of Growth Hormone (GH), Ipamorelin is unique in that it does not stimulate ACTH, Cortisol, or Prolactin, even at high doses

Durability of Results: Maintenance Studies: Tirzepatide (SURMOUNT-3): Continued treatment: Additional 5.5% weight loss Stopped treatment: Regained 14% of weight Conclusion: Need ongoing treatment Semaglutide (STEP-4): Continued treatment: Maintained loss, continued losing Stopped treatment: Regained most weight Conclusion: Need ongoing treatment Phentermine: FDA-approved for 12 weeks only Weight regain after stopping is universal Not a long-term solution All Weight Loss Medications: Obesity is chronic disease Medications treat symptoms, dont cure Stopping medication weight regain Long-term or indefinite use necessary for sustained results Safety Profile Comparison: Discontinuation Due to Side Effects: Tirzepatide: 6.2% Semaglutide: 6.9% Liraglutide: 9.9% Naltrexone-bupropion: 25% (very high) Orlistat: 15-20% Phentermine-topiramate: 8-10% GLP-1s have excellent tolerability considering their effectiveness

But the argument is that a slower start with better adherence ultimately produces better outcomes than a faster start that triggers side effects severe enough to cause missed doses or protocol abandonment
It is a physiological response, your body reallocating resources during perceived metabolic stress
Patients may need to begin a clear liquid diet or modified prep protocol 48 to 72 hours in advance, rather than the usual 24-hour prep window