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this dose is for tolerance, not efficacy Drug levels building but not yet at steady state Week 4-8: First Dose Increase (4mg) Appetite suppression becomes more pronounced Weight loss begins (typically 2-5 lbs in this period) GI side effects may briefly worsen then stabilize Reaching ~90% of steady state for current dose Week 12-16: Therapeutic Range (8mg) Significant appetite suppression and satiety Weight loss accelerates (4-8 lbs expected in this phase) Energy expenditure increase may become noticeable (feeling warmer, higher resting heart rate) Many users find this dose sufficient and don't escalate further Week 20-24: Maximum Dose (12mg, if needed) Peak therapeutic effect for those who escalate to maximum dose Cumulative weight loss typically 15-20% by this point Side effects usually stabilized if titration was gradual Full steady-state levels reached (~4-5 weeks at this dose) Week 24-48: Maintenance Phase Continued weight loss at a slower rate (1-2 lbs per week) Approaching maximum weight loss (~24% at 12mg dose) Metabolic improvements (BP, lipids, glucose) become more pronounced Side effects minimal as body fully adapted Pharmacokinetics matter: Retatrutide has a half-life of approximately 6 days, which means it takes about 4-5 weeks (4-5 half-lives) to reach steady-state drug levels at each dose

Tchernof A, Poehlman ET

- Suppress appetite - Slow gastric emptying (food stays in the stomach longer) - Increase feelings of fullness - Reduce calorie intake, often dramatically - Fast initial weight loss - Reduced cravings - Easier adherence to a calorie deficit in the short term From a purely scale-based perspective, GLP-1 medications can appear very effective

Update on obesity in psoriasis patients