What if less could be more? A new approach to GLP-1 weight loss drugs

In recent years, GLP-1 drugs like Ozempic and Wegovy have reshaped the debate around weight loss and metabolic health. For many, these medications have been life-changing. Yet despite their transformative potential, a troubling trend has emerged. Many patients find that they are prescribed medications without taking into account their different metabolisms and needs. This one-size-fits-all approach is failing patients and its consequences are impossible to ignore.

The trap of standardization

The statistics say it all: Half of U.S. patients using GLP-1 to treat obesity stopped using them within the first year, and most regained weight within the next year. It’s not just a matter of patient compliance. It is the predictable result of rigid practices and constrained health systems that impose standard doses on patients, regardless of their individual needs or response to medications.

This one-size-fits-all approach, developed by major pharmaceutical companies, assumes that what works for the average patient in clinical trials will work for everyone. In reality, individual differences in metabolism, body composition, and drug sensitivity mean that many patients are pushed to higher doses than they might actually need to see results.

This standard dosing approach creates a double burden for patients. Unnecessarily high doses of a weight loss drug increase the risk of unwanted side effects – fatigue, headaches and, most commonly, gastrointestinal problems which affect 40-70% of GLP-1 users. These symptoms often become so intolerable that patients simply stop treatment.

Even those who can tolerate the side effects face another obstacle: cost. GLP-1 drugs are among the most expensive prescriptions, and patients often end up paying higher prices for doses that may be excessive for their needs. For those without reliable insurance coverage, this creates an impossible financial burden that often forces them to discontinue treatment just as the medication begins to work. In fact, of 3,000 U.S. adults using GLP-1s, 45% reported stopping their treatment, citing cost and insurance barriers as the primary reason.

This is not only ineffective, it is retrograde. Current protocols ignore individual variations, and in most cases, providers do not have the capacity to care for every patient due to the constraints of the current healthcare system.

Start small, scale intelligently: the arguments in favor of individualized dosing

Microdosing, or starting with a lower dose than the standard and gradually increasing based on patient response, marks a move away from one-size-fits-all protocols toward personalized medicine. The goal is not to achieve a fixed dose, but to work with each patient’s optimal treatment plan and schedule.

What started as preliminary discussions in late 2024 quickly gained traction, with microdosing widespread enough that some telehealth companies have even begun building dedicated programs around the topic. Microdosing is not a shortcut or a trend: it is an evolution toward a more adaptable, patient-centered method of care.

A 2025 survey found that 36% of GLP-1 weight loss users currently microdose their medications without medical supervision, while an additional 32% have tried it in the past. Their motivations reveal the main problems with standard prescribing: 66% did it to reduce side effects, while 38% did it to make it financially viable.

This approach becomes particularly attractive given that GLP-1 drugs offer benefits beyond weight loss. Studies have shown reduced inflammation, lower cardiovascular risk, and even possible neuroprotective benefits – and many of these aren’t strictly dose-dependent. Patients can still see significant health gains at lower doses, especially with consistent use over time.

Navigating uncharted territory

As microdosing grows in popularity, the crucial question remains: How can patients and providers approach the practice responsibly? Despite its many advantages, microdosing introduces variables, such as dosing inconsistencies and increased complexity in monitoring responses, requiring increased clinical monitoring and structured protocols.

The answer lies in structured clinical guidelines that emphasize monitoring outcomes and tailoring care to each individual. Instead of asking “what dose is standard for this medication,” providers should ask “what dose does this patient need?” » Done correctly, this method requires more medical supervision, not less.

Patients who experiment in isolation or rely on unverified online advice risk their safety and success. Instead, this approach requires close monitoring, as with other medications, with oversight from doctors who understand its benefits and the specific needs involved.

From one-size-fits-all to patient-centered care

GLP-1 drugs are here to stay. But if we want them to reach their full potential, we need to evolve the way we prescribe, dose and support patients. Microdosing is not about following a trend. It’s about expanding our treatment toolbox to reflect what patients need: a sustainable, accessible and personalized approach.

Microdosing will not be the right choice for everyone. But for many patients, it already makes the difference between stopping obesity treatment early and lasting progress. With more research and clinical monitoring, microdosing could become a cornerstone of not only obesity care, but also how we manage chronic and complex diseases more generally.

Photo: Peter Dazeley, Getty Images

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