What if Less Can Be More? A New Approach to GLP-1 Weight Loss Medications

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

The standardization trap

The statistics say it all: half of U.S. patients using GLP-1s for obesity care discontinued use within the first year, with most regaining the weight within the following year. This isn’t simply a matter of patient compliance. It’s a predictable outcome of rigid practices and constrained healthcare systems that put patients on standard doses, regardless of their individual needs or response to medication. 

This one-size-fits-all approach, developed by large 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 medication sensitivities mean that many patients are pushed to doses higher than they may actually need in order to see results. 

This standard dosing approach creates a double burden for patients. Unnecessarily high doses of a weight loss medication increase the likelihood of adverse side effects – fatigue, headaches, and most commonly, gastrointestinal issues that plague 40-70% of GLP-1 users. These symptoms often become so intolerable, that patients simply quit treatment.  

Even those who can tolerate the side effects face the other barrier: cost. GLP-1 medications are among the most expensive prescriptions, and patients often end up paying premium 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 working. In fact, of 3000 US adults who use GLP-1s, 45% reported discontinuing their medication, naming cost and insurance barriers as the primary reason. 

This isn’t just inefficient, it’s backwards. Current protocols ignore individual variation, and in most cases providers do not have the capacity to care for each and every patient due to constraints in the current healthcare system. 

Starting small, scaling smart: The case for individualized dosing

Microdosing, or starting with a dose below the standard and gradually increasing based on the patient’s response, marks a move away from one-size-fits-all protocols toward personalized medicine. The goal isn’t reaching a fixed dose, but working with each patient’s optimal treatment plan and schedule. 

What started as early discussions in late 2024 has quickly gained traction, with the microdosing being mainstream enough that some telehealth companies have even begun building out dedicated programs around it. Microdosing is not a shortcut or a trend – it is a shift towards a more adaptable, patient-focused method of care. 

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

This approach becomes particularly valuable given that GLP-1 medications 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 may still see meaningful health gains at lower doses, especially with consistent use over time.

Navigating uncharted territory

As microdosing gains popularity, the critical question remains: how can patients and providers approach the practice responsibly? Despite its many benefits, microdosing introduces variables, such as dosing inconsistencies and increased complexity in monitoring responses, requiring more clinical oversight and structured protocols.

The answer lies in structured clinical guidelines that emphasize tracking outcomes and tailoring care to the individual. Instead of asking “what dose is standard for this medication,” providers should ask “what dose does this patient require?” Done correctly, this method demands greater medical supervision, not less. 

Patients experimenting in isolation or relying on unverified online advice risk their safety and success. Instead, this approach requires close supervision similar to other medications, with oversight from physicians who understand its benefits and the specific needs involved. 

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

GLP-1 medications 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 isn’t about chasing a trend. It’s about expanding our treatment toolkit to reflect what patients need: a sustainable, accessible, and personalized approach.

Microdosing won’t be the right choice for everyone. But for many patients, it’s already proving to be the difference between quitting obesity treatment early and making lasting progress. With more research and clinical oversight, microdosing could become a cornerstone not just in obesity care, but in how we manage chronic, complex conditions more broadly.

Photo: Peter Dazeley, Getty Images

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