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acts on reward circuitry Setmelanotide (Imcivree): MC4R agonist for genetic obesity (LEPR, POMC deficiencies) SGLT2 inhibitors (empagliflozin, dapagliflozin): Not FDA-approved for obesity alone but cause weight loss
This stabilizes blood sugar levels and prevents hunger-triggering spikes
For patients who tolerate well and want to push results, we sometimes increase Retatrutide to 8mg weekly between weeks 9 and 12, and bump MOTS-C to three times per week
Tirzepatide remains active and effective across an 8-day interval thanks to its long half-life
The fenfluramine component was identified as the primary culprit, but the association left a lasting shadow over phentermine as well
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