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The marketing aimed specifically at women, particularly around perimenopause and hormonal weight gain, is a targeting strategy rather than a pharmacological distinction

consideration of dose escalation 6 months : Formal assessment of treatment efficacy according to appropriate criteria: For diabetes (NICE NG28): HbA1c reduction of at least 11 mmol/mol (1.0%) and weight loss of at least 3% For weight management: At least 5% weight loss from baseline on maintenance dose (per SmPC and NICE guidance) Annually thereafter : Ongoing monitoring of metabolic parameters, cardiovascular risk factors, and treatment appropriateness Treatment adjustments may be necessary if: Side effects remain intolerable despite supportive measures Weight loss plateaus before reaching target (may warrant dose increase if not at maximum) Inadequate glycaemic control persists (may require additional diabetes medications) Significant weight loss goals are achieved (maintenance strategies and potential dose reduction) Patients should maintain open communication with their healthcare team, reporting both positive developments and concerns

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Then, they work up to a higher dose over time to help reduce side effects like nausea or stomach upset

Caleb Alexander, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, suggested that the size of the effect on overdose deaths appeared too large to be believable, though he applauded a number of strengths of the new study