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Rather than stopping entirely, stepping down to a maintenance dose typically 5mg or 7.5mg provides enough appetite suppression and GIP/GLP-1 receptor stimulation to maintain weight without the cost or side effect profile of the higher escalation doses

Mechanism of metformin regulation in central nervous system: progression and future perspectives

For personalized advice, especially if you are unsure about timing or experience side effects, consult a medical professional

Hearing loss is not listed among recognised adverse effects in the Summary of Product Characteristics for semaglutide

Recent genetic and biochemical studies suggest that the dysregulated metabolic mediators released by adipose tissue including adipokines, cytokines, chemokines, excess lipids and toxic lipid metabolites promote IR in other tissues