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Cualquier mencin a control ponderal corresponde a evidencia internacional y no debe interpretarse como recomendacin para uso fuera de indicacin en el pas, salvo que exista actualizacin regulatoria formal y comunicacin oficial aplicable a la prctica clnica local

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My general framework: Start with semaglutide if cost is a significant concern, or if there is no strong reason to expect poor tolerance Start with tirzepatide if the patient has tried semaglutide before and struggled with side effects, if faster initial response matters clinically, or if the patients goals require larger total weight loss Switch to tirzepatide if a patient on semaglutide is experiencing persistent nausea or has plateaued and escalation options are limited One pattern worth noting: men I see a consistent pattern with male patients who struggle to tolerate semaglutide nausea and GI disruption can be particularly disruptive for them, and theyre often less willing to push through it

Do not be that patient

Whether adding cagrilintide preserves more lean mass than retatrutide alone or whether the added satiety drives more lean-mass loss by reducing protein intake further is unknown

I was approved within hours