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Phase 2 trial (NEJM 2023) used a structured ramp to 12 mg/week but at trial doses of 8 mg and 12 mg, dropout from gastrointestinal events was substantial

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Other regulatory factors, such as bile acids, can stimulate the release of GLP-1 and PYY by activating the TGR5 receptor on the surface of intestinal L cells (3537)

4.5 mg arm: 10.8% mean loss

But here's the plot twist that matters most: After 20 weeks, the appetite-suppressing effects started to fade