These injectable or oral medicines copy a natural gut hormone to curb appetite, steady blood sugar, and drive major weight loss. Large studies show reduced heart attacks, strokes, and death, plus kidney and liver benefits. Key trade-offs are digestive effects and muscle loss. Benefits fade after stopping, and the drugs are costly. (Full Review)
| Marker | Target | Why |
|---|---|---|
| HbA1c | < 5.4% (functional); < 5.7% conventional | Tracks glucose control and response |
| Fasting glucose | 75–90 mg/dL (functional); < 100 conventional | Early marker of glycemic response and hypoglycemia risk |
| Fasting insulin | 2–5 µIU/mL (functional) | Gauges insulin resistance improvement |
| Body composition (DEXA) | Preserve lean mass; reduce visceral fat | Detects muscle/bone loss versus fat loss |
| eGFR | > 90 mL/min/1.73m² (functional); > 60 conventional | Monitors kidney function and protection |
| Lipid panel | Triglycerides < 80 mg/dL; HDL > 50 mg/dL (functional) | Tracks cardiometabolic improvement |
| Ferritin / iron studies | Ferritin 50–150 ng/mL (functional) | Detects reduced iron absorption/intake |
| Vitamin B12 | > 500 pg/mL (functional); > 200 conventional | Screens for deficiency from reduced intake |
| Lipase | Within lab reference range | Screens for pancreatic irritation |
Cadence: Baseline before starting; reassess ~4–12 weeks after starting and after each dose escalation, then every 3–6 months during maintenance, with body-composition and nutritional review at similar intervals