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50.3 percent) Digestive symptoms were more common and led to discontinuation in 6.4 percent of the semaglutide group Severe low blood sugar was rare and similar between groups (1.6 percent vs

Tirzepatide is a dual agonist, working on both GLP-1 and GIP receptors, which produces larger average weight loss in head-to-head trials

Current NHS eligibility criteria for semaglutide 2.4 mg (Wegovy) for weight management, according to NICE TA875, include: Body Mass Index (BMI) 35 kg/m with at least one weight-related comorbidity (such as type 2 diabetes, hypertension, dyslipidaemia, obstructive sleep apnoea) For people from certain high-risk ethnic groups (such as South Asian, Chinese, Black African, or African-Caribbean), lower BMI thresholds apply (typically reduced by 2.5 kg/m) Treatment must be prescribed within specialist weight management services only Treatment is limited to a maximum duration of 2 years Must be used as an adjunct to a reduced-calorie diet and increased physical activity Liraglutide 3 mg (Saxenda) availability varies significantly across NHS regions and is not routinely commissioned in many areas

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IGF-1 levels, the most reliable blood marker of growth hormone activity, typically rise 15 to 25% above baseline within 8 to 12 weeks of consistent nightly dosing (Walker, Clin Interv Aging, 2006)