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But is this effective, and is it safe? As a GP, people are asking me these questions. Here’s what we know — and what we don’t know yet.
Why are people microdosing weight-loss drugs?
Three common reasons come up when I ask patients why they microdose weight-loss drugs.
How do people microdose weight-loss drugs?
Injectables come in an adjustable auto-injector pen which is twisted until the dose counter shows the prescribed dose in milligrams. There’s a click every time the dial is turned. Once the prescribed dose is showing, it’s injected under the skin.
Alternatively, they may inject the full recommended dose but do so less often than once per week.
Is it safe?
But these drugs do expire after a few weeks, and microdosing could increase the risk of inadvertently using them after their expiration date. Injecting out-of-date medication can be a significant health risk. For example, it could cause infection if bacteria has started to grow.
Because there are no clear guidelines around microdosing, patients should only try it with caution and under medical care. Their team can assist with issues such as accounting for the limited shelf-life of the medication.
Is it effective?
In my experience there’s a reason patients increase their doses as recommended: they simply don’t lose enough weight on the starting doses.
It’s also important to note that for patients using Wegovy to reduce heart attack and stroke risk — which Australia’s Therapeutic Goods Administration recently approved it for — there’s no evidence that cardiovascular benefits will be achieved at lower-than-recommended doses.
Is there any role for microdosing weight-loss drugs?
When side-effects are not manageable: when side-effects are intolerable for patients, even on the lowest introductory dose, there may be a role for individualised approaches. But this is best done with clear communication and regular monitoring, so patients are not under-treated.
Maintenance of weight loss: once therapeutic levels have helped patients achieve their goal weight, lowering the dose may be a helpful longer-term way of keeping them there. We know stopping these drugs altogether results in rebound weight gain. We await evidence for microdosing for weight maintenance.
