gila
A weekly GLP-1 starts. From there the year splits: unsupervised escalation, or physician-led titration, monitoring, nutrition, and a plan for stopping. Fifteen minutes through both.
15-minute walkthrough
The year, beat by beat
Week 1–4
Early weight-loss % · first ~6 months · trial averages
Unsupervised
GI side effects hit hard during escalation. Without pacing guidance, patients quit early or change doses alone.
Physician-led
Planned dose steps, symptom guidance, and a clinician to call when side effects spike.
Ongoing
Kilograms lost · 100 kg start · trial end-points
Starting weight 100 kg — mean loss at peak follow-up in curated anchors
Unsupervised
Unmanaged intake risks lean-mass loss. Appetite suppression is not “all fat.”
Physician-led
Protein targets and resistance-training guidance built into the plan.
Baseline → follow-up
Peak average weight loss by programme
Unsupervised
No scheduled bloodwork or dose adjustment tied to tolerance and comorbidity progress.
Physician-led
Check-ins and labs so dose and metabolic progress are tracked — not assumed.
Month 3–12
Real-world discontinuation
2/10
2/10
4/10
Unsupervised
Stop rates climb through the year. Motivation and side effects collide — and unsupervised patients leave.
Physician-led
Behavior coaching and peer support aimed at the highest-leverage window on the stop curve.
If treatment pauses
Weight regained after stopping · % of prior loss
Unsupervised
A pause becomes a cliff — published patterns show weight returning hard after cessation.
Physician-led
A defined maintenance path when life interrupts treatment — follow-through, not denial.
~12 months
Unsupervised
About 35% stop by a year (~1 in 3; ~2 in 10 by ~6 months). After stopping: ~60% of lost weight back in a year; ~half by week 23 (~5 months) (~5 mo).
2/10
2/10
4/10
Regain after stopping
On treatment
Trial averages reach ~20% while people remain on treatment. No invented “system vs unsupervised” stop-rate — only named failure points against published on-treatment averages.
Trial averages while staying on treatment
No fabricated comparative outcome. Stop-rate bands mix an illustrative RWE composite with named Indian RWE (PMID-41798487). Regain follows the PMID-41938838 systematic review. The pitch is the mechanism: titration, monitoring, adherence, and maintenance against those failure points.
Clinical intake
India-adjusted BMI (WHO Asia-Pacific / South Asian risk) — not US FDA label cutoffs. Metabolic risk rises at lower BMI in South Asians.
Waist as supplementary marker: >90 cm men, >80 cm women (South Asian phenotype).
Assessed by an obesity-trained physician, diabetologist, or endocrinologist — not a wellness form.
Diabetes / prediabetes status
Total cholesterol, LDL, HDL, triglycerides
Baseline and contraindication screen
Dosing caution in renal impairment
Plus MTC / MEN2 history screen
Women of childbearing potential
When intake falls under appetite suppression
Exam measure at intake
Framed from India-adjusted BMI practice (WHO Asia-Pacific / ESI obesity guidance orientation) — not US FDA cutoffs.
The medicine is the same. The difference is whether titration, labs, nutrition, adherence, and a stop plan are built into the year — or left to chance. Unsupervised paths collide with published stop and regain curves; physician-led paths are built for those exact failure points.
That is the whole pitch. The evidence desk has the papers behind each beat.