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This study is registered with ClinicalTrials.gov, NCT03989232

General Clinical Approach: Most healthcare providers follow a stepwise approach to weight management pharmacotherapy: Monotherapy first : Optimize a single agent before considering combination therapy Lifestyle foundation : Ensure dietary modification and physical activity are maximized Adequate trial duration : Allow 3-6 months to assess full response to initial therapy Continuation criteria : Per guidelines, patients should achieve 5% weight loss after 12 weeks on a therapeutic dose to continue medication [27] [28] Reassess goals : Determine if additional intervention is truly necessary Given tirzepatide's superior efficacy compared to older weight loss medications, providers typically recommend optimizing tirzepatide dosing (up to 15 mg weekly for Zepbound) before adding other agents

The most common potential side effects of Ozempic may include: Nausea Vomiting Diarrhea or constipation Stomach pain With any drug, including phentermine or Ozempic, allergic reactions are rare

Bacteriostatic Water consists of: Sterile water for injection 0.9% benzyl alcohol The benzyl alcohol acts as a preservative, helping to reduce the growth of bacteria within the solution after first use