Madison Burgess decided to get serious about weight loss when the scale hit 91 kilograms (200 pounds). She began taking Ozempic. The medication worked better than she ever thought possible: even on the low starter dose, she lost more than 2 kg (5 lbs) within the first week.

Problems began, however, when Burgess, a 25-year-old healthcare administrator from Bloomfield, Michigan, ramped up her intake, as per the manufacturer鈥檚 guidelines. 鈥淭he higher doses were rough on me,鈥� she says. The constipation, nausea, diarrhoea and acid reflux hit hard and made eating difficult. That鈥檚 when she decided to drop back down to a lower dose and determine whether she could continue seeing benefits.

Burgess is just one of a growing number of people who are 鈥渕icrodosing鈥� 鈥� a practice more typically associated with psychedelics such as LSD and psilocybin 鈥� by taking lower-than-standard amounts of weight-loss drugs such as Wegovy and Mounjaro (see 鈥淗ow they work鈥�, below).

For some, the hope is to avoid side effects while losing weight, while others want to tap into the anti-inflammatory effect of these medications or reap their other benefits for the heart and the brain (see 鈥淎 wonder drug鈥�?, below). Microdosing the drugs has even been by ultra-wealthy elites like tech entrepreneur Bryan Johnson, and is rumoured to be the secret weapon of Hollywood stars wanting to look svelte for photo calls.

The question is, does this off-label, low-dose experimentation work?

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Medications such as Ozempic, Mounjaro and their ilk come in pre-loaded injectable pens. In conjunction with their healthcare provider, users typically follow a dosing regime that goes up. . In the first month, users take a low introductory dose of 0.25 milligrams a week. This then doubles, and then doubles again until a 鈥渕aintenance鈥� dose of either 1.7 or 2.4 mg per week is achieved, which is then taken long term. These standard doses are the only strengths that have been studied in large-scale clinical trials.

For this reason, microdosing these weight-loss medications isn鈥檛 approved by the US Food and Drug Administration (FDA) or by other health authorities. But that hasn鈥檛 stopped people from trying it, says at the Veterans Affairs St. Louis 午夜福利1000集合 Care System in Missouri.

For Burgess, small doses of between 0.25 and 0.5 mg per week have been a success: she has lost 27 kg (60 lbs) and reached her goal weight without the problematic side effects. 鈥淎t the lower doses, I don鈥檛 have symptoms,鈥� she says. Burgess continues to take the drug to avoid regaining weight 鈥� an additional motivation for microdosing.

Inflammation

Another microdosing enthusiast, , a nurse practitioner who owns her own medical weight-loss practice in Golden, Colorado, says that low doses of tirzepatide have generally improved her quality of life. She takes 2 mg per week (the recommended starter dose is 2.5 mg) and contends that microdosing has reduced her inflammation, as evidenced by her having fewer aches and pains, given her more energy, and generally helped her choose a more wholesome diet. 鈥淗aving less thoughts about food and less cravings makes it much easier to want to choose healthy foods,鈥� says Sorensen.

础濒-础濒测鈥檚 identified a host of health benefits in addition to weight loss for those taking the medications, including a reduced risk of substance use disorders, Alzheimer鈥檚 disease, dementia, clotting disorders and many other conditions. But these were at higher doses and there is no data to show that similar results will occur in those who microdose.

鈥淔or most people, we need higher doses to see weight loss and diabetes results, but there are some exceptions,鈥� says Carolynn Francavilla, an obesity physician in Denver, Colorado. The major clinical trials investigating semaglutide have found a large variability in response. Around , achieving weight loss in excess of 20 per cent; their sensitivity to the medication may mean that it takes far less of it for them to see results.

Longevity

Whether the drugs are indeed a fountain of youth remains unclear, but we do know that they can . 鈥淚t is plausible that microdosing could provide some [anti]inflammatory benefits 鈥� but we just don鈥檛 know yet,鈥� says Al-Aly.

Still, the medications shouldn鈥檛 be taken haphazardly. 鈥淭here should be a medical problem that we鈥檙e improving if we鈥檙e going to use the medications at any dose,鈥� says Francavilla. And it could be dangerous for some people, especially those with , some types of thyroid cancer and some gastrointestinal issues like , a condition that leads to delayed gastric emptying.

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In the US, many of those who microdose source their GLP-1 drugs from compounding pharmacies. These provide custom-made medications from pharmaceutical-grade ingredients when the branded medications are in short supply. This is a cheaper option than buying Wegovy and other brands at retail pharmacies, but comes with the risk of contamination and inaccurate dosages, as these injections aren鈥檛 FDA-approved for safety and quality. In the coming months, however, the compounding of semaglutide injections , as there is no longer a shortage of the brand-name versions. This will have knock-on implications for microdosers like Burgess, who had started using compounded injections rather than Ozempic in her bid to avoid regaining weight.

Still, Burgess isn鈥檛 planning to stop microdosing semaglutide anytime soon. 鈥淚t鈥檚 a tool that helped me in my weight-loss journey,鈥� she says.