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This titration strategy served several purposes: Reduced the severity of gastrointestinal side effects such as nausea, vomiting, and diarrhea Allowed clinicians to identify dose thresholds for tolerability versus efficacy Ensured progressive exposure to triple agonist activity without overwhelming the bodys hormonal systems Monitoring and Adjustments During escalation, patients were monitored for: Glucose control and insulin sensitivity Cardiovascular markers such as blood pressure and lipid profiles Liver enzymes and kidney function to assess safety at higher doses Adverse event reporting, especially GI events, which tend to peak during dose escalation This monitoring informed adjustments some participants remained at moderate doses if they were unable to tolerate higher weekly injections

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