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The third family, IGF-1 LR3, skips the GH-signaling step entirely, binding directly to the IGF-1 receptor on muscle tissue and activating the PI3K/Akt and MAPK pathways tied to cell growth

The Warning Letters targeted mostly semaglutide, tirzepatide and retatrutide as well as other peptides such as BPC-157 and selective androgen receptor or anabolic steroids (SARMS) such as trendione

The lower doses still land in territory that would have seemed remarkable a decade ago

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The steelman argument against switching: A thoughtful clinician might argue against switching in the following scenario: a patient on Wegovy 2.4 mg has lost 12% of body weight over 6 months, tolerates the medication well, and has 8% more to lose to reach goal weight

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