Erica Liebman wanted to lose weight, but she was nervous to try a drug like Ozempic. Ms. Liebman, a psychologist in Philadelphia, had heard horror stories of side effects — nausea, vomiting, intense constipation.
So Ms. Liebman turned to a solution that, despite limited evidence, seems to be growing more popular: “microdosing” weight loss drugs, or taking very small amounts.
To consumers like Ms. Liebman, microdosing is a hack: a way to lose weight while sidestepping unpleasant side effects from standard doses. On social media platforms like Reddit and TikTok, people post their personalized dosing schedules and share supposed results.
Ms. Liebman learned about the idea when she heard Tyna Moore, a health influencer, speak on a podcast about microdosing Ozempic. Ms. Moore has promoted microdosing not just for weight loss but to help with a range of conditions, including high blood pressure, autoimmune diseases and brain fog. In an interview, Ms. Moore said that nearly 500 people have enrolled in her online course, “Ozempic Done Right University,” which costs more than $2,000 and includes advice on microdosing.
The question now: Is microdosing a gimmick, or does it actually work?
At this point, doctors aren’t sure. Theoretically, these medications are so potent that perhaps even tiny doses could curb hunger somewhat, said Dr. Daniel Drucker, a researcher at the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital in Toronto and one of the first scientists to study medications like Ozempic. Many who promote microdosing online claim that the small doses are enough to help them lose a few pounds and quiet their cravings. Others claim microdosing helps them keep off the weight they lost while taking standard doses of weight loss drugs.
Ozempic, Zepbound and other new diabetes and weight loss drugs follow a titration schedule: patients start on a low dose, and then work their way up to larger amounts over several weeks. But there’s very little data to suggest taking even smaller doses (say, 0.05 milligram, compared to a standard 0.25 milligram starting dose of Ozempic) can lead to weight loss or help maintain it.
“There’s this desire for ultra-personalization,” said Dr. Andrew Kraftson, a clinical associate professor in the division of metabolism, endocrinology and diabetes at Michigan Medicine. “I can understand that and affirm it. But we don’t have guidance to tell people to do microdosing on their own.”
If people do lose weight from small doses, that may be because they are what scientists call “super responders,” referring to a subset of people who quickly lose substantial amounts of weight on these medications.
It’s also possible that the benefits some microdosers claim to have seen are the result of the placebo effect, Dr. Kraftson said. If people think they’re getting a boost from the medication, they might feel more encouraged to make lifestyle changes that can lead to weight loss.
Michael Hammer, 47, started microdosing Ozempic in 2022. He had already taken standard doses of the medication for three months, but hated the side effects. He felt he was going to throw up whenever he ate. He ate so little that he was worried he would become malnourished.
“I was like, I’d rather give it up than be this sick,” he said.
Mr. Hammer had gotten his Ozempic prescription through Calibrate, a telehealth company. When he reached out to Calibrate to see if there was any way he could reduce the side effects, an employee suggested he could try microdosing.
Samantha Baker, the vice president for marketing at Calibrate, said in an email that “it is well-documented in the industry, beyond Calibrate, that some patients experience side effects” with drugs like Ozempic, and that “microdosing has been utilized as a strategy to mitigate those effects.”
To Mr. Hammer, the smaller doses were a tool that helped him make lifestyle changes. Now that he didn’t feel sick all the time, he worked out more and focused on eating healthier foods. He lost 50 pounds. He still felt queasy sometimes, but not nearly as intensely as he had with the larger doses.
Microdoses are not likely to be harmful, said Dr. Drucker, who has consulted for Ozempic’s maker, Novo Nordisk.
“I’m not concerned that they’re going to grow three arms or have something horrible happen to them,” he said.
But doctors said they worried about patients taking small doses without the guidance of a medical professional. Stretching out the doses might lead people to accidentally use medications past their expiration date, said Dr. Brianna Johnson-Rabbett, an endocrinologist at Nebraska Medicine.
And several doctors said they concerned that the trend might encourage people to turn to compounded weight loss drugs, which are copycat versions that the Food and Drug Administration does not vet and has repeatedly warned come with health risks. Compounded weight loss medications come in vials that make it easier to customize doses than name-brand pens.
Ms. Liebman takes one-fifth the recommended starting dose of compounded tirzepatide, a version of the substance in the weight loss drug Zepbound. It helped her lose a small amount of the weight she had found difficult to shed since turning 40.
She still gets hungry, but she now has no trouble stopping herself from eating more after a modest meal. And she finds herself thinking less about food throughout the day — an outcome she said would be worth it even if she lost no weight at all.
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