Why some people are microdosing popular weight-loss drugs

Mint

24-05-2025

Microdosing isn't just popular for psychedelics.
Some consumers are taking smaller than standard doses of GLP-1s—the popular class of weight-loss and diabetes drugs that include Ozempic, Wegovy, and Zepbound—or spacing out doses longer than indicated.
The reason: to save on money or lessen side effects. Some people say they can lose or maintain weight on such tiny doses and others believe the microdoses can help with other health-related factors.
The truth: This may be more of a social-media phenomenon than a reality. Doctors say yes, some people are super responders to the drugs and can lose or maintain weight loss at low doses—but it's unusual to lose all your weight with these.
The majority of people microdosing will need to escalate their dose, which can be done more slowly for those with bad side effects, notably gastrointestinal issues.
Still, people are trying microdosing. Here's what to know about it.
The first challenge with microdosing is the method of delivery. The prescription drugs entail taking weekly self-injections with pens.
Currently, most people taking alternative doses of GLP-1 drugs are using cheaper compounded versions of the medications, says Dr. Katherine H. Saunders, a clinical assistant professor of medicine at Weill Cornell Medicine and co-founder of FlyteHealth, a medical obesity-treatment company. (Saunders, like many doctors, doesn't recommend compounded copies of the drugs because of potential safety issues; the federal government has cracked down on the compounded market).
The only weekly GLP-1 drug that makes it easy to take alternative doses is Ozempic. It comes in a self-injectable pen where doses are administered with clicks. The other drugs have mostly been sold as single-dose injectable pens. But some patients will stretch out doses taking them every 10 days to two weeks. And once used the pens have a shelf life of 56 days.
Zepbound single-dose vials became available in the U.S. last year for self-pay customers only. This makes it theoretically possible to microdose by drawing out smaller amounts of liquid with a syringe.
But the single-use vials are free of preservatives. So using them after the rubber stopper is punctured increases risk of infection, says Anne Kome, a clinical pharmacist at University of North Carolina Health in Chapel Hill.
Saunders says many people taking fractional doses likely don't meet the criteria for the drugs and are trying to lose a little weight or are hoping for potential longevity benefits.
They are people like Rachel Ratliff, a 56-year-old retired corporate lawyer in San Francisco. She was effortlessly skinny until she hit menopause and gained 10 pounds. Ratliff says she was always ravenous and nothing she did to take the weight off worked.
Ratliff decided to try a compounded version of tirzepatide—the active ingredient in Eli Lilly's Zepbound and Mounjaro. 'I started taking [tirzepatide] out of vanity but it's completely changed my relationship to food and given me the ability to make healthier food choices," she says.
Initially she took the usual starting dose of 2.5 milligrams, which wiped her out. Then she tried a quarter dose. 'It was amazing, it took the edge off my hunger," she says.
Ratliff says she lost 10 pounds in the first six weeks and continues to take a maintenance dose. This costs about $50 a month.
Saunders says some people are so-called 'super responders" who are very sensitive to medications and may need lower than a standard dose. 'We're personalizing the dose, not microdosing them on purpose," she says.
Most people learn about microdosing from TikTok, according to a recent survey of 640 GLP-1 users conducted by Tebra, a health-software company.
Thirty-six percent of respondents said they microdose. Among them, 48% take smaller injections than prescribed and 43% split doses over a longer period. Sixty-six percent microdosed to reduce side effects; 40% wanted to ease into the medication; and 38% did it to save money.
Spokespeople for Novo Nordisk (Ozempic and Wegovy) and Eli Lilly (Mounjaro and Zepbound) said they don't condone or encourage misuse of their products. They said microdosing poses potential safety risks.
Doctors agree that patients shouldn't be choosing to microdose on their own.
'What about a patient microdosing on their cancer therapeutic or how about microdosing on their blood pressure medication based on how they feel? Or how about their insulin?" says Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women's Hospital in Boston. 'We have a disease here—not cosmetics."
Patients who try to conserve medicine by spreading out their doses may experience worse side effects, such as nausea and gastrointestinal issues, says Dr. Gitanjali Srivastava, a professor and co-director at the Vanderbilt Weight Loss Center.
'The body is not exposed to that medication for longer periods of time so they are less tolerable," she says. Taking doses that aren't standard can also lead to more dosing errors.
One promising area of microdosing may be health benefits independent of weight loss, researchers say.
Data published at the European Congress on Obesity conference last year found that people who took semaglutide—sold under the brand names Ozempic and Wegovy—and didn't lose much weight had the same 20% reduction in heart attacks and strokes as those who took it and did lose weight, says Dr. Daniel Drucker, an endocrinologist and professor at University of Toronto who studies GLP-1 drugs.
'And so then the question is, if it doesn't matter whether or not you lose weight, does it matter how much semaglutide you actually took to get that benefit?" he says.
We don't know the answer, he says, because trials use standard doses of the drugs.
'I think what we're starting to see is that there are clearly weight loss and glucose independent benefits of these medicines," says Drucker. 'But what we don't have is data saying 'and you can achieve those benefits with microdosing.'"
Write to Sumathi Reddy at [e-mail]