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However, the studies are focused mainly on individuals without diabetes

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Once an effective dose is reached and HbA1c targets are met, the focus shifts to maintenance

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Strategies for managing plateaus include: Verify medication adherence and proper injection technique Reassess dietary intake, as reduced appetite may normalize over time Increase structured physical activity with emphasis on resistance training Consider dose optimization if the patient is not yet at the maximum approved dose Evaluate for addition of a complementary medication (phentermine, naltrexone/bupropion, or topiramate) Reframe expectations: weight maintenance at a lower body weight is itself a significant clinical success Clinical Training and Certification The complexity of prescribing incretin-based medications for obesity demands formal clinical education beyond what most providers receive in residency or advanced practice training