India Pharma Outlook Team | Tuesday, 01 September 2026
Low-dose GLP-1 drugs can still help people lose weight, even when patients remain on the starter dose. However, the weight loss is much lower than results seen with higher doses.
A new observational study looked at patients taking low doses of semaglutide and tirzepatide. It found measurable weight loss after one year. The findings also showed fewer reports of nausea and constipation than with higher doses.
Researchers studied 1,068 patients who stayed on the lowest approved doses for at least six months. The group included 534 patients taking semaglutide and 534 taking tirzepatide.
Patients taking semaglutide remained on a 0.25-milligram starter dose. Those taking tirzepatide stayed on a 2.5-milligram starter dose.
After one year, patients recorded the following average weight loss:
The results were considerably lower than those reported with recommended higher doses. Earlier research found average one-year weight loss of 20.2 percent with tirzepatide and 13.7 percent with semaglutide.
The study suggests that GLP-1 drugs can have a measurable effect even below their usual maintenance doses. However, patients should not expect the same level of weight loss seen with higher doses.
Semaglutide and tirzepatide are normally started at low doses. Doctors then increase the dose gradually to help the body adjust and reduce side effects. However, many patients do not reach the recommended maintenance dose. Several factors can influence this decision.
The study also found that patients on sustained starter doses reported substantially less nausea and constipation. Still, lower doses did not eliminate side effects.
Also Read: GLP-1 Side Effects: Tips for Gastrointestinal Comfort 2026 Update
The research found differences between the two medicines beyond weight loss. Low-dose tirzepatide was linked to kidney injury in 2.7 percent of patients after two years. The rate was 0.4 percent among patients taking semaglutide.
Tirzepatide also showed higher rates of several reported adverse events:
Semaglutide had higher rates of some other events. These included ear inflammation, heavy sweating and ankle swelling. Semaglutide also has a U.S. approval for reducing the risk of worsening chronic kidney disease. Tirzepatide does not have the same specific kidney-protection approval.
The researchers stressed that the study was observational. Therefore, it cannot establish a direct cause-and-effect relationship. Study leader Venky Soundararajan said patients using lower-than-recommended doses need more awareness about both benefits and risks. He also noted that the two medicines are not equivalent.
Novo Nordisk has started a clinical trial studying lower maintenance doses of its Wegovy pill. However, results are expected to take years. For patients who are not seeking very large weight loss, the findings suggest that starter doses may still provide some benefit. But the results also show why dose, effectiveness and side effects need to be considered together when using GLP-1 drugs.
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