What is GLP-1 microdosing and does it work?

The standard ladders were built to answer one question: how much weight can this drug remove? Microdosing answers different questions — how little drug holds the result? how gently can a sensitive person start? — that the trials never asked. The three legitimate use cases: 1. Maintenance. After reaching goal, full doses can be more suppression (and cost) than holding weight requires. Stepping down to a low dose — or stretching intervals — and watching the scale is increasingly common practice. (Maintenance dosing in detail.) 2. Sensitivity. Some people get strong appetite effects or strong nausea at 0.25 mg semaglutide. Fractional steps below the ladder keep them in the game — and since pens don’t dial that low, this is largely compounded-product territory. 3. Relapse prevention at lower BMIs — the documented-history scenario covered in can I get a GLP-1 under BMI 27, where sub-therapeutic dosing is the protocol, not a stepping stone. The evidence, honestly: dose–response data shows real appetite effects at the lowest tested doses, and STEP 4 proved continuing some semaglutide preserves weight while stopping reverses it. What’s missing is the dedicated trial — nobody has randomized maintenance patients to 0.5 vs 2.4 mg. So: plausible, practiced, unproven. Anyone selling guaranteed microdose outcomes is ahead of the data. Guardrails that mark a responsible protocol: written rationale; eating-disorder screening with a hard BMI floor (18.5); a dosing ceiling with re-qualification required to exceed it; provider review rather than self-serve; refusal of cosmetic-only requests. A few telehealth programs have formalized exactly this — NexLife publishes a tiered microdose protocol with mandatory synchronous provider review for the lower-BMI tier, which is the structure to look for anywhere; the full breakdown — including why DIY pen-stretching tends to under-deliver — is in the microdosing guide.