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Although compounded drugs are permitted to be prescribed under federal law, they are not FDA-approved and do not undergo safety, effectiveness, or manufacturing review

Scientific American

The typical escalation looks like this: Weeks 1 through 4: 0.25 mg per week (adjustment phase, minimal visible effects) Weeks 5 through 8: 0.5 mg per week (appetite suppression becomes more consistent) Weeks 9 through 12: 1.0 mg per week (significant appetite reduction, weight loss accelerates) Weeks 13 through 16: 1.7 mg per week (strong effects for most users) Week 17 onward: 2.4 mg per week (full therapeutic dose) Each dose increase brings a noticeable step up in effect intensity

Vitamin B12

Drinking large volumes of water with food compounds the volume issue