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A personalized approach considers: Your BMI and weight loss goals Blood sugar response Side effects (especially nausea and GI symptoms) Coexisting health conditions like PCOS or hypothyroidism Whether you're using it for diabetes, obesity, or both Doctors usually start you on the lowest dose, then increase it every few weeks if tolerated

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This can be linked to a significant reduction of serine palmitoyl transferase (SPT) protein levels and the downregulation of the ceramide-synthesis enzymes ceramide synthase 5 ( CERS5 ) and delta(4)-desaturase as well as sphingolipid 1 ( DEGS1 ) expression at both messenger-RNA and protein levels