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Progress in Brain Research, 185 , 105-129

Weeks 1-4 (2 mg dose) Weight loss is typically modest: 2-3% of body weight Appetite reduction may begin within the first week of injection Gastrointestinal side effects (nausea, decreased appetite) are most common during initial dosing For a person weighing 250 lbs (113 kg), this represents approximately 5-7 lbs (2-3 kg) Results may not be visually apparent to others at this stage Weeks 4-8 (4 mg dose) Weight loss accelerates as the dose increases Cumulative loss of approximately 4-5% of body weight Appetite suppression becomes more pronounced Clothing may begin to fit differently For a 250 lb individual: approximately 10-12 lbs (4-5 kg) lost Weeks 8-16 (6 mg to 9 mg) This is the period of most rapid dose escalation Cumulative loss of approximately 10-13% of body weight Results typically become noticeable to others Physical function improvements may become apparent (easier mobility, reduced joint discomfort) For a 250 lb individual: approximately 25-32 lbs (11-15 kg) lost Weeks 16-24 (reaching 12 mg maintenance) Full maintenance dose is reached around week 17 for the 12 mg regimen Weight loss rate is near its peak Cumulative loss of approximately 17-18% at 12 mg Significant changes in appearance, clothing size, and physical capabilities For a 250 lb individual: approximately 42-45 lbs (19-20 kg) lost Weeks 24-48 Weight loss continues at a gradually declining rate By week 48, mean loss of 24.2% at 12 mg (Phase 2 data) Cardiometabolic improvements (blood pressure, lipids, blood glucose) are well-established For a 250 lb individual: approximately 60 lbs (27 kg) lost Beyond 48 Weeks TRIUMPH-4 demonstrated continued weight loss to at least 68 weeks: -28.7% at 12 mg Whether weight loss continues beyond 68 weeks remains unknown

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Studies done in the elderly showed parallel results in terms of muscle output and endurance

Several studies have shown that L-carnitine supplementation can decrease the markers of muscle damage and inflammation, such as creatine kinase, lactate dehydrogenase, and C-reactive protein