| Say microdosing, and many people think of psychedelics. But some patients are experimenting with so-called microdosing of weight-loss drugs, hoping to slim down, experience fewer side effects — and, yes, spend less money at the pharmacy. The trend has exploded on social media sites including Reddit and TikTok. But doctors warn that the medications, often copycat versions of drugs like Novo Nordisk A/S's Ozempic and Eli Lilly & Co.'s Zepbound, haven't been tested for use at these dosages and therefore may not work. Taking them this way could even carry unknown risks. Microdosing traditionally means taking very small amounts of a drug, but with weight-loss medications, the definition varies. The term can refer to patients who stick with a low starter dose of the medication, rather than increase their dosage over time, as is standard practice. Some participants are also spreading standard doses out. Mariah Hopkins, a 33-year-old mom of four who works in social media marketing, practices both. After taking a higher dose of an Ozempic copycat recommended by her doctor, Hopkins felt like she wasn't losing weight as quickly, and decided to switch back to an earlier dose, a 0.25 milligram injection. She also began taking the shots every two weeks, instead of the recommended weekly cadence. Hopkins says the "low and slow" regimen is working for her. Microdosing cuts down on the cost of the medications, as does a financial relationship Hopkins has with a medical spa, which includes discounts on the drugs. She says she lost most of her weight at the lowest dose, "so why wouldn't I just go back there?" This kind of microdosing has been popularized by gurus like Tyna Moore online. Moore, for instance, touts the benefits in YouTube videos and even offers a nearly $2,300 training course, "GLP-1s Done Right University." And microdosers claim that the technique helps regulate glucose levels, lowers inflammation and lessens side effects like nausea. Yet microdosing has not been studied in clinical trials, not even in studies of the name-brand shots manufactured by Novo and Lilly, says Katherine Saunders, an obesity medicine physician. There's even less research on the cheaper copycat versions made by compounding pharmacies. Saunders notes that at higher doses, overweight patients as well as those with diabetes and obesity typically see more weight loss and lower their risk of major cardiac events like a heart attack. But lower doses, taken by patients without those conditions? That's uncharted territory. "These medications are really powerful and they shouldn't just be used without the proper education and support from a trained clinician," Saunders says. "At a teeny tiny dose, you can't assume that you get any of the benefits that come along with higher doses." David Shafer, a plastic surgeon and owner of the Shafer Clinic in New York City, has similar concerns, and worries about patients making dosing errors. "We always call it Dr. Google. And then even worse is Dr. Instagram," Shafer says. His clinic has even had GLP-1 patients come in looking for help after "macrodosing" — taking high doses in an effort to lose weight faster — and subsequently experiencing symptoms like extreme nausea and muscle loss. - Jessica Nix | 
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