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Protocol 1: Cagrilintide monotherapy (first-time user) Goal: Lose 20-30 lbs over 12-18 months Approach: Cagrilintide: Titrate to 2.4mg weekly over 12 weeks Maintain 2.4mg for 12-18 months minimum Weekly subcutaneous injection Supporting strategies: High-protein diet (1g per lb goal weight minimum) Resistance training 3-4x weekly (preserve muscle) 8,000-10,000 steps daily Sleep 7-9 hours Hydration 80+ oz daily Stress management Expected results: Month 3: 8-12 lbs lost Month 6: 15-20 lbs lost Month 12: 22-28 lbs lost Month 18: 24-30 lbs lost (plateau, maintain) Cost: $12,000-24,000 total (18 months) Protocol 2: Adding cagrilintide to existing semaglutide Goal: Break plateau, lose additional 10-20 lbs Situation: Already on semaglutide 2.4mg, plateaued Approach: Continue semaglutide 2.4mg weekly Add cagrilintide starting 0.6mg weekly Titrate cagrilintide to 2.4mg over 12 weeks Maintain both Expected results: Month 1-2: Plateau broken, 3-5 lbs lost Month 3-6: 8-12 lbs additional lost Month 6-12: 12-18 lbs additional lost Total: 10-20 lbs beyond semaglutide plateau Who this helps: Plateaued on GLP-1 alone Want maximum medical weight loss Good tolerability to peptides Can afford combination Protocol 3: CagriSema from start (aggressive) Goal: Maximum weight loss (40-60+ lbs) Approach: Semaglutide: Titrate to 2.4mg over 16 weeks Cagrilintide: Titrate to 2.4mg over 12 weeks (start week 5) Both at maximum doses Maintain 12-18 months Expected results: Month 6: 25-35 lbs lost Month 12: 40-55 lbs lost Month 18: 50-65 lbs lost Percentage: 15-25% body weight Best for: Significant obesity (BMI 35-45+) Need maximum weight loss Excellent GI tolerability Can afford combination Cost: $14,000-28,000 (18 months) Protocol 4: Cagrilintide + body recomposition Goal: Fat loss + muscle preservation/gain Approach: Cagrilintide: 2.4mg weekly (fat loss) CJC-1295: 200mcg 5x weekly (GH, muscle) Ipamorelin: 200mcg 5x weekly (body composition) High protein (1.2-1.5g per lb goal weight) Heavy resistance training 4-5x weekly Expected results: Fat loss: 20-30 lbs Muscle preserved or slightly gained Better body composition than diet alone More "toned" appearance Who this helps: Want to look good, not just lose weight Athletes/fitness enthusiasts Concerned about muscle loss Can afford multi-peptide stack See our peptide cycle planning guide and can you cycle different peptides at SeekPeptides

The 5-on-2-off schedule for GH secretagogues exists for a specific reason: maintaining receptor sensitivity

Your doctor will determine the right schedule for you

Effective preventative measures for patients at risk for cholelithiasis include a slower rate of weight loss, increasing/including some dietary fat in the diet (assuming the patient has been on a very low-calorie diet containing little or no fat), or administration of ursodeoxycholic acid