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Metabolomic and ionomic analyses highlight the coordinated regulation of osmolyte accumulation and ionic homeostasis as a decisive determinant of tolerance, particularly under salinealkaline conditions, where ion transporter regulation must be synchronized with osmotic adjustment

If any part of that chain is wrong, the final amount can be wrong too

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Phase 2 results at 48 weeks (Jastreboff et al., NEJM 2023): Phase 3 TRIUMPH-4 at 68 weeks (Lilly Press Release, Dec 2025): The 12 mg dose produced 28.7% body weight loss, an average of 71.2 lbs from a 248.5 lb baseline