Are you on tirzepatide or semaglutide and struggled with inconsistent weight loss and side effects? On this episode of On The Pen, Dave Knapp and Dr. Ian Ellis dive into the surprising variability of GLP-1 dosing (retatrutide, tirzepatide), even when the weekly dose remains the same. We explore how these subtle dosage changes can lead to frustrating glp-1 side effects and why many individuals eventually give up on their weight loss medication. This new way of thinking about glp-1 dosing could change the obesity medicine game. Referenced Links: http://www.OTPLinks.com00:00 Why most GLP-1 users are never on the same dose twice01:55 Dr. Ian's background: trainer, nutritionist, ER physician04:00 His obsessive relationship with food and body composition07:45 The two impossible choices: obsession or obesity10:12 How medical school destroyed his health10:25 A colleague mentions Ozempic for the first time11:35 His first dose and what real satiety feels like13:00 Why the same dose felt worse every single week15:00 30 lbs lost but the body scan results were horrifying17:30 Why elderly patients are especially at risk on GLP-1s18:35 Patient case: Pat May, 310 lbs, lost over 100 lbs20:45 Semaglutide half-life and dose stacking explained24:50 The therapeutic window and finding your ideal level26:30 Why the dosing protocol was built for trials not people28:00 You are never on the same drug level twice29:00 Patient case: Mary Alice lost 30 lbs below the starting dose32:00 The math behind calculating your precise GLP-1 level35:00 The VoaFit app and making precision dosing scalable36:00 Their patients lost more weight using half the medicine39:30 Why 40 to 70 percent of people quit GLP-1s42:00 Compounding pharmacies and the case for flexible dosing46:00 Using GLP-1 as a thermostat dial for your appetite56:45 Where precision dosing is available now58:30 Beyond GLP-1s: applying this to testosterone and more1:05:30 Why hitting the dose ceiling kills long-term results1:07:00 Dr. Ian's outcome: off GLP-1s completely1:10:00 Fixing a broken one-size-fits-all dosing paradigm1:13:00 How to find Dr. Ian Ellis and VoaFit