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The recommended approach is to try conservative management strategies first (cool compresses, antihistamines, clothing changes), then consider dose adjustment if symptoms persist beyond 4 weeks, and only discuss discontinuation if symptoms are severe and unresponsive to other interventions

Plasma dosage of ghrelin, IGF-1, GLP- 1 and leptin related to gastric emptying and esophageal pH-impedance in children with obesity

Equity and access considerations also remain central

Dose Optimization Not everyone needs or tolerates the maximum 12mg dose to achieve their goals

doi: 10.1016/j.ejmech.2024.116342

If they have questions, your care team follows up by message, so there is no in-person visit required