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Graphical Abstract Keywords Metabolic dysfunction-associated steatotic liver disease, Glucagon-like peptide-1 receptor agonist, Clinical trial, Treatment, Metabolic dysfunction-associated steatohepatitis, Fibrosis Introduction Nonalcoholic fatty liver disease has been used to describe hepatic steatosis without significant alcohol intake

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Standard titration schedule from trials 12-week escalation protocol: Weeks 1-4: 0.6mg weekly Initiation dose Body adapts to amylin effects Minimal side effects at this level Weight loss begins (modest) Weeks 5-8: 1.2mg weekly First dose increase (doubling) Gastric slowing becomes more noticeable Appetite suppression strengthens Accelerated weight loss Weeks 9-12: 1.8mg weekly Second increase Strong satiety effects More pronounced GI effects possible Approaching maximum efficacy Week 13+: 2.4mg weekly (maintenance) Target therapeutic dose Maximum weight loss velocity Maintained indefinitely Nausea typically resolved by this point (adapted) Why this schedule works: Gradual exposure reduces side effects 4-week intervals allow full adaptation Doubling steps (0.61.22.4) are tolerable Proven in hundreds of patients Balances speed with tolerability Use our peptide calculator and peptide dosing guide at SeekPeptides for precise calculations

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