Myra Ahmad Believes One-Size-Fits-All GLP-1 Dosing Is Failing Patients

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GLP-1 medications such as semaglutide and tirzepatide have reshaped the treatment of obesity and metabolic disease. This change has developed faster than almost any drug class in recent memory.

Yet a stubborn problem sits alongside the enthusiasm. A large share of patients stop taking them.

Myra Ahmad, the physician who founded and runs the telehealth marketplace Mochi Health, argues that the dropout problem is not mainly a failure of patient willpower but a predictable result of how the drugs are dosed.

In a January 2026 op-ed for MedCity News titled “What if Less Can Be More?”, Ahmad made the case that rigid, standardized dosing is “failing patients,” and that a more individualized approach could be the path toward sustainable progress.

This argument touches a genuine and growing question in metabolic medicine: how do you keep people on therapies that work only if they stay on them?

The dropout problem

About half of U.S. patients who start GLP-1s for obesity care discontinue within the first year, she wrote, with most regaining the lost weight over the year that follows.

Side effects contribute to this problem. Gastrointestinal problems, the most common complaint, affect an estimated 40 to 70 percent of GLP-1 users, and at higher doses, those symptoms can become intolerable enough that people simply stop.

Cost is the other major driver. GLP-1 medications remain among the most expensive prescriptions on the market.

Patients without dependable insurance coverage can face bills that become unsustainable just as the drug begins to work.

Ahmad pointed to a survey of 3,000 U.S. adults using GLP-1s in which 45 percent reported discontinuing, citing cost and insurance barriers as the primary reason.

Her contention is that standard protocols compound both problems by pushing many patients toward higher doses than their physiology actually requires, raising both the side-effect burden and the price.

The case for individualized dosing

The alternative Ahmad describes is microdosing, which she defines as “starting with a dose below the standard and gradually increasing based on the patient’s response.”

The goal, she wrote, “isn’t reaching a fixed dose, but working with each patient’s optimal treatment plan and schedule.”

Ahmad’s argument leans on the observation that some of the benefits of GLP-1 drugs may not be strictly dose-dependent.

Beyond weight loss, she noted, studies have associated the medications with reduced inflammation, lower cardiovascular risk, and possible neuroprotective effects.

Patients may capture meaningful gains at lower doses, particularly with consistent use over time.

If that holds, then a lower, better-tolerated, and less expensive dose could keep more patients in treatment without sacrificing the outcomes that matter.

There is already evidence that patients are reaching this conclusion on their own. Ahmad cited a 2025 survey finding that 36 percent of GLP-1 weight-loss users were microdosing without medical supervision, and another 32 percent had tried it previously.

Among them, 66 percent said they did so to reduce side effects and 38 percent to make treatment financially sustainable, the same two pressures behind the dropout numbers.

In other words, a substantial group of patients is already improvising the very strategy Ahmad argues the medical system should be delivering deliberately.

More oversight, not less

What separates Ahmad’s position from a simple endorsement of lower doses is her focus on the clinical side of care.

“Done correctly, this method demands greater medical supervision, not less,” she wrote. Microdosing introduces variables, including dosing inconsistencies and a more complex picture to monitor, that require structured protocols and close oversight from clinicians who understand the medications.

Patients adjusting doses on their own, or following unverified advice online, take on real risk to both their safety and their results.

Ahmad’s framing positions personalization not as a shortcut but as a more demanding standard of care.

One that asks providers to track outcomes patient by patient and tailor treatment accordingly, rather than defaulting to a single titration schedule for everyone.

She is careful to note that microdosing “won’t be the right choice for everyone,” a hedge that keeps the argument grounded in clinical judgment rather than blanket prescription.

Where the science is heading

Ahmad’s dosing argument fits a broader prediction she has made about how the GLP-1 market will evolve.

Speaking with Women of Wearables in April 2026, she suggested the category will follow the path of earlier drug classes such as antidepressants, birth control, and biologics.

“First we just have one drug, then a best-in-class drug, and eventually the market breaks down to match the individual patients with the drug that’s best for them,” she said, adding that the field is still early in that progression and that the next phase will require more sophisticated care models and the clinicians to run them.

That view has its skeptics. Standardized dosing exists in part because it is backed by clinical-trial protocols, is simpler to administer safely at scale, and avoids the monitoring burden that individualized regimens create.

Microdosing for obesity remains an area where rigorous, long-term comparative evidence is still developing. Much of the current activity is happening outside formal clinical guidelines.

A reasonable counterargument is that the discipline of standard dosing protects patients precisely because it does not rely on every provider getting personalization right. Ahmad’s response, in effect, is that the status quo is already failing on its own terms when half of patients abandon treatment within a year.

Her op-ed stops short of claiming microdosing is proven for everyone. It argues instead that the question providers ask should change, and that the infrastructure to answer it, structured guidelines, outcome tracking, and real clinical oversight,  needs to be built.

As a physician-founder making that case from inside a company built around personalized care, she has an evident interest in the conclusion.

But the underlying tension she identifies, between protocols optimized for the average patient and the individual variation those protocols ignore, is a real one that metabolic medicine will have to resolve as the GLP-1 era matures.