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Metformin improves insulin sensitivity and modestly curbs appetite, while Contrave targets the brains reward and hunger pathways
In clinical trials, participants indeed received counseling to improve diet and exercise (STEP 1 provided monthly individualized lifestyle counseling to all arms (source))
Prolactin lowering suppress insulin secretion and decrease insulin sensitivity, therefore dopamine receptor agonists which act at the pituitary to lower serum prolactin levels are expected to impair glucose tolerance
The key takeaway is that while the time of day is flexible, what matters most is taking the injection consistently at the same time every week
However, both medications can cause gastrointestinal side effects that may be more pronounced when used together, requiring medical monitoring
Price: $300 Maintenance Pricing Once patients finish their starter package, renewal pricing depends on the therapeutic dose that best controls appetite and supports steady progress
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