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Metabolic Signaling & Energy Balance Explored in relation to lipid metabolism , substrate utilization, and systemic energy homeostasis

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3.1% placebo Primary concern in under-12s / Disruption of normal linear growth and pubertal timing Monitoring frequency / Clinic visits every 4 weeks for the first 6 months when used off-label Key labs at baseline / Fasting glucose, HbA1c, lipid panel, LFTs, TSH, vitamin D, zinc, ferritin Growth parameter / Height velocity z-score tracked every 3 months against CDC growth charts Bone health / DXA scan recommended at baseline if BMI z-score exceeds +2.5 and prior to dose escalation Nutrition screen / Pediatric dietitian assessment mandatory before initiation GI adverse events / Nausea and vomiting are the most common early adverse events