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Do I need to fail another weight-loss medication first (step therapy)

doi:10.1155/2015/318125

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In humans, GH secretion during early sleep may be nearly totally suppressed by administration of a specific GHRH antagonist ( Growth hormone injections are traditionally timed to align with the natural circadian rhythms of GH secretion, typically during the early night, to coincide with the onset of slow-wave sleep ( We hypothesized that daily GH injections given in the evening could disrupt sleep both by inhibiting GHRH secretion, and due to the discomfort and psychological distress associated with the injection and local reactions

Treatment: PIGS: 3-5ml first injection