The FDA recently approved generic liguratide, which is an older form of these drugs. I'm giving it some thought if my side effects don't come down enough from my switch from Zepbound to Ozempic. I entirely support a ramp-up, ramp-down approach. I'm now on a low maintenance dose of Ozempic because I hit my goal weight, and I know if I stop entirely all my bad habits and the food chatter in my head will restart. I especially like Ozempic (and will appreciate liguratide) because it uses a multi-pen instead of a single-use pen, which means I can click-count. There is only one manufacturer of the generic at this point, but I'm guessing the price may come down further later in the year when they have competition. So this is an option if insurance doesn't provide coverage.

In the meantime, if you haven't considered time-restricted eating, you might do so. I have found over the years that it has been a helpful form of control. Done perfectly, it focuses on avoiding eating between an early dinner and an early morning breakfast, so it reinforces (and is reinforced by) your circadian rhythms. I need to have a small amount of protein/fat before I go to bed to minimize migraines triggered overnight by low blood sugar, so I just avoid food from bedtime until lunchtime.