“Do you have an extra ticket?” a man shouted outside SoFi Stadium last Thursday.

The World Cup has been drawing fans from around the globe. But for many, getting a seat in the stadium has come at a steep price.

Some were lucky enough to nab $400 to $500 tickets through official World Cup lotteries, others paid thousands of dollars to catch the action IRL. Tickets for the upcoming USA versus Turkey match were selling for more than $1,400 on resale sites.

The demand has been so high that authorities have been warning fans about how to avoid ticket scams.

As crowds flocked into the stadium, we asked attendees about how much they paid to get into the most-watched sporting event in the world. Here’s what they shared.

Their responses have been lightly edited for length and clarity.

Luis Moreno, Luis Moreno Jr., Angelica Castellano, Diana Moreno and Ramon Aguilera of Orange County

Luis Moreno, Luis Moreno Jr., Angelica Castellanos, Diana Moreno and Ramon Aguilera sport Mexico gear.

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How much did you pay for your tickets?

Diana: We don’t want to say because I don’t want our parents to know.

*Whispers* We paid retail. It was like $500 per ticket. For Father’s Day, we wanted to make sure he got to enjoy it.

Why did you want to attend the World Cup?

Castellano: We went in ‘86 in Mexico, ‘94 in Pasadena and now here. We’re excited because I want to enjoy it with my kids. If we didn’t come, I would’ve been sad because they need to see how it is.

Diana: Now, it’s our turn. Even though [today’s match] is not our country, we still had to come and experience it. We’ll watch our team play later on the big screen.

Did you have to give up anything to be here?

Diana: Work, but that doesn’t matter. This is more important. Time with family.

Luis Jr.: Sleep. [Laughs]

Diana: It’s Thursday. We’re out here watching the game, we’re drinking, so there’s no complaints.

Was it worth it?

Diana: Absolutely. No matter what happens today. The fact that we’re here, it’s already a success.

Tell me about your outfit. You’re rocking Paisaboys, an L.A. brand.

Diana: I got the Paisaboys shirt on, repping. I know they have a collaboration with Nike. I got my Nike shoes on and I’m just ready to have a good time. My mom sewed her top last night. She wanted to add a little touch to it.

Angelica: Yes! This is an old, old, old jacket.

Diana: My dad’s outfit is sponsored by me. All Adidas, Father’s Day gift.

Luis Sr.: I got lucky this year.

Adam Chapman and Sarah Harrell of Washington, D.C.

Adam Chapman and Sarah Harrell.

How much did you pay for tickets?

Harrell: We went to two games: USA versus Paraguay [in Los Angeles] and Senegal versus France in New Jersey/New York.

Chapman: The L.A. tickets were way more expensive. We bought them presale for like $1,940, but the [seats] were still very high in the arena and the resale prices are actually cheaper than the ones we bought on presale. It’s horrible. [Laughs]

Why did you want to come to the World Cup?

Chapman: This is my first men’s World Cup. I went to the women’s World Cup in Australia a couple years ago. The last time the U.S. had a men’s World Cup here was like forever ago. We’re probably not going to have another in our lifetime, so I really wanted to make sure we had a chance to go to some games.

Did you have to give up anything to be here?

Harrell: We’re moving the day we get back, so we were packing until the moment we got here. Some of this gear was last-minute purchasing in order to make that work. Also, we took a six-hour plane ride, middle seats. We really committed to get here. We got cat sitters, we both took days off from work, the whole thing.

Was it worth it?

Chapman: Yeah, just for the experience. It’s more money than we would’ve wanted to pay but yeah.

Harrell: We bought the tickets like a year and a half ago, so it’s been on the calendar forever. We ended up getting to bring my brother and his best friend to celebrate his 40th birthday, so it sort just worked out for all of us.

Laila Samimi and Elizabeth Cambage of Los Angeles

Laila Samimi and Elizabeth Cambage.

How much did you pay for your ticket?

Cambage: Nothing. Sorry.

Samimi: We were blessed.

Why did you want to attend the World Cup?

Cambage: This is my first fútbol game ever. I wanted to come cause it’s L.A. Yay sports! It’s a once-in-a-lifetime opportunity. Let’s get out there and get into it.

Samimi: I’m born and raised in L.A. so I’m happy to see the World Cup here.

Tell me about your outfit inspiration.

Samimi: I’m wearing Honor the Gift, Russell Westbrook’s brand, a Nike top, my shorts are from a random boutique in L.A. and Jordan shoes.

Cambage: I just went crazy at the Nike store. I’m not gonna lie. We just came from the Nike store. I’m reppin’ USA today. Yes, I am Australian, but I do live in America and USA is AUS. [Laughs]

Kenan Sahbaz of St. Louis and family

Bosnia and Herzegovina fans cheer on their team.

How much did you pay for your ticket?

I got mine directly through the FIFA website. We paid $500 a piece. I brought my son, my cousins and their kids.

Why did you want to attend the World Cup?

Sahbaz: This is our very first World Cup. It’s a historic event for our very small country, Bosnia and Herzegovina. This is a huge accomplishment in the past 12 years. This is going to be the first time we’ve made it here again. We’ve got a really good squad and I think we can do some amazing things for our country. This is a time when we really need some support and joy in the country, and no better way to do it than at the World Cup.

Who’s your favorite player?

Kids: Džeko.

Did you have to give up anything to be here?

Sahbaz: A lot. Work. Time. We were initially going to go on vacation to the Bahamas, but I asked him either the Bahamas or the World Cup. So when we found out that we made it, it was the World Cup. We canceled everything else. We even went to the qualifiers in Wales and that was a once-in-a-lifetime experience as well. There was just no way we were going to miss it.

Was it worth it?

Sahbaz: 100%. Win or lose, we still win today.

Daniel Henriquez and David Njenga of Seattle

David Njenga, left, sports Kenya gear, while Daniel Henriquez cheers for El Salvador.

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How much did you pay for your ticket?

Henriquez: This match was $500 each. We bought it in like October of last year.

Why did you want to attend the World Cup?

Njenga: Because this is the World Cup. You have to go to a World Cup. This is my second one. I was in Qatar for the last World Cup.

Henriquez: The energy! World Cup baby!

Njenga: There’s people from all over the world. We are all assembled here to enjoy this moment.

Henriquez: This is what happens when all the world comes together. This is our utopia. We all love each other. We’re all here for one thing, to support our country.

Did you have to give up anything to be here?

Njenga: My job. I have to be at work right now, but I took the day off. I don’t mind.

Henriquez: I’m a nurse for the fire department. My boss was awesome. She gave me a day off. I love my boss Nancy. Go Nancy!

Was it worth it?

Njenga: It is worth every penny. It’s not even the money. It’s the experience. After this, we head to San Francisco for another game.

Henriquez: Then we’re heading to Vancouver and then we have another game in Seattle.

Njenga: We’re going to six games [in total]. Our Houston tickets were the cheapest. They were about $400.

Cindy Vazquez of Granada Hills

Cindy Vazquez Zavala reps Mexico with her outfit.

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How much did you pay for your ticket?

It was free.99. Shh!

Why did you want to come to the World Cup?

This is my first World Cup. The Jordan team invited me to attend this game, so lucky me. That’s why I’m wearing Jordans today. I’m in the industry so they invited a few employees from neighborhood stores to come.

Tell us about your outfit inspiration.

Today there’s a Mexico game, so I still gotta rep even though I’m attending this match [Switzerland versus Bosnia and Herzegovina]. The outfit is a Nike T90 jersey and my lace is from Amazon. I got the little [soccer] ball, the little World Cup and teddy bear from the gas station. I needed it.

Did you have to give up anything to be here?

I actually had to request PTO to attend, but the store is still running without me. Right after this game, I actually have to jet back. I work at Feature, which is a sneaker boutique in Studio City. S/O Feature for allowing me to come here!

Fabian Almiron of Spain

Fabian Almiron, originally from Paraguay but currently living in Spain, rides Metro to the game.

How much did you pay for your ticket?

I paid $1,100 for the first game [June 12], $290 for the Turkey game [June 19] and the last game with Australia was $170 [June 25].

Why did you want to come to the World Cup?

This is my first World Cup. I live in Spain, but I’m rooting for Paraguay. I’m very excited to be seeing them participate after 16 years.

Did you have to give up anything to be here?

I used like 20 to 25 days of vacation time to come see the World Cup.

Was it worth it?

Yes!

Sunny Kwong, Sam Mallari, Antonio Evangelista, Michael Evangelista of San Diego and Los Angeles

Antonio Evangelista, Sam Mallari, Michael Evangelista and Sunny Kwong are decked out in Bosnia and Herzegovina gear.

How much did you pay for your ticket?

Michael: We paid $400 each. We got lucky with the last chance lottery. They released the tickets a few months ago.

Why did you want to attend the World Cup?

Michael: We’re rooting for Bosnia this time. This is our first World Cup.

Antonio: It’s a lifelong dream. I’ve loved the sport ever since I was in the Philippines.

Did you have to give up anything to be here?

Michael: Most of us had the day off. I worked in the morning at like 6 a.m. and then I’m going to work afterward. I really wanted to carve out time to be there.

Mallari: I took time off because this is my first soccer game ever and I wanted to experience the World Cup with true fans.

Was it worth it?

Michael: 100%. It’s honestly a once-in-a-lifetime experience. It’s been awesome to be here with my dad. We watched the last World Cup finals and we were literally in tears. I know he’s been playing soccer ever since he was in the Philippines military.

Antonio: 20 years.

Becky Clift of Orange County and William Wagner of San Diego

Colleagues William Wagner and Becky Clift sport traditional festival inspired outfits to cheer on Switzerland.

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How much did you pay for your ticket?

Clift: They were gifted to us.

Wagner: We’re a fortunate group.

Why did you want to come to the World Cup?

Clift: The World Cup in America is super fun, so we wanted to support it and be a part of it. This was the game that we got tickets for, so we decided to dress up a little bit and have some fun.

Wagner: We’re both soccer people. We both speak the world’s language, so we’re happy to be a part of it here.

Tell me about your outfit inspiration.

Wagner: I have a very close Swiss friend who was equipped for this. One quick phone call and here I am.

Clift: Then I had to get mine so I could support.

Did you have to give up anything to be here?

Wagner: A full day of work. We’re both engineers. We know each other through work.

Was it worth it?

Wagner: We’ll find out.

Clift: Heck yeah!

Jorge Morales of Topanga

Jorge Morales holds out a ball he got at the World Cup opener in Mexico City.

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How much did you pay for tickets?

It was between $800 to $900 for my USA versus Paraguay tickets. I bought them through Seat Geek.

Why did you want to come to the World Cup?

I wanted to experience it not just in Los Angeles, but I also wanted to experience it in Mexico. I’m going to three games in Los Angeles and four in Mexico City. Going to my first World Cup in Mexico City was a whole different ballgame. Mexico played in their home country and they won. It was like pandemonium. Even though it was raining over there at the time, it was still a lot of fun. Everyone was hugging each other. I’m looking at you, New York Knicks fans. [Laughs]

Did you have to give up anything to be here?

I’m used to traveling, so I’m like this ain’t nothing. I just wanted to experience a World Cup game and the fact that it’s in three countries, you’re not going to experience that any other time. It’s the one and only World Cup where you’re going to see three countries hosting it.

Alexi Kulik, Marcella Harkness, Luke Kulik and Ian Harkness of San Diego

Switzerland fans Alexi Kulik, Marcella Harkness, Luke Kulik and Ian Harkness.

How much did you pay for your ticket?

Ian: $450 per ticket.

Alexi: We won the ticket lottery. That’s the only way ‘cause the resale is expensive.

Why did you want to attend the World Cup?

Marcella: This is our first World Cup!

Ian: I was at the Switzerland versus Qatar game. Similar outfit. We got it dialed this time. Lots of fun. Tough ending, but what are you going to do?

Luke: We wanted to support Switzerland. Everyone in the family is Swiss. It’s fun to go to a World Cup game. We were just excited to get tickets. I think it’s a great way for the family to spend time together and a good excuse to get out of work.

Did you have to give up anything to be here?

Luke: Time off work. Time to come here. We drove up here. I don’t think we gave up much. We just enjoy being here.

Ian: $450.

Alexi: And we woke up at 5 a.m., so that we could come up here and spend the day together.

Was it worth it?

All: Yes!

Anja Gegic, Dino Gegic, Benjamin Mustafic, Nordin Kapic, Armin Kapic of Los Angeles

Bosnia and Herzegovina fans Anja Gegic, Dino Gegic, Benjamin Mustafic, Nordin Kapic and Armin Kapic.

How much did you pay for your ticket?

Nordin: $3,000. We’re like literally on the field.

Anja: $450. In L.A., we got it like that.

Why did you want to attend the World Cup?

Anja: This is our second time ever qualifying for the World Cup. We are so proud to be here and support our country today.

Nordin: I mean, look around. Why would you not want to be here today?

Armin: We’re hoping for the win!

All: 2-0!

Bendicht Hügli and Lucia Grajales of Mexico City

Lucia Grajales and Bendicht Hugli, both currently living in Mexico City, hold a Swiss flag.

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How much did you pay for your ticket?

Hügli: The ticket was $650. That’s stealing. That’s robbery. When I went in ‘86, I think the tickets were 10% of the price I paid for this year.

Why did you want to attend the World Cup?

Hügli: I had some business in San Diego. I saw Switzerland is going to be here, so let’s hit it and break the bank to get tickets. I went to the World Cup in Mexico City in ’86. I saw 12 games. I’m going to one this time.

Was it worth it?

Hügli: We’ll see. If Switzerland plays lousy, then I’m going to be pissed, but I think they’ll do better than in the first game.

Flavia Sacco and Isidoro Garcia of Washington, D.C.

Flavia Sacco and Isidoro Garcia root for Paraguay.

How much did you pay for your ticket?

Isidoro: I think it was around $500 per ticket. Again, we were very lucky because Paraguay was the first game.

Flavia: It was early bird without knowing who was going to play.

Isidoro: We’re also going to the Paraguay versus Turkey game in San Francisco and the third one in Mexico City.

Why did you want to come to the World Cup?

Flavia: We’re rooting for Paraguay. I’m from Paraguay, born and raised.

Isidoro: This is my second World Cup. I went to the one in Qatar. We were very excited about it. Actually, we were very lucky too because we bought Paraguay’s tickets when they were selling them blank. So we just bought the three tickets for Paraguay before knowing the group stage and then it turned out to be in the U.S., so it was awesome.

Flavia: We were hoping it would be on the East Coast because that’s where we live and it ended up being on the other side of the country, but we already had the tickets and we really wanted to go to a game, so we flew. We’re coming straight from the airport. We have our 5-month-old baby who is at the hotel with my mom.

Did you have to give up anything to be here?

Isidoro: I guess time with our daughter. Even though it’s only going to be a few hours, we miss her a lot. She’s very tiny. Every [moment] is precious with her.

Was it worth it?

Isidoro: Yes, even though it’s a few hours and hopefully Paraguay will pull it off.

Jorge Espinosa of Los Angeles

Jorge Espinosa of Los Angeles.

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How much did you pay for tickets?

For the USA versus Paraguay ticket, I think I paid like $1,800, and for another match, I think I paid about $1,020, so a little less. I think that’s when the prices started to go down.

Why did you want to come to the World Cup?

I’ve always wanted to go. I missed my chance to go to Brazil in 2014. I really wanted to go, but I had just taken a huge trip to Asia, so I couldn’t really go. I didn’t have any money left and I’ve been thinking about the World Cup being here since it was awarded to the U.S. I was really bummed out when it was awarded to Qatar instead of the U.S. and also instead of Australia. I’m really excited about it. It feels unreal.

What does it mean for the World Cup to be in your hometown?

It means so much. I remember when they had it here in ‘94. I didn’t get a chance to go to any of the games, but the energy that you feel around the city is like next level. The events they’ve been hosting are so awesome. You get to meet more people from other walks of life and other countries.

Did you have to give up anything to be here?

I just pretty much had to pick up more debt, but I get points so it’ll help fly somewhere. Also, debt disappears when you die so they can try coming after me for that World Cup money, but they never will. [Laughs]

Was it worth it?

I looked at the price and was like, “It’ll never be this cheap in my life, ever.” It’s only ever going to go up, and, hey, it’s in my backyard.

Additional reporting and translation by Dante Estrada.

Facts by day, fiction by night! At the end of a long day in the newsroom, many of our journalists head home and escape into novels of all types. We asked our NPR colleagues what fiction they’ve enjoyed reading so far this year, and these are the titles they shared. (You can also check out their nonfiction picks here; and sign up for our Books newsletter for weekly recommendations.)

A Bad, Bad Place by Frances Crawford

The opening chapter of A Bad, Bad Place is delivered in a short burst. We are presented with three characters — Janey, her nana, Sid Vicious (the rescue dog) — and one heck of a predicament. As 12-year-old Janey states: “It’s Sid’s fault that I found the dead body.” It becomes her job to unwind the mystery of her discovery in her rough neighborhood in 1979 Glasgow, Scotland. Recalling what she saw (and admitting what she didn’t tell police) is key. Frances Crawford shapes this world with such care and love, even in tough circumstances. Read this book. — Shannon Rhoades, supervising senior editor, Weekend Edition

A Perfect Hand by Ayelet Waldman

The hero of A Perfect Hand is Miss Alice Lockey, lady’s maid to Lady Jemima Alderwick. Alice falls in love with Charlie Wells, who is the valet to the eccentric Lord Wynstowe, but for the two to be together, they must devise a plot to bring about an unlikely romantic union between their employers, who, naturally, hate each other. What starts as a classic marriage plot, though, evolves into a very different, more complex story. Alice, you see, has been reading about the burgeoning women’s rights movement in her 19th-century England. And maybe, just maybe, she has begun to imagine a future for herself that — gasp! — might not involve marriage after all. — Samantha Balaban, senior producer, Weekend Edition

Cherry Baby by Rainbow Rowell

This is the first novel I’ve read that asks: How do you navigate being fat in a GLP-1-crazed world? And on top of unwanted fame and changing marital expectations? Fortunately, Cherry, Rainbow Rowell’s hero, is proudly fat and fierce, which helps when her husband, Tom, creates a semi-autobiographical comic with a character who looks so much like Cherry (double chin and all) that strangers recognize her. It becomes a hit, and Tom goes to Hollywood, leaving Cherry behind with the dog. But she refuses to stay downtrodden — I found Cherry’s spirit irresistible. — Emiko Tamagawa, senior producer, Here & Now

Cry Havoc by Rebecca Wait

There’s a whole genre of books set in quaint British boarding schools (the Harry Potter series, Tom Brown’s School Days, etc.). Cry Havoc is nothing like any of them. Set in a dilapidated, fifth-rate girls school in the 1980s, this dark and hilarious novel follows a teenage student, Ida Campbell, as she eats inedible school dinners, rooms with a hostile and self-destructive roommate and grapples with a bizarre epidemic that causes members of the student body to jerk their arms and legs uncontrollably. The book also contains one of the most brilliant, side-splitting scenes set at a school play ever written. — Chloe Veltman, correspondent, Society & Culture Desk

Dear Monica Lewinsky by Julia Langbein

This is the only novel of the hundreds I have read where I reread the ending three times: It was that satisfying! Julia Langbein’s comic romp takes us through the summer of 1998, when a college student is out of her depth in a study abroad program surveying the iconography of minor medieval French churches. She’s also out of her head with desire for one of her teachers, mirroring a certain political scandal erupting in the U.S. Who’s she gonna call on decades later when the teacher’s retirement sends her into a middle-aged tailspin? Saint Monica Lewinsky, of course! Insightful, hilarious and, in the end, everybody gets exactly what they deserve. — Melissa Gray, senior producer, Weekend Edition

It doesn’t take much these days to fall down a GLP-1 rabbit hole on the internet. TikTok, Instagram, Facebook and Reddit all feature streams of testimonials from people touting the miracle — and warning of the risks — of GLP-1 drugs like Ozempic and Wegovy.

In recent years, microdosing — taking smaller doses than what’s generally prescribed for obesity and diabetes — has also cultivated a cult-like following online. Microdosing advocates claim it can help with weight loss by reducing cravings, better metabolic health, reduce inflammation, enhance mood and cognitive function, and even potentially improve longevity, all while coming with less side effects and being more affordable than larger doses.

Microdosing GLP-1s began emerging as a trend after Wegovy, an Ozempic competitor, was approved by the FDA for obesity in 2021. (Previously, Ozempic was being used for weight loss, but had only been approved for diabetes.) In the years following approval, a growing number of household names from Oprah to Elon Musk spoke publicly about their positive experiences using GLP-1s for weight loss. This fueled an exponential growth in interest among the public, but not everyone qualifies for GLP-1s through their insurance or can afford them, even if they do.

All of the major brand-name medications people currently use for weight loss are based on one of two molecules: semaglutide or tirzepatide, and most are self-injected weekly. Ozempic and Wegovy contain semaglutide, which works by mimicking a hormone called GLP-1 that helps regulate appetite and blood sugar. Mounjaro and Zepbound contain tirzepatide, which targets that hormone plus another one involved in metabolism.

The price of weight loss

Brand name GLP-1s cost around $10,000 per year or more if paid for out of pocket, and around $300 to $1,200 per year if covered by insurance. Many insurance plans, however, will only pay for GLP-1s if a person has a diagnosis of diabetes, not obesity. On top of that, one of the biggest complaints about GLP-1s, when taken according to the standard doses approved by the FDA — is that they cause side effects such as nausea, diarrhea and fatigue. Influencers, everyday people and even some medical professionals online now recommend microdosing as a potential solution.

“In three weeks, I have lost 7 pounds and [have] very few side effects. Before now I was terrified of them. They put my husband on [a] standard dose for diabetes and he was just so sick,” reads a Reddit post by MenloShark25, who says they’re receiving their prescription through telehealth provider Midi.

“I’m microdosing. I’m on week 4 of [semaglutide] and my mind is blown,” reads another Reddit post by palenesslitethesky. “I feel so much better than I expected to. The microdosing is great for me because I was super scared about getting constipated. I am down 9 pounds and my tastes changed. I was addicted to sugar!! Addicted. Now I hardly want sugar.”

The DIY injections boom

In 2025, following the surge of anecdotal reports online about microdosing, a number of telehealth companies such as Fridays, Noom and Found Health started offering GLP-1 protocols at lower doses and lower costs. Previously, people who were taking smaller doses of GLP-1s were either getting them “off label” from a physician — which means they were prescribed, but not based on the protocols approved by the FDA — or getting them illegally online and figuring out how to take them on their own. One controversial aspect of microdosing GLP-1s is that, when they’re taken in smaller doses, they often come from compounding pharmacies that make their own versions of FDA-approved drugs. This allows for dose customization but isn’t subject to the same reviews for safety, efficacy or consistency, and may carry added risks related to quality control, potency variation or contamination.

For people like Monika Awadalla, however, they feel they have no choice but to find GLP-1s on their own, unable to afford the cost of treatment through a physician. Awadalla, a 31-year-old caretaker living in Huntington Beach, has been buying a compounded tirzepatide from an illegal manufacturer in China that she connected with through a Facebook group about a year and a half ago. In that time, she’s gone from 245 pounds to 140 pounds.

“I’m extremely happy now,” she says. “I don’t need to stay home, I’m not embarrassed, I’m already looking forward to summer. Everything is just in its right place.” The manufacturer, who communicates on encrypted messaging boards such as Telegram and Signal, charges $290 for 10 vials of compounded tirzepatide, which will last Awadalla about a year.

Based on stories like Awadalla’s, it’s no wonder so many people are curious about microdosing GLP-1s through their doctor, telehealth companies and illegal suppliers. But do we have enough information yet on the benefits and risks? Here’s the deal.

A doctor’s take

For now, there’s no scientific studies looking at the efficacy and safety of microdosing GLP-1s. Dr. Shauna Levy, medical director for the Tulane Weight Loss Center, says that doesn’t mean it doesn’t work, but that the medical community just doesn’t know. Even if it does cause weight loss or a reduction in inflammation, she says, it’s unclear whether those results will persist long-term or whether the practice causes harm.

One of the biggest problems with the term “microdosing,” as it pertains to GLP-1s, Levy says, is that it’s “vague,” and there’s no consensus on what it’s referring to. “Microdosing GLP-1s is almost becoming this buzz word that carries inconsistent meaning. I think there are many people who are using it as a marketing tool because they want people to think you’re not on a full dose of a GLP-1,” she says. “But if we’re really talking about treating obesity, those microdosing doses are not going to be effective for most people, and so I worry people are going to pay for it cause it’s cheaper and then it’s not going to work for them and they’re going to think ‘here’s one more thing that’s not working for me.’”

Levy says GLP-1s, when prescribed correctly, are “fantastic” for treating obesity. In her patients, gastrointestinal effects are common but generally tolerable. She also believes that it’s important to expand the criteria for obesity so that more people qualify for these drugs through the proper channels, but says it’s crucial that patients receive ongoing care from a medical professional who has been licensed by the American Board of Obesity Medicine. “A lot of GLP-1s are being prescribed by untrained in obesity professionals,” Levy says. “My No. 1 issue is who is prescribing it.”

Dr. Sara Siavoshi, a board-certified obesity, neurology and headache specialist, treats about 5,000 patients in her practice. She estimates 30 to 40% of them are microdosing either tirzepatide or semaglutide. Siavoshi defines a microdose as “the lowest dose of a GLP-1 that lowers food noise without causing any significant weight loss.” Food noise, a term used in obesity medicine, refers to chronic unwanted thoughts that make healthful choices (both about how much to eat and what to eat) difficult. If the GLP-1 dosage leads to more weight loss than 3 or 4 pounds, she says, then she doesn’t define it as a microdose. She says most people seem to think a microdose means an amount that’s lower than what’s commercially available, but in her practice, she hasn’t seen it benefit most of her patients when doing that. Generally, she’s found success in putting people on the lowest commercially available dose of a GLP-1. “I’ll tell you the patient satisfaction rate is extremely high and patients are very, very happy on these meds,” Siavoshi says. In addition to reducing food noise, her primary goal is to lower inflammation in patients with autoimmune conditions.

Recommended: continuous, certified care

Siavoshi emphasizes the importance of working with someone who has been trained in obesity medicine, pointing to the American Board of Obesity Medicine’s website, where patients can look up their providers and make sure that they’re certified. She’s not opposed, she said, to all online platforms providing care, but says it’s essential to be getting consistent support from someone who can put together a treatment plan and be there throughout the process.