The aesthetic physician as a gatekeeper of safety in the era of unsupervised GLP-1/GIP agonist use

Objetivos: In certain countries, such as Russia, GLP-1 and GIP agonists are more accessible due to their low price and the lack of strict prescription control. It is widely known that these drugs induce weight loss, which has led to their immense popularity for body mass reduction without medical supervision. These medications carry numerous side effects and risks of complications and require significant patient discipline, which is typically explained by the endocrinologist prescribing the medication for obesity or type 2 diabetes. Introducción: To define the critical role of the aesthetic practitioner as a health provider in identifying unsupervised GLP-1/GIP use and implementing a mandatory multidisciplinary safety protocol. Materiales / método: Aesthetic physicians must systematically address the hidden risks of these agonists, including sarcopenia and nutritional collapse. During consultation, we should mandate a comprehensive screening protocol: biannual abdominal and thyroid ultrasound, blood analysis (calcitonin, liver enzymes, vitamin panels), impedancemetry, and ophthalmologic examination. Crucially, patients must be educated on the heightened risk of aspiration under anesthesia and the reduced efficacy of oral contraceptives. Resultados: Furthermore, the physician must provide evidence-based nutritional support to counteract the catabolic effects of rapid weight loss. This involves an integrated dietary strategy emphasizing energy balance, hydration, and specific supplementation: Omega-3s and Creatine (5 g/d) combined with resistance training (≥150 min/week) to preserve muscle mass; a high-fiber intake (>10 g/d) with probiotics to optimize gut motility and the microbiome; and targeted micronutrients (Calcium, Iron, Magnesium, Choline, Vitamins A, C, D, E), along with antioxidants and inflammatory agents like Polyphenols, CoQ10 Conclusión: The aesthetic physician does not merely inject or operate; they serve as the guardian of common sense. By implementing this all-encompassing safety and nutritional framework, we protect patients whose pursuit of thinness often overrides their health. We transition from passive observers to active participants in harm reduction and longitudinal patient safety.