Visceral fat is the specific target studied.
Compounded tesamorelin centered on the molecule's studied visceral-fat pathway and the medical oversight it deserves.
About 10 minutes. No charge unless your clinician approves.
Not all abdominal fat is the same tissue.
Abdominal fat is not one uniform tissue. Subcutaneous fat sits beneath the skin. Visceral adipose tissue sits deeper in the abdomen, around the internal organs. The pivotal tesamorelin trials treated those as separate compartments and measured them separately with CT imaging.3
That specificity is the reason tesamorelin is interesting.
Tesamorelin is a growth hormone releasing factor analog. Rather than supplying growth hormone directly, it acts on the pituitary to stimulate the synthesis and pulsatile release of your own.4 The pivotal phase 3 program studied people who had developed excess visceral abdominal fat in the setting of antiretroviral therapy. The target was that fat accumulation, not HIV itself. Across both randomized placebo-controlled trials visceral adipose tissue decreased while abdominal subcutaneous fat did not change significantly.3
That distinction has appeared outside the original population as well. In a separate randomized, placebo-controlled trial of 60 adults with abdominal obesity and reduced growth hormone secretion, tesamorelin significantly reduced visceral adipose tissue while abdominal subcutaneous fat again did not change significantly.6 Same abdomen, different compartment, different result.
Specificity distinguishes this molecule. Tesamorelin is studied around visceral adipose tissue, not generic weight loss, and licensed-pharmacy sourcing plus clinician supervision separate the prescription from research-market vials.
- Falutz J, Mamputu JC, Potvin D, et al. Effects of tesamorelin (TH9507), a growth hormone-releasing factor… J Clin Endocrinol Metab. 2010.DOI
- EGRIFTA WR (tesamorelin) for injection, for subcutaneous use. Full Prescribing Information. Theratechnologies Inc. Revised 03/2025.
- Makimura H, Feldpausch MN, Rope AM, et al. Metabolic effects of a growth hormone-releasing factor in obese… J Clin Endocrinol Metab. 2012.DOI
For the case a clinician can define precisely.
The Visceral Fat Question
The concern is not simply a larger waist. Your clinician has a reason to think visceral adiposity belongs in the clinical picture, and can explain why tesamorelin is being considered.
The Metabolic Context
You want the conversation to go deeper than appearance. Your provider is looking at fat distribution alongside metabolic markers and the rest of your health rather than treating the mirror as the endpoint.
The Monitored Plan
You want treatment with clinical follow-through built in. Tesamorelin raises IGF-1 and can affect glucose tolerance, which is why both belong in the ongoing medical conversation.
Compounded tesamorelin is not an FDA-approved drug product. The FDA-approved tesamorelin medicine is indicated for reduction of excess abdominal fat in adults living with HIV who have lipodystrophy. The pivotal visceral fat figures on this page come from people with excess abdominal fat that developed in the setting of antiretroviral therapy, and tesamorelin was being studied to reduce that fat rather than to treat HIV. Those exact effect sizes should not be assumed to apply unchanged to every cause of visceral adiposity, though separate randomized research in adults with abdominal obesity and reduced growth hormone secretion has also shown a selective reduction in visceral adipose tissue. The approved labeling states that tesamorelin is not indicated for weight loss management and has a weight neutral effect. A licensed provider determines whether compounded tesamorelin fits your case, or whether another treatment serves you better.
This might not be the right fit if:
- An active malignancy, or treatment for a previous malignancy that is not complete
- Disruption of the hypothalamic-pituitary axis from pituitary disease, surgery, head irradiation or significant head trauma
- Pregnancy or a planned pregnancy
- A known hypersensitivity to tesamorelin
- An acute critical illness ## Updated copy: Recovery Peptides
Your intake screens for all contraindications. Every candidate is evaluated by a licensed clinician before any prescription is issued. No prescription is issued without clearance.
Tesamorelin, prescribed with care.
Compounded by a licensed 503A pharmacy. Prescribed by a licensed provider after clinical review.
- A subcutaneous injection, self-administered at home exactly as prescribed
- Compounded by a licensed 503A pharmacy to your clinician’s specification
- Glucose evaluated before treatment, with glucose and IGF-1 monitored during therapy
- Injection sites rotated as directed to reduce site reactions
- Reviewed and adjusted through your ongoing provider relationship
Prescription issued subject to provider judgment. Results vary. Not a guarantee of outcomes.
*Price reflects a 3 month commitment. Other billing options are shown at checkout.
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What the research shows
Visceral fat fell 15.4% against placebo across two randomized trials.
The detail
The two pivotal phase 3 trials were pooled and analyzed together. Across 806 participants, 543 receiving tesamorelin and 263 receiving placebo, visceral adipose tissue measured by CT changed by minus 24 plus or minus 41 square centimeters with tesamorelin against plus 2 plus or minus 35 with placebo at 26 weeks, a treatment effect of minus 15.4 percent. The clinical target was excess visceral fat that had developed in the setting of antiretroviral therapy. Tesamorelin was not being studied as a treatment for HIV.3
The same analysis found no measurable effect on subcutaneous fat.
The detail
The same pooled analysis measured abdominal subcutaneous adipose tissue separately and found minus 2 plus or minus 32 square centimeters with tesamorelin against plus 2 plus or minus 29 with placebo, P equals 0.08, a treatment effect of minus 0.6 percent. The measurable effect was in the visceral compartment, not in the fat under the skin.3
The same selective effect appeared outside the original study population.
The detail
A separate randomized, double-blind, placebo-controlled study enrolled 60 adults with abdominal obesity and reduced growth hormone secretion, a population defined by neither HIV nor antiretroviral therapy. Over 12 months tesamorelin reduced visceral adipose tissue against placebo with a treatment effect of minus 35 square centimeters, 95 percent confidence interval minus 58 to minus 12, P equals 0.003, while abdominal subcutaneous adipose tissue did not change significantly at P equals 0.40.6
A separate trial found a 4.1 point reduction in liver fat fraction.
The detail
A randomized, double-blind, multicentre trial enrolled 61 adults living with HIV who also had nonalcoholic fatty liver disease, defined by a hepatic fat fraction of at least 5 percent, and randomized them to tesamorelin or placebo for 12 months. The absolute treatment effect on hepatic fat fraction was minus 4.1 percentage points, 95 percent confidence interval minus 7.6 to minus 0.7, P equals 0.018. This was a liver fat study, not a study of tesamorelin as a treatment for HIV.5
What it does not show
The pivotal effect size should not be treated as universal.
The detail
The 15.4 percent visceral fat treatment effect comes from the pooled phase 3 population, who had excess abdominal fat that developed in the setting of antiretroviral therapy. Separate randomized research in adults with abdominal obesity and reduced growth hormone secretion found a significant visceral fat reduction without a significant subcutaneous fat reduction. Together those support the finding beyond the original population, but they do not establish that every cause of visceral adiposity responds by the same magnitude.36
The approved labeling states it is weight neutral and not for weight loss.
The detail
The FDA-approved labeling states under limitations of use that the product is not indicated for weight loss management as it has a weight neutral effect. The pivotal trial data support that distinction. Tesamorelin changed visceral adipose tissue without functioning as a conventional weight loss medication. This is not a scale-first treatment.4
Visceral fat returned after treatment was stopped.
The detail
In the extension phases of the two pivotal studies, participants who had received tesamorelin for 26 weeks and were then switched to placebo saw visceral adipose tissue increase by 22 percent and 16 percent over the following 26 weeks, and IGF-1 moved back toward baseline. The measured effect in those studies depended on continued treatment.4
The trials cited here did not study longevity.
- Falutz J, Mamputu JC, Potvin D, et al. Effects of tesamorelin (TH9507), a growth hormone-releasing factor… J Clin Endocrinol Metab. 2010.DOI
- Makimura H, Feldpausch MN, Rope AM, et al. Metabolic effects of a growth hormone-releasing factor in obese… J Clin Endocrinol Metab. 2012.DOI
- Stanley TL, Fourman LT, Feldpausch MN, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a… Lancet HIV. 2019. )30338-8.DOI
- EGRIFTA WR (tesamorelin) for injection, for subcutaneous use. Full Prescribing Information. Theratechnologies Inc. Revised 03/2025.
- Falutz J, Allas S, Blot K, et al. Metabolic effects of a growth hormone-releasing factor in patients with… N Engl J Med. 2007.DOI
- Falutz J, Potvin D, Mamputu JC, et al. Effects of tesamorelin, a growth hormone-releasing factor, in… J Acquir Immune Defic Syndr. 2010.DOI
Do not use if you have
- Disruption of the hypothalamic-pituitary axis from pituitary disease, surgery, head irradiation or significant head trauma
- Active malignancy
- Known hypersensitivity to tesamorelin
- Pregnancy
Serious risks
- Fluid retention presenting as edema, arthralgia and carpal tunnel syndrome
- Glucose intolerance or diabetes mellitus. Elevated HbA1c meeting the diabetes threshold developed in 5 percent of treated participants against 1 percent on placebo
- Malignancy considerations, because growth hormone is a growth factor
- Increased mortality reported with pharmacologic growth hormone in acute critical illness
- Hypersensitivity reactions including pruritus, erythema, flushing, urticaria and rash, which occurred in 4 percent
Commonly reported
- Arthralgia
- Injection site erythema
- Injection site pruritus
- Pain in extremity
- Peripheral edema
- Myalgia
Because it is an injection
- Injection site reactions occurred in 25 percent of treated participants against 14 percent on placebo
Reported effects follow the growth hormone axis. This is a compounded preparation, which means it has not been reviewed by the FDA for safety, effectiveness, or quality. Tesamorelin stimulates growth hormone production and raises IGF-1, a growth factor, and the effects of prolonged elevations in IGF-1 are unknown, so IGF-1 is monitored during therapy and treatment is reconsidered if it stays persistently elevated. Glucose status is evaluated before treatment and monitored during therapy, and a participant with diabetes is monitored for development or worsening of retinopathy. The approved labeling also describes these risks. A licensed provider decides whether tesamorelin belongs in your plan, and a licensed 503A pharmacy prepares the compounded prescription only after that decision.
Asked and answered.
You are not charged, and you are not left guessing. Your clinician explains the reasoning and, where it helps, what a better path might look like. Reviews are typically completed in under 24 hours.
No. The approved labeling states that tesamorelin is not indicated for weight loss management and has a weight neutral effect. The pivotal research measured visceral adipose tissue separately from body weight. If weight loss is your goal, say so in your Assessment, because a different treatment conversation may fit better.
Tesamorelin is the active ingredient in an FDA-approved prescription medicine, indicated for reduction of excess abdominal fat in adults living with HIV who have lipodystrophy. That approval belongs to the manufactured medicine and not to this compounded preparation. No compounded medication is FDA-approved, including this one. Compounded medicines are made to your individual prescription by a licensed pharmacy rather than manufactured and approved as a finished drug product. Use outside the approved indication rests on the prescribing clinician’s independent medical judgment.
Because a specific clinical problem had emerged. Earlier generations of antiretroviral therapy were associated in some patients with major changes in fat distribution, including disproportionate accumulation of visceral abdominal fat. The pivotal tesamorelin program was built to study that fat accumulation and measured visceral adipose tissue directly with CT imaging. Tesamorelin was not being used to treat HIV. The target was the fat distribution. Later randomized research in adults with abdominal obesity and reduced growth hormone secretion found the same selective reduction in visceral adipose tissue. The original population matters because it defines the approved indication and the source of the pivotal effect sizes. It should not be confused with the biological target of the treatment.
The reduction in visceral adipose tissue was not maintained after tesamorelin was discontinued in the pivotal studies. Participants who switched from tesamorelin to placebo after 26 weeks saw visceral adipose tissue increase by 22 percent and 16 percent across the two trials over the following 26 weeks, and IGF-1 moved back toward baseline. That is useful to understand before treatment begins. In those studies the measured effect was linked to continued treatment.