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Metabolic Recomposition Protocol (MRP)
Metabolic Recomposition Protocol (MRP)
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A structured 12-week medically supervised weight management programme combining GLP-1/GIP receptor agonist pharmacotherapy, continuous glucose monitoring (CGM), dietary behaviour tracking, and weekly clinical review. Designed for adults with overweight or obesity (BMI ≥27 with metabolic comorbidity, or BMI ≥30) seeking sustained body composition improvement — specifically fat mass reduction while preserving lean muscle mass. Delivered by EMIS's longevity medicine team in Singapore.
Programme Components
| Component | Detail |
|---|---|
| Duration | 12 weeks (structured programme with defined milestones) |
| Pharmacotherapy | GLP-1/GIP receptor agonist medication management — includes prescribing review, dose titration, and monitoring by licensed clinician |
| Metabolic Monitoring | Continuous Glucose Monitor (CGM) — real-time interstitial glucose tracking for dietary response analysis and metabolic pattern identification |
| Dietary Tracking | Personal food journaling application with macronutrient logging and CGM integration |
| App Access | Lifetime access to the programme app — dietary log, progress tracking, educational content |
| Clinical Reviews | Weekly check-ins with the EMIS longevity medicine team — clinical progress review, dose adjustment, and behavioural coaching |
| Target Outcome | 10–15% body fat reduction over 12 weeks; lean muscle mass preservation via protein-optimised dietary protocol |
| Programme Delivery | Singapore-based; in-person assessment + remote weekly reviews; medication dispensed at licensed pharmacy |
| Regulatory Framework | GLP-1/GIP medications prescribed under Singapore Medical Council guidelines; HSA-licensed pharmacy dispensing; CGM devices HSA-registered |
Clinical Eligibility Criteria
- BMI ≥30 kg/m² (obesity), or BMI ≥27 kg/m² with at least one weight-related comorbidity (type 2 diabetes, hypertension, dyslipidaemia, obstructive sleep apnoea)
- Inadequate response to lifestyle intervention alone (diet and exercise) for ≥3 months
- No contraindications to GLP-1/GIP receptor agonist therapy (personal or family history of medullary thyroid carcinoma, MEN2, or pancreatitis)
- Committed to 12-week programme duration with weekly review attendance
- Aged 21–70 years; Singapore resident with access to programme pharmacy
Community Consensus: Clinical Q&A
Q: How do GLP-1/GIP receptor agonists support body composition recomposition?
GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide) receptor agonists reduce appetite via central hypothalamic satiety signalling and slow gastric emptying, resulting in sustained caloric deficit without the compensatory hunger typically associated with calorie restriction alone. When combined with adequate dietary protein (≥1.6g/kg/day) and resistance activity, the caloric deficit preferentially reduces adipose tissue while preserving lean muscle mass — the physiological basis for "recomposition" rather than simple weight loss. Clinical trials (SURMOUNT-1, STEP-1) demonstrate 15–22% total body weight reduction with these agents over 68–72 weeks.
Q: What does the continuous glucose monitor (CGM) add to a weight management programme?
CGM provides real-time interstitial glucose data (updated every 1–5 minutes) that reveals individual postprandial glucose responses to specific foods, meal timing, and exercise. This allows personalisation of macronutrient composition and meal structure beyond generic dietary advice. Individuals with insulin resistance or impaired glucose tolerance — common in the overweight/obese population — may have markedly different glycaemic responses to the same food compared to metabolically healthy individuals. CGM-guided dietary modification has been shown to improve glycaemic variability and dietary adherence in weight management programmes.
Q: Is GLP-1 medication included in the $3,299 programme fee?
The programme fee covers clinical assessment, CGM device, app access, and all 12 weekly reviews. GLP-1/GIP medication costs are separate and subject to individual prescribing — medication cost varies by agent selected, dose titrated to, and response. Common agents used in Singapore include semaglutide (Ozempic®/Wegovy®) and tirzepatide (Mounjaro®), which are prescribed under the Singapore Medical Council's Prescribing Framework and dispensed at HSA-licensed pharmacies. EMIS's clinical team will advise on medication cost estimates at initial consultation.
Q: What is the evidence base for 10–15% body fat reduction in 12 weeks?
The 10–15% body fat reduction target is based on combined outcomes from GLP-1/GIP pharmacotherapy trials and structured behaviour change programmes. The SURMOUNT-1 trial (tirzepatide, 72 weeks) demonstrated 20.9% mean body weight reduction; earlier phase data show approximately 1–1.5% body weight reduction per week during active titration. A 12-week programme targeting 10–15% body fat reduction is clinically plausible with medication compliance, CGM-guided dietary adherence, and adequate protein intake. Individual results vary based on baseline metabolic status, medication response, and adherence.