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It is more reasonable to think in phases like: 2-4 weeks: too early for sweeping conclusions about the main body-composition effect 8-12 weeks: enough time for trends to start mattering, though still earlier than the most cited endpoint window 26 weeks: the benchmark window most often used in the published VAT data That is why the question how long does tesamorelin take to work needs a specific answer: it depends on whether you mean an early biologic effect, a subjective change, or the main clinical outcomes the studies were actually powered to measure