Tesamorelin,
the GHRH peptide for visceral fat reduction.

Tesamorelin is FDA-approved for the reduction of excess abdominal fat in adults with HIV-associated lipodystrophy. Off-label, tesamorelin peptide is used for general visceral fat reduction, non-alcoholic fatty liver disease (NAFLD), age-related growth hormone decline, body composition improvement, and research into the metabolic effects of restored pulsatile GH secretion. The underlying mechanism — GHRH receptor agonism leading to endogenous GH release — makes tesamorelin applicable wherever elevated but physiologic growth hormone signaling is desired. See the tesamorelin benefits guide for the full list of studied applications.

Yes. Tesamorelin is a synthetic 44-amino-acid peptide — specifically, an analog of human growth hormone–releasing hormone (GHRH) with a trans-3-hexenoic acid modification on the N-terminal tyrosine that confers resistance to DPP-IV degradation. Because tesamorelin is a peptide, it must be administered by subcutaneous injection; oral tesamorelin would be destroyed by stomach acid and digestive enzymes before reaching the bloodstream. The full amino acid sequence is identical to endogenous human GHRH, which is why tesamorelin produces physiologic rather than supraphysiologic GH pulses.

IGF-1 elevation from tesamorelin peptide is measurable within days of starting therapy. Visible body composition changes typically begin around weeks 4–8, with the largest VAT reductions occurring between weeks 8 and 26. Phase III trials showed approximately 15% visceral fat reduction at 26 weeks and 18% at 52 weeks, meaning most of the benefit is achieved in the first six months. Other effects — improved sleep quality, skin changes, modest lean mass gains — generally appear in the first 4–8 weeks. See the tesamorelin results timeline for a week-by-week breakdown.

The standard FDA-approved tesamorelin dose is 2 mg administered as a single subcutaneous injection daily, typically into the abdomen. This is the dose used in all Phase III clinical trials and is the recommended protocol for visceral fat reduction. Off-label dosing for body composition sometimes uses lower doses (1 mg daily) based on tolerability, and some research protocols have explored every-other-day dosing, but efficacy data at doses below 2 mg daily is limited. See the tesamorelin dosage guide for complete protocol information, reconstitution math, and injection technique.

Tesamorelin produces body recomposition rather than significant scale-weight loss. Phase III data shows that tesamorelin reduces visceral adipose tissue by 15–20% while slightly increasing lean body mass, resulting in a net scale-weight change that is typically modest (a few pounds). This is mechanistically different from GLP-1 agonists like semaglutide and retatrutide, which produce large appetite-mediated weight loss. Tesamorelin peptide should be understood as a body composition and visceral fat tool, not a primary weight-loss drug. See the tesamorelin for weight loss guide for a detailed comparison.

Tesamorelin is the full 44-amino-acid GHRH sequence with DPP-IV resistance; sermorelin is a shorter 29-amino-acid GHRH fragment without that resistance. This makes tesamorelin significantly more potent and longer-acting, which is why tesamorelin required FDA approval as a prescription drug while sermorelin is available more broadly. Clinically, tesamorelin produces larger VAT reductions and stronger IGF-1 elevation, while sermorelin is generally milder and often used for general GH support rather than targeted visceral fat reduction. See the tesamorelin vs sermorelin comparison for a complete analysis.

Yes. The most studied tesamorelin stack pairs it with ipamorelin, a ghrelin receptor (GHSR) agonist that triggers GH release through a different pathway. This dual-pathway approach — GHRH agonism via tesamorelin plus ghrelin mimicry via ipamorelin — produces greater GH pulse amplitude than either peptide alone because the two mechanisms are complementary rather than redundant. Tesamorelin can also be stacked conceptually with compounds like BPC-157 for recovery or with testosterone optimization protocols, though specific clinical data on these combinations is limited. See the tesamorelin and ipamorelin stack guide.