Not necessarily. Depot formulations often use different delivery mechanisms than standard subQ injections. Some options being explored:

• Microparticle suspensions: Drug encapsulated in biodegradable polymer microspheres that slowly release the active ingredient. The injection volume might be slightly larger but uses the same gauge needles.
• In-situ gelling systems: Liquid at injection that forms a solid depot under the skin.
• Extended half-life engineering: Modifying the molecule itself (via albumin binding, Fc fusion, or PEGylation) to have a 4-week half-life. This could be the same volume as a weekly injection.

Ecnoglutide uses molecular engineering rather than a depot system, so the injection experience should be similar to current weekly GLP-1 pens.

Something I haven't seen discussed: what about the psychological benefit of less frequent injections? For people who are anxious about injections, reducing from 52 to 12 per year is significant. And for those who feel stigma about using "weight loss drugs," having a less visible, less frequent treatment might reduce that burden.

My friend hides her Wegovy pen when people visit because she doesn't want to explain it. Monthly dosing would mean fewer pens to store/hide.

Valid point. The stigma issue is real and often underestimated. But I'd push back slightly on the framing — we shouldn't have to design drug delivery around stigma. We should work to reduce the stigma itself.

That said, from a pure practicality standpoint, monthly dosing is superior for travel (one pen covers a whole month), storage (fewer units in the fridge), and healthcare system burden (fewer pen/syringe disposals, fewer pharmacy pickups).

The most exciting long-term prospect might actually be implantable devices — a subcutaneous implant that releases GLP-1 RA continuously for 6-12 months. This exists conceptually (similar to contraceptive implants like Nexplanon) but is probably 7-10 years from clinical reality for GLP-1s.

Great discussion. Worth mentioning that the trade-off between dosing frequency and flexibility isn't straightforward. Some patients actually prefer weekly dosing because it gives them more control. They can adjust timing around meals, skip a dose if they're sick, or coordinate with their schedule.

Monthly dosing removes that flexibility. The ideal future probably involves having both options available so patients and clinicians can choose what works best for each individual.