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The mechanism is straightforward: appetite suppression reduces food intake, which lowers protein consumption, at the same time that caloric restriction increases the body's whole-body essential amino acid requirements

Zhu J, Zhang WEI, Wang D, Li S, Wu WEI

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More specifically, it seems to be a combination of: documenting the medical needs of patients (probably through intake forms) who are experiencing or have experienced nausea, vomiting, or other drug tolerance-related issues associated with GLP-1s (which are discussed in this Hims paper), and providing personalized compounded semaglutide in doses outside the 10% threshold to address those documented medical needs