after signing the informed consent form, the patient becomes a participant in the study.

the patient attends a clinic visit where body weight, waist circumference, and blood pressure are measured.

a questionnaire that assesses physical function and quality of life (iwqol-lite-ct) is completed.

blood samples may be taken to establish health status before treatment begins.

the patient is assigned, in a double‑blind manner, to receive either pf-08653944 or a matching placebo.

the assignment is unknown to both the patient and the study staff.

the patient receives a subcutaneous injection of the study medication once every month.

the injection is given for a total of 72 weeks (approximately 1.5 years).

the exact dose and volume are defined by the study protocol and are administered by a qualified professional.

at each monthly visit, the patient’s body weight, waist circumference, and systolic blood pressure (sbp) are recorded.

the patient completes the iwqol-lite-ct physical function questionnaire to track changes in quality of life.

any side effects or health concerns are discussed with the study team.

throughout the 72‑week period, the patient reports any adverse events or new symptoms to the study staff.

the study staff evaluates safety information and may adjust care as needed, while maintaining the blind.

the patient attends a final clinic visit where the same measurements taken at baseline are repeated.

the primary outcome, percent change in body weight from baseline, is calculated.

secondary outcomes, including absolute body weight change, waist circumference change, sbp change, and the iwqol-lite-ct score change, are also recorded.

after the final assessments, the patient stops receiving study medication.

the patient may be offered standard care or follow‑up as recommended by their health provider.