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It is gradual and cumulative component studies report matrix/skin changes over weeks, not days

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Growth hormone secretion from the anterior pituitary gland is controlled by two primary opposing signals: Growth hormone-releasing hormone (GHRH): Produced by the hypothalamus, GHRH stimulates GH synthesis and release from pituitary somatotroph cells Somatostatin: Also produced by the hypothalamus, somatostatin inhibits GH release, creating a pulsatile pattern of secretion A third regulatory pathway involves ghrelin and growth hormone secretagogues (GHS) , which act through a separate receptor system (GHS-R1a) to amplify GH release independently of GHRH (1)

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According to Sasmaz et al

These effects are dose-dependent and typically resolve within 48 weeks as GLP-1 receptor density downregulates in the gut