All of the human clinical trials of tesamorelin were done in people with HIV lipodystrophy, and if I am remembering correctly all at 2mg/day. To the best of my knowledge, no studies have ever been done in humans in any other state, so none in any kind of general population. None for obesity either.
So it can be said that it has been shown to reduce visceral fat in persons with HIV lipodystropy, and there did not seem to be any concerning effects on cardiovascular risk markers in that group, apart from blood sugar. This does not mean it is tested or known to be safe in the general population, but has much better evidence than anything else that messes with the GH system. And it can obviously cause GH related side effects like increased sugars and insulin resistance, fluid retention and carpal tunnel syndrome. And may or may not increase cancer risks, and reduce lifespan.
Any claims beyond this by pretty much anyone are bro science, not science. There is no scientific basis for days on /off treatment, but there is no scientific base for its use outside of HIV lipodystropy. As far as I am concerned anyone using the term protocol is making stuff up, I have yet to ever see one that is actually consistent with human trial evidence.
Given there is some evidence at least of being tested in humans, and most people taking it are going to be on GLP's reducing the negative effects on blood sugars, it is probably the safest option, ( if you have to use something that messes with HGH ) but getting sugars, lipids, blood pressure and IGF-1 tested is still a good idea. Just because the studies only used 2mg , does not mean 1mg is a problem. But it is quite a lot more expensive than HGH.