Are you asking why larger people need more medicine, or how scientists figure out the dosage?
For the first one, it’s because the chemicals from the drugs are more diluted in larger people and they won’t work as well. Larger people have more liquid inside their bodies.
For the second one, it’s a lot of trial and error. They test medicines on rats, which can be somewhat reliably scaled up to people with a little math. But then human trials will use different dosages and study the results.
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