[Question] is 98.4% actually fine or am I being sold a rounding error
is 98.4% actually fine or am I being sold a rounding error. One vial, one service, one member paying, which is the only kind of result this board should treat as evidence.
98.4% — those are the numbers, and they are the ones I am willing to defend.
The escalation schedule in the trials existed to keep people on the drug. It is a tolerability ramp, and it is why the label reads the way it does.
Delayed gastric emptying is most pronounced early and attenuates with continued dosing, which is why the nausea usually fades at a stable dose.
If somebody has the same thing measured a different way, post it next to mine and we will see whether they agree.
best — the order this archive was captured in
Research-use-only material is not approved for human use, so anything in this thread about how a compounded or research vial "should" behave is a chemistry discussion, not a dosing one.
Disagree. 2.4 is the top of the label, not the goal, and "everyone ends up there" is just survivorship in the posts you read.
That figure is the 68-week trial mean, not a weekly rate. Dividing it by the weeks gives you a number that does not mean anything.
Careful. A four-week stall is inside normal variation and treating it as failure is how people escalate for no reason.
2.4 is a ceiling, not a target
Small correction: 2.4mg is the maintenance ceiling on the label, not the starting maintenance dose. The distinction matters for anyone reading this later.
Small correction: 2.4mg is the maintenance ceiling on the label, not the starting maintenance dose.
Right, and the timescale is the bit that keeps getting lost. Judge a step at a month, not at a weekend.
Steady state after a dose change takes four to five half-lives, so the fair judgement point on a new step is about a month, not four days.
What dose and how many weeks at it before this started?
Correcting myself from earlier in the thread: I said week 10 and it was week 18. Same shape, wrong number.
How long was the stall before you decided it was a stall?
Same. I sat at 2.4mg for three months because it was working and there was nothing to fix.
The mental model that finally made this click for me: there are two curves, and people watch the wrong one.
The first is exposure, which is set by the dose and smoothed by a week-long half-life. It changes when you change the dose and then settles over about a month. The second is body weight, which is exposure filtered through appetite, food, water, sleep, training and the scale itself, and which moves in steps rather than a line.
Almost every "it stopped working" post is somebody watching curve two over a fortnight and drawing conclusions about curve one. If the appetite effect is still there, exposure is fine. Wait the month.
STEP-1 ran 68 weeks and landed just under 15% mean body weight change on 2.4mg. It is an average of a wide distribution, not a target you have missed.
Weight change and appetite change are different endpoints on different timescales. Conflating them is where most of the confusion on this board starts.
On the "everybody ends up at 2.4" claim, which comes up every few weeks.
The escalation schedule in the trials was designed to get people to a fixed study dose. Real use is not a trial. The dose that keeps your appetite quiet with side effects you can live with is the dose, and for a lot of people on this board that has been 0.25mg for a very long time.
The counter-argument, which is fair: some people genuinely do need the top of the range, and staying low out of caution costs them months. That is a conversation with someone who knows your history, not with us.
The weekly interval comes out of the half-life — roughly a week — so you are on a smooth curve rather than a series of spikes. That is also why moving your day slightly does very little.