went back down from 2.4 to 1.7 and lost more. explain that
Thinking out loud about this: went back down from 2.4 to 1.7 and lost more. explain that.
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.
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.
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.
Would rather be corrected in public than confident in private.
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.
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.
stalling at 2.4mg is information, not a verdict
This matches me almost exactly, right down to the constipation showing up on the second day and being gone by the fourth.
STEP-1 averaged just under 15% at 68 weeks, so a 10% year is not a failure
Weight change and appetite change are different endpoints on different timescales. Conflating them is where most of the confusion on this board starts.
the scale is the least sensitive instrument you own
What dose and how many weeks at it before this started?
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.
How long was the stall before you decided it was a stall?
Correct, and worth adding: the trial average is an average. Half the people in it did worse than 15% and were still on the drug.
protein first, then everything else gets easier
week 16 plateau is the most predictable thing in this entire board
do not chase somebody else’s titration schedule, they are not you
The appetite thing was the surprise. I expected to feel full. What I got was simply not thinking about food between meals.
Kept a log from week one and the single most useful column turned out to be waist, not weight.
Delayed gastric emptying is most pronounced early and attenuates with continued dosing, which is why the early fullness usually fades at a stable dose.
Cosigning. The appetite change and the scale change ran about three weeks apart for me too.
the appetite signal and the scale move on different clocks
dose day drift of a day either way is fine, the curve barely notices
Yes — and the honest version is that most of the "it stopped working" posts turn out to be a normal fortnight of water weight.
Removed the dose recommendation. You can describe what you did; you cannot tell somebody else what to take.