[Discussion] we talk about dose like it is a score and it is not
Posting this as a discussion rather than a claim: we talk about dose like it is a score and it is not.
Weight change and appetite change are different endpoints on different timescales. Conflating them is where most of the confusion on this board starts.
Delayed gastric emptying is most pronounced early and attenuates with continued dosing, which is why the reflux usually fades at a stable dose.
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.
If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.
best — the order this archive was captured in
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.
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.
How long was the stall before you decided it was a stall?
How long was the stall before you decided it was a stall?
Adding one thing to this: the appetite effect and the scale run on separate clocks, so both halves can be true at once.
dose day drift of a day either way is fine, the curve barely notices
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.
Correcting myself from earlier in the thread: I said week 5 and it was week 13. Same shape, wrong number.
Correcting myself from earlier in the thread: I said week 5 and it was week 13.
Right, and the timescale is the bit that keeps getting lost. Judge a step at a month, not at a weekend.
Strongly agree on protein. It did more for my constipation than any of the things I bought to fix my constipation.
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.
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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.
the ladder exists because the gut needs the time, not because the pharmacy likes paperwork
My stall was eleven weeks. Eleven. Then it moved again without me changing anything at all.
My stall was eleven weeks.
This is the part I would underline for anyone skimming. Everything else in the thread is downstream of it.
Cosigning. The appetite change and the scale change ran about three weeks apart for me too.
That reads like a titration plan and this board cannot give you one. Somebody who actually knows your history has to.
staying at 2.4mg for an extra month is a legitimate plan
The appetite thing was the surprise. I expected to feel full. What I got was simply not thinking about food between meals.
Not convinced. You changed the dose and the week at the same time, so you cannot attribute the change to either.
the appetite signal and the scale move on different clocks
Small correction: 2.4mg is the maintenance ceiling on the label, not the starting maintenance dose. The distinction matters for anyone reading this later.
Agreed, and the bit people skip is that the ladder is a tolerance ladder. It is not a potency ranking.
Careful. A four-week stall is inside normal variation and treating it as failure is how people escalate for no reason.
Kept a log from week one and the single most useful column turned out to be waist, not weight.
- 1dose day drift of a day either way is fine, the curve barely notices15 comments in this branch · started by u/rasmus_kimani