u/forest_plot_fiona

and the confidence interval is narrow, which for a composite endpoint in a CKD population is not guaranteed.

which is a good example of why a surrogate moving in a worrying direction is not an outcome. SELECT is the reason we can say that with any confidence at all.

which is a real selection effect and it is baked into every score on the site. the vote count is a measurement of who was online, not of what is true.

the confidence interval on the regain magnitude is also worth remembering exists even if most people never see the actual figure, headline numbers always undersell the spread

even if someone ran it, you'd want a fairly large n to detect a modest GI-tolerability difference, underpowered small trials on this exact question would probably just add noise to an already noisy topic

this is a general problem with the whole directory and nobody has solved the presentation of it. the vendors with three tests look tighter than the vendors with eleven, and that is an artefact.

agreed, if there were a clean population-level week-4 dip it'd be a much bigger deal in the discontinuation literature than it is

Retitled: the original quoted a diabetes endpoint as an obesity result.

Retitled: the original quoted a diabetes endpoint as an obesity result.

people have always done this. the point estimate is the headline, the interval is the story, and the interval loses every single time.

lead with the range. "96.5 (93.7–98.4)" is one extra clause and it changes the entire meaning of the sentence.

Yes. The appendix tables are where the subgroup and the adverse event detail actually live.

right, the published curves are already averaged over hundreds of people, individual noise is much louder than the population curve suggests

Fertility can change with weight loss and improved insulin sensitivity. That is a well-described phenomenon and worth knowing about in advance rather than discovering.

draw at the same point in the week if you want comparability

Bought small deliberately because the evidence base is thin. That felt like the only defensible approach.

Retitled: the original quoted a diabetes endpoint as an obesity result.

Left up and flaired Trial Data. The publication is linked rather than the coverage, which is what we ask for.

say what you are actually asking, the vocabulary here is imprecise

Same lab as the previous draw?

The step schedule question, answered properly, because it comes up weekly.

The label sets a minimum interval of four weeks between increases. That is a floor on how fast you may go, and it exists because tolerability, not efficacy, is what limits most people. There is nothing in the pharmacology that says you must increase at four weeks, or at eight, or ever.

What decides it in practice is whether the effect you want is still there. If appetite is quiet and the trend is going the right way, the dose is doing its job. If both have genuinely gone flat for six weeks or more, that is a conversation worth having with someone who knows your history.

Kept a log purely because so few people are logging this one. It is one person and it is not data.

SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change. SURPASS is the diabetes programme and reports glycaemic endpoints, so quoting the two interchangeably is a category error.

Week 6 was the first time the scale moved after a five-week stall. I changed nothing in that window.

Retitled: the original quoted a diabetes endpoint as an obesity result.

Switching from semaglutide, since three people asked in this thread alone.

There is no published dose equivalence between the two. The conversion tables that circulate are somebody’s arithmetic, not data. What people report here is that the first month after a switch is often flat, that the appetite effect feels differently shaped rather than simply stronger, and that starting at the bottom of the ladder again is the common approach.

None of that is a recommendation. It is what the threads say, and the threads are not a clinic.

Retitled: the original quoted a diabetes endpoint as an obesity result.

Same experience with the appetite effect being flatter across the week rather than front-loaded.

the trials were not designed to answer most of the questions asked here

Anything involving pregnancy, contraception efficacy or fertility planning belongs with a clinician. That is not a disclaimer, it is where the answers actually are.

Retitled: the original quoted a diabetes endpoint as an obesity result.

Push back: "gentler than sema" is a population statement.

Not sure about this bit. The GIP arm being real does not tell you that it is what caused your particular week.

Have you held a step for longer than the four-week minimum at any point?

Left up and flaired Trial Data. The publication is linked rather than the coverage, which is what we ask for.

Small fix: SURMOUNT is the obesity programme, SURPASS is the type-2 programme. They are different endpoints and the numbers do not transfer.

Sulphur burps for the first eight days after each step, then nothing. Predictable enough that I planned my week around it.

Careful with that mean. The distribution around it was wide enough that it describes very few individual participants.

Appetite effect for me is flat across seven days. On sema it was a wave. Same person, different molecule.

Added the trial identifier to the title so this thread is findable in two years.

the confidence interval is the finding, the point estimate is the headline