u/injection_site_iris

Correction: TRIUMPH is the phase 3 programme. The number you are quoting is from the phase 2 readout, which is a different trial.

the TRIUMPH programme is still running, so anything definitive is premature

Stopped abruptly once and gradually once. The gradual one was easier to interpret because I could see what was changing.

watch appetite, not the scale, for the first month

Yes. Nobody here is paid and the disclosure page says so in tedious detail, which is the correct level of tedious.

That is an employer plan process, and the provincial route is different in both form and timeline.

Special authorization is a documented exception process with published criteria. Applications that answer those criteria explicitly, point by point, fare better than general clinical narratives.

Preparing to stop, as described by people here who have done it.

Write down where you are first: dose, date, weight, waist, and an honest note about how appetite feels. That page is what makes the following six months interpretable rather than a fog of impressions.

Decide in advance what you are watching for and over what period — appetite in the first month, weight over three, and a specific threshold at which you would want to revisit the decision. Have the conversation with a clinician before rather than after.

None of that is a schedule. It is a way of arriving at whatever happens next with information rather than with a vague sense of how it is going.

watch appetite, not the scale, for the first month

What the glucagon arm is doing, as best anyone can say from public data.

GLP-1 and GIP agonism cover appetite and insulin secretion in ways that are now reasonably well characterised. Glucagon receptor agonism is the third leg and it is associated with increased energy expenditure and with effects on hepatic fat.

Mechanistically that is why this compound reads as a different proposition rather than a stronger version of a dual agonist. Clinically, the size and durability of that difference in humans is precisely what is not yet established, and anyone telling you otherwise is filling a gap with confidence.

That reads as advice to stop, which is not something anyone here should be offering.

Imaging-derived liver fat fraction is a surrogate. It correlates with histology imperfectly, and a trial reporting one is not reporting the other.

Which phase and which arm are you quoting?

Do you have the publication or the press release?

Histological endpoints in this field are scored on biopsy: resolution of steatohepatitis without worsening of fibrosis, or improvement in fibrosis without worsening of steatohepatitis. Both are harder to achieve and to interpret than an imaging surrogate.

non-scale victories count and they are the ones people remember

Same read. The energy-expenditure mechanism is the interesting bit and it is not established in humans at scale.

small trial, big effect, wide error bars

The standing caveat, written out properly because it keeps getting compressed into a footnote.

Nothing containing this compound is approved by any regulator. Research-use-only material is not approved for human use. That is not a legal formality on this board — it is why there is so little independent data, why the escalation schedules people post are invented, and why nobody here can answer a dosing question.

What this board can usefully do is read the published trials carefully, log independent purity results, and be honest about how thin the evidence base is. Everything else belongs somewhere with a clinician in it.

Independent purity testing on this compound is thin compared with the older molecules, simply because fewer members have paid for it. Fewer results means wider uncertainty, not a verdict.

text only here, by community rule, and it works better than you would think

Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.

Push back: quoting the phase 2 headline as an expected outcome is not a fair reading of a small trial with wide intervals.

Correction: that is regulatory approval, not coverage. They are separate decisions by separate bodies.

Do you have the publication or the press release?

Disagree that the pace matters as much as you think. Durable is better than fast and nobody posts about durable.

Imaging-derived liver fat fraction is a surrogate. It correlates with histology imperfectly, and a trial reporting one is not reporting the other.

What was the comparator?

Intention-to-treat analyses everybody randomised regardless of what they did afterwards. Completer analyses only those who finished. The second is systematically more flattering and both are legitimate if labelled.

Cosigning on discontinuation. It is a result about tolerability and it gets buried every time.

Correction: SURMOUNT is the obesity programme and SURPASS is the diabetes one. The figure you quoted belongs to the other one.

the appendix is where the interesting tables live

Read a press release and the publication three months apart. The hedging in the second one was substantial.

ranked feeds mean the top comment is not the best answer

Wrote down one non-scale thing every week. Reading a year of those back was more affecting than any number.

Small fix — you have described interval stretching and called it a taper. The exposure profiles differ.

What to measure if you want to stay sane through the flat parts.

Weight, under consistent conditions, no more than weekly. Waist, monthly — it frequently keeps moving when the scale does not. And one non-scale thing a week written down: a garment, a staircase, a distance, an ordinary task that got easier.

A year of those three is a far better record than a year of daily weights, and reading the third column back is the part that actually means something. The daily number is noise dressed up as information, and it has ruined more months on this board than any plateau.

Correction: TRIUMPH is the phase 3 programme. The number you are quoting is from the phase 2 readout, which is a different trial.

Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.