u/sofia_wikstrom

Most of the common complaints trace back to slowed gastric emptying — early fullness, reflux, nausea after a large or fatty meal. That is also why meal size and speed change the experience more than anything else.

holding a dose an extra month is a legitimate answer to bad tolerance

the phase 2 numbers were striking and they were also 48 weeks in a small population

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

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

the habits are the part that has to outlive the dose

the energy-expenditure story is mechanistically interesting and clinically unproven

Did protein intake change in the same window?

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.

Are you tracking heart rate at all?

That reads like advice, and none of us can give it. Describe what you did, not what somebody else should do.

Sat at 1.0mg for four months because it was doing the job. Everyone told me to go up. The one time I did, the only thing that changed was the fatigue.

STEP-1 averaged just under 15% at 68 weeks, so a 10% year is not a failure

a rough fortnight at each step is normal, a rough three months is not

STEP-1 averaged just under 15% at 68 weeks, so a 10% year is not a failure

Stopped at a low step because there was no reason to go further and no data to tell me what further would do.

Not convinced. You are attributing a week of reflux to the glucagon arm when the escalation rate alone would explain it.

nothing here is available as a prescription product, so read every thread with that in mind

That is body weight change, not fat mass. The trials report the first and people quote it as the second.

Are you measuring anything other than weight? Waist is usually the one that keeps moving.

STEP-1 averaged just under 15% at 68 weeks, so a 10% year is not a failure

micro_bump_mick is describing the standard shape here and it matches the trial data better than most anecdotes do.

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.

appetite returns before the scale acknowledges anything

STEP-1 averaged just under 15% at 68 weeks, so a 10% year is not a failure

Careful with the rankings. A phase 2 result and a phase 3 result are not on the same evidential footing and cannot be listed in one table.

staying at 1.7mg for an extra month is a legitimate plan

Yes — the glucagon arm is what makes it a different proposition rather than a stronger version of the others.

The effect on gastric emptying is most pronounced early and attenuates with continued dosing, which is the mechanism behind the "it settles at a stable dose" pattern the whole board reports.

It is a triple agonist at the GLP-1, GIP and glucagon receptors.

Disagree with this specific inference. A 48-week readout does not tell you the shape of the curve after it.