SarahChen_PharmD said:

I have been on semaglutide for nine months, currently holding 1.7mg rather than pushing to 2.4mg, and the last two dose steps bought me much less than…

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

SarahChen_PharmD said:

I have been on semaglutide for nine months, currently holding 1.7mg rather than pushing to 2.4mg, and the last two dose steps bought me much less than…

I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.

Answering the narrow version, because the broad one does not have a single answer. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.

Happy to go further on any of that.

anders_CPH said:

All true, with one condition: that curve is for people who reached the dose on schedule.

That holds for the injectable. The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people quote them as if they were.