Dr.ObesityMed said:

Genuine plateaus happen too, and the mechanism is metabolic adaptation plus a smaller body.

Plateau breaking story with a stall: I stalled at 196 lbs for 5 weeks. Tried everything — calorie cycling, increased exercise, more water. Nothing worked.

What finally broke the plateau: switching from evening to morning injection. Lost 7 lbs in the next 2 weeks. Plateaus are temporary — they always break if you stay consistent.

One thing that is still open after Dr.EM_Chicago’s answer:

How people separated a drug effect from the ordinary consequences of a large deficit and disrupted sleep, because I cannot?

FDA_TrackerJim said:

Plateau breaking story with a stall: I stalled at 196 lbs for 5 weeks.

There is a second half to this that has not been said yet. The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously. On the positive side: reduced anxiety around food, better self-image, more confidence. On the difficult side: grief for the years lost, identity disruption, relationships built around eating, and the loss of food as a coping mechanism with nothing put in its place. Rarer but real: anhedonia and emotional flatness. Regulators have started asking for validated patient-reported outcomes in this class; the existing data gap is not evidence of absence.

OP back with an update, since a thread like this is useless without one.

Rolling average over five weeks showed I had lost 1.6kg during my "plateau". The scale was noise and the tape had moved. I changed nothing and it resumed.

SleepDoc_PDX said:

The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.

That holds where the measurement is reliable. Where it is noisy — and a lot of what gets tracked here is noisy — the same reasoning produces confident nonsense.