Collecting this in one place because it comes up every few weeks and the answer is always assembled from scratch. It is about semaglutide, and it is deliberately narrow — everything I am not confident about is marked as such.
What is actually established
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.
The condition it depends on
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.
The practical version
Worth knowing that the injection site changes very little. Abdomen, thigh and upper arm are bioequivalent for semaglutide, so a site change is not a plausible explanation for a bad week.
What I am not sure about
What I actually want to know is whether anyone has held at a sub-maximal dose long term and kept the result, or whether the maintenance data only exists at 2.4mg. Not looking for reassurance. Looking for the part I have got wrong.
— sophie_paris · corrections welcome and will be edited into this post with credit