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Evidence-based GLP-1 & peptide discussion since 2023
ForumsPublic SquareIs there a ceiling effect for GLP-1-mediated weight loss?

Is there a ceiling effect for GLP-1-mediated weight loss?

Dr.ObesityMed Mon, Jun 8, 2026 at 5:24 AM 20 replies 213 viewsPage 1 of 4
Dr.ObesityMed
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Jun 8, 2026 at 5:24 AM#1

I keep finding that the number in the press summary and the number in the paper are not the same number, and the difference is always in the same direction.

What I am after is how to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases.

Numbers rather than impressions, if you have them.

49 19EndoResFellow, PharmacoVig_BOS, SurmountFan_IN and 46 others
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Dr.RenalNash
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Jun 8, 2026 at 5:26 AM#2

Answering the narrow version, because the broad one does not have a single answer. Relative and absolute effects need reading together. A 20% relative reduction on a high baseline risk is a large absolute benefit; the same relative figure on a low baseline risk is a small one, and press summaries almost always quote the relative number because it is bigger.

Happy to go further on any of that.

48 18pam_stl, wei_SG, cory_ATX and 45 others
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quinn_sf
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Jun 8, 2026 at 5:27 AM#3
Dr.RenalNash said:
Relative and absolute effects need reading together.

Bayesian meta-analysis perspective on the trial evidence: traditional frequentist meta-analyses report point estimates and confidence intervals. Bayesian approaches provide probability distributions that are more intuitive for clinical decision-making.

For example: "There is a 98.5% probability that semaglutide 2.4mg produces >10% weight loss vs placebo" is more actionable than "RR 3.4, 95% CI 2.8-4.1, p<0.001."

The the trial evidence evidence is strong under both frameworks, but Bayesian analysis better communicates the degree of certainty for individual patient counseling.

Last edited: Jun 8, 2026 at 11:27 AM
47 17mona_PHX, andrew_nyc, Dr.EndoEP and 44 others
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bri_stats
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Jun 8, 2026 at 5:29 AM#4
Dr.ObesityMed said:
I keep finding that the number in the press summary and the number in the paper are not the same number, and the difference is always in the same…

This matches mine closely enough to be worth saying so. The gap between trial results and real-world results is consistent and it is not fraud. Trial participants get titration by protocol, scheduled contact, free drug and dietetic support; removing that infrastructure costs a few percentage points every time it has been measured. When your own curve sits below the published mean, that is the likeliest explanation before anything about you or your material.

46 16JessicaM_2024, TomFromTexas, mike.trainer_LA and 43 others
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Dr.PulmRoch
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Jun 8, 2026 at 5:38 AM#5

From the other side of the consultation, briefly.

Dr.ObesityMed said:
...regarding the trial evidence...

I think this is an underappreciated point. To expand on it with some data:

A recent meta-analysis of 18 RCTs (n=15,600) found that the trial evidence was associated with a robust effect size across diverse patient populations[1].

The NNT was 15, which is comparable to antihypertensives for stroke reduction. That's a strong clinical argument for this approach.

45 15KristenIndy, MarkLI_maint, Dr.PeteFamMed and 42 others
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