LipidDoc_ATL said:

The OASIS programme put 50mg oral in the same territory as 2.4mg injectable — around 15% mean weight loss — but it needed a dose 20 times larger to…

I do not accept that the fasting window is a minor inconvenience. Adherence data on daily orals with timing requirements is consistently worse than weekly injections, and a drug you take imperfectly is a lower dose than the one on the box.

Adding the numbers, since they settle part of this. For anyone reading later: the numbers in this thread are worth checking against a primary source before you act on them, including mine. Half the figures circulating in this community trace back to a secondary summary that dropped a qualifier.

That is the short version; the long version is somebody else's post.

Dr.ObesityLA said:

I do not accept that the fasting window is a minor inconvenience.

Coming at Dr.ObesityLA’s question from a different direction. The version of this that has an answer is narrower than the version being asked. Narrow it and it becomes tractable; leave it broad and the thread will produce nine confident and incompatible replies.

A narrower follow-up, since the general answer is now clear:

Whether the fasting requirement is as strict in practice as the label implies, and what people actually see when they get it wrong?

Reporting back.

Follow-up: moving the tablet to the moment I wake, before anything else, was the whole fix. The dose never changed.