Started at 0.25mg with a fairly bad first week, held each step the full four weeks, and I am now at 1mg with no side effects worth naming.
What I am after is what the dose-response curve actually looks like above 1.7mg, because the trial means hide how few people account for the extra loss.
I have searched first, so if this is covered somewhere point me at it and I will read it.
Taking the question as asked, rather than the general version of it. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.
LarryQC_SD said:Steady state is the thing most people miss.
LarryQC_SD has the substance of this right. The condition it depends on is worth stating. The mechanism that matters here is not stomach emptying, it is central. GLP-1 receptor agonism in the arcuate nucleus stimulates POMC neurons and suppresses AgRP/NPY signalling, which is why the effect is appetite and food salience rather than physical fullness. Delayed gastric emptying largely tachyphylaxes over the first months; the appetite effect does not.
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View ResultsDr.EndoIndy said:Started at 0.25mg with a fairly bad first week, held each step the full four weeks, and I am now at 1mg with no side effects worth naming.
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.
Adding the clinical framing, because it changes how the question reads.
Dr.EndoIndy said:...but the FDA says semaglutide...
Interesting point. I want to add some regulatory nuance: the FDA labeling reflects the specific clinical trial data submitted for approval. Real-world clinical practice often extends beyond the FDA label based on emerging evidence and clinical judgment.
Example: semaglutide was first approved for diabetes (Ozempic), then obesity (Wegovy). The molecule didn't change — our understanding of its applications expanded. Similarly, semaglutide may evolve as more data accumulates.