The figures, for anyone assembling their own picture. A quick sanity check on any figure quoted here: is it mean or median, is it intention-to-treat or completers, and what was the comparator. Three questions, and they resolve most disagreements in these threads.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

Following on from Dr.ReproEndo — and this may be the naive question:

How to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases?

BethLabQueen said:

A quick sanity check on any figure quoted here: is it mean or median, is it intention-to-treat or completers, and what was the comparator.

Coming at BethLabQueen’s question from a different direction. 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.

I would rather be corrected than agreed with, if it comes to it.

Reporting back.

Follow-up: I read the paper rather than the summary and the qualifier I was missing was in the second paragraph of the results.

lisa_labSD said:

The gap between trial results and real-world results is consistent and it is not fraud.

Glucagon receptor pharmacology in triple agonists (retatrutide), relevant to the glucagon co-agonists: the glucagon component is the most controversial because glucagon traditionally raises blood glucose. So why include it in an anti-obesity drug?

Key insight: glucagon increases energy expenditure (thermogenesis), promotes hepatic lipid oxidation, and reduces appetite through distinct CNS mechanisms. The hyperglycemic effect is counterbalanced by the GLP-1 component's insulin secretagogue action.

Net result: more weight loss through increased expenditure (glucagon) + decreased intake (GLP-1/GIP), with neutral or improved glycemia. An elegant pharmacological balancing act[1].