This one has a reasonably settled answer, so here it is. The pharmacokinetics explain nearly every practical question asked here. Albumin binding above 99% slows clearance enough to make weekly dosing possible; a terminal half-life near a week means four to five weeks to steady state and therefore a four-week titration interval; subcutaneous bioavailability around 89% means injection site barely matters. Those three facts answer most timing questions before they are asked.

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

HPLC_Greg said:

The pharmacokinetics explain nearly every practical question asked here.

Agreed, and the adaptation point cuts both ways: tachyphylaxis to gastric emptying is why tolerability improves, and it is also why people who were relying on physical fullness feel the effect fade while the appetite effect is still working.

NicoleRaleigh said:

My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

Can confirm. Same sequence, different timescale.

Adding the clinical framing, because it changes how the question reads.

Senior perspective on cardiovascular risk: I'm 62 years old and started this journey skeptically. My internist recommended it after years of failed interventions.

8 months later: down 55 lbs, more mobile, pain reduced, medications simplified. My quality of life has improved dramatically. I wish this existed 20 years ago.

To other older adults hesitating: the SELECT trial proved benefit in our age group. You deserve to feel good in your body regardless of age.