Dr.EndoEP said:

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

Correct as far as it goes. The part it does not cover is what to do when the honest answer is "not enough data", which is more often than anyone likes.

mona_PHX said:

The phase 2 numbers were about 24% mean weight loss at 48 weeks on the top dose, with the curve still descending at the end of the study.

This is exactly what I could not find anywhere else. Sending this to two other people who asked me the same thing last week.

Dr.EndoEP said:

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

This is where I part company with the consensus forming above. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

One concrete data point for the thread. Give anything pharmacological four weeks before you judge it, and give anything measured weekly a four-point rolling average before you call it a trend.

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