KevinCompounds said:

Admin said: ...but the FDA says semaglutide...

Same position here, arrived at the long way round. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.

Dr.AddMedPHL said:

The boring version of this is the one that works, and the boring version is: measure a baseline, change one variable, wait, measure again under the…

Saving this. It is the first explanation that did not require me to already understand it.

Adding the clinical framing, because it changes how the question reads. Worth answering the question that was asked rather than the one behind it. The narrow version usually has an answer; the broad version usually does not, and answering the broad one is how a thread stops being useful.

julia.endo said:

Worth answering the question that was asked rather than the one behind it.

Same position here, arrived at the long way round. 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.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part.