Clinical perspective, offered as context rather than as advice. The useful move here is to separate what is established from what is widely repeated. Those two sets overlap less than the confident tone of most write-ups suggests, and the second set is where nearly all the disagreement on this board comes from.

dave_SLC said:

With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most…

Coming at dave_SLC’s question from a different direction. Whatever the answer turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, and invite the correction. That is slower than asserting, and it is the only version that survives being wrong.

The figures, for anyone assembling their own picture. 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.

A narrower follow-up, since the general answer is now clear:

How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?

Moderator note: the sourcing question belongs in the vendor section and has been split out. Thread quality here is what the rules are for. Keep it up.