mike_nyc said:

The OASIS programme put 50mg oral in the same territory as 2.4mg injectable — around 15% mean weight loss — but it needed a dose 20 times larger to…

I do not accept that the fasting window is a minor inconvenience. Adherence data on daily orals with timing requirements is consistently worse than weekly injections, and a drug you take imperfectly is a lower dose than the one on the box.

Adding the numbers, since they settle part of this. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

Dr.MetabolicMD said:

I do not accept that the fasting window is a minor inconvenience.

Adding the part of the answer the thread has not reached. 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.

Worth separating that from semaglutide, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

Following on from HPLC_Greg — and this may be the naive question:

How much of the oral variability is the SNAC absorption window and how much is dose, because the two get conflated constantly?

Reporting back.

Update — I went back to the injectable. Not because the tablet did not work, but because the fasting window and my mornings were never going to agree.