TrialTracker_MD said:

The intervention that works is boring and well evidenced: resistance training two to three times a week at a genuine effort, protein at 1.4 to 2.0…

TrialTracker_MD said:

...the STEP extension data on maintenance dosing is concerning...

Let me offer a different interpretation of the same data. Yes, 2/3 of weight was regained after discontinuation. But consider:

• This is consistent with EVERY chronic disease medication ever studied
• 1/3 of patients maintained significant weight loss — who are they and why?
• The metabolic improvements partially persisted even with weight regain
• The data supports long-term treatment, not a "course" of therapy

The takeaway isn't "the drug fails when you stop" — it's "chronic diseases require ongoing treatment." We've always known this.

Dr.PainCLE said:

Agreed on the ranges, with the condition that a single DEXA is not a measurement, it is one draw from a distribution.

That reframing is the part I needed. Adding it to my notes with a link back to this thread.

TrialTracker_MD said:

The intervention that works is boring and well evidenced: resistance training two to three times a week at a genuine effort, protein at 1.4 to 2.0…

This is where I part company with the consensus forming above. I think this board over-worries about lean mass. Some lean loss is obligatory — you need less muscle to move a smaller body, and preserving mass you no longer need is not a health outcome. The question is whether strength and function held, and mine did.

Correct me if the detail matters more than I have assumed.

LindaRN_retired said:

Planning the end of this rather than the middle of it, which nobody around me seems to want to talk about while it is still going well.

STEP 5 long-term data on maintenance dosing: the 104-week (2-year) extension showed sustained weight loss of -15.2% with continued semaglutide vs weight regain in the discontinuation group[1].

Key insight: weight loss continued to accrue between weeks 68 and 104 in many patients, suggesting the nadir may not occur until year 2+. The 68-week primary endpoint in most trials may underestimate maximal efficacy.

This supports long-term, open-ended treatment rather than fixed-duration "courses" of therapy.

Moderator note: a post naming a supplier has been edited. Discuss suppliers in the review sections, not here. Thread quality here is what the rules are for. Keep it up.