From the other side of the consultation, briefly. 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.

Dr.PeteFamMed said:

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

This is where I part company with the consensus forming above. The counter-case has not been addressed. Somebody upthread described the situation that does not fit, and the thread moved on rather than engaging with it, which is the failure mode this board is supposed to avoid.

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

Dr.PeteFamMed said:

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

Agreed on the mechanism, with the caveat that the head-to-head used semaglutide 1mg, not 2.4mg. It is still the best direct evidence available, but it is not the comparison most people think they are citing.

Happy to go further on any of that.

Dr.PeteFamMed said:

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

This answered a question I did not know how to ask. Taking it to my next appointment.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful.