[Discussion] we are measuring plateau at the wrong time and calling it noise
Thinking out loud about this: we are measuring plateau at the wrong time and calling it noise. On the "everybody ends up at 2.4" claim, which comes up every few weeks. The escalation schedule in the trials was designed to get people to a fixed study dose. Real use is not a trial. The dose that keeps your appetite…
The weekly interval comes out of the half-life — roughly a week — so you are on a smooth curve rather than a series of spikes. That is also why moving your day slightly does very little.
week 20 plateau is the most predictable thing in this entire board
stalling at 0.25mg is information, not a verdict
Careful. A four-week stall is inside normal variation and treating it as failure is how people escalate for no reason.
Genuine question — is the appetite effect still there, or is it just the scale that has paused?
Disagree. 2.4 is the top of the label, not the goal, and "everyone ends up there" is just survivorship in the posts you read.
STEP-1 averaged just under 15% at 68 weeks, so a 10% year is not a failure
Small correction: 2.4mg is the maintenance ceiling on the label, not the starting maintenance dose. The distinction matters for anyone reading this later.
dose day drift of a day either way is fine, the curve barely notices
Sceptical of the mechanism you are proposing. Gastric emptying slows, it does not stop, and the timings you describe do not follow from it.
Sceptical of the mechanism you are proposing.
Disagree with this specific line. A pause at 0.5mg is not evidence that 0.5mg has stopped working.
the scale is the least sensitive instrument you own
nausea that arrives on day two and fades by day four is the standard shape