unpopular opinion: most of what gets said here about titration is guesswork
Posting this as a discussion rather than a claim: unpopular opinion: most of what gets said here about titration is guesswork.
Weight change and appetite change are different endpoints on different timescales. Conflating them is where most of the confusion on this board starts.
Delayed gastric emptying is most pronounced early and attenuates with continued dosing, which is why the sulphur burps usually fades at a stable dose.
My stall was eleven weeks. Eleven. Then it moved again without me changing anything at all.
Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.
best — the order this archive was captured in
How long was the stall before you decided it was a stall?
What did week 49 look like compared with this one? The month either side is the useful comparison.
Steady state after a dose change takes four to five half-lives, so the fair judgement point on a new step is about a month, not four days.
Correct, and worth adding: the trial average is an average. Half the people in it did worse than 15% and were still on the drug.
STEP-1 ran 68 weeks and landed just under 15% mean body weight change on 2.4mg. It is an average of a wide distribution, not a target you have missed.
dose day drift of a day either way is fine, the curve barely notices