walking through what SURMOUNT-4 actually showed about stopping, since it gets misquoted constantly
See SURMOUNT-4 cited a lot in tapering discussions, often slightly wrong, so here's my attempt at describing what the withdrawal arm actually showed rather than the telephone-game version. SURMOUNT-4 (JAMA, 2024) had participants titrate up on tirzepatide, then randomized a subset to either continue the drug or…
this is a good-faith and accurate summary, and the "it wasn't a taper-speed comparison" point is the one I see get lost most often. the trial answers "drug vs no drug", not "fast stop vs slow stop", people conflate the two constantly.
exactly why I wrote it, saw three threads this month alone treating it as if it settled the taper-speed question when it never asked that question
the confidence interval on the regain magnitude is also worth remembering exists even if most people never see the actual figure, headline numbers always undersell the spread
and the regain curve over time matters more than a single endpoint number too, where the curve is steepest tells you more than the final value alone
agreed, though I don't have the exact shape of that curve memorized well enough to describe it precisely here, would want to actually pull the supplementary figures before saying more