[Discussion] dual agonist is doing more work than we give it credit for
The title is the argument: dual agonist is doing more work than we give it credit for. Here is the rest of it.
The distribution matters more than the mean. In the trial population the interquartile spread was wide enough that two honest people can have completely different runs on the same arm.
Research-use-only material is not approved for human use. Anything in this thread about how a research vial "should" titrate is a discussion about chemistry, not a plan.
Vials and pens carry the same molecule; what differs is fill volume, device tolerance and whether you are doing your own arithmetic. Neither is inherently more accurate.
Corrections welcome, especially the pedantic ones. Pedantry is how this board earns its reputation.
best — the order this archive was captured in
The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.
The step schedule question, answered properly, because it comes up weekly.
The label sets a minimum interval of four weeks between increases. That is a floor on how fast you may go, and it exists because tolerability, not efficacy, is what limits most people. There is nothing in the pharmacology that says you must increase at four weeks, or at eight, or ever.
What decides it in practice is whether the effect you want is still there. If appetite is quiet and the trend is going the right way, the dose is doing its job. If both have genuinely gone flat for six weeks or more, that is a conversation worth having with someone who knows your history.
if 7.5 is working, 10 is not automatically better
SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change. SURPASS is the diabetes programme and reports glycaemic endpoints, so quoting the two interchangeably is a category error.
zepbound and mounjaro are the same compound with different labels
the trials titrated on a calendar, real people titrate on symptoms
sulphur burps are the signature complaint and they are not dangerous
Yes — 10mg being a genuine landing place for a lot of people is underrated. There is no medal for 15.
On comparing yourself with the trial number.
SURMOUNT-1 reported roughly 21% mean body weight change at 72 weeks on the highest arm. Three things get dropped every time that figure is quoted here. It is a mean, and the distribution around it is very wide. It is 72 weeks, which is a year and a half. And it is a trial population with trial support, which is not the same as a person with a spreadsheet.
Use it as a rough shape, not a benchmark. A 12% year is inside the ordinary range and people quit over it every week on this board.
Correction to my own post above — I said 12.5mg and I have been on 10mg since the spring. Same argument, wrong number.
This matches mine. Milder injection-site soreness than I expected, and what there was settled inside a fortnight of each step.
dual agonist, so the GIP arm is doing something the sema threads will not tell you about
the four-week step schedule is the label, not folklore
Appetite effect for me is flat across seven days. On sema it was a wave. Same person, different molecule.
the appetite effect is blunter than sema, in a good way, most weeks
pens and vials are the same molecule, the price is the difference
the early fullness profile is genuinely gentler than people expect coming from sema
Did you come to this from sema, and if so how long was the gap?
- 1The four-week interval in the label is a minimum. Nothing about the…8 comments in this branch · started by u/elin_ferrari