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c/tirzepatide·posted 1 year ago by u/emil_okwuosa

small win: dual agonist stopped being a problem at week 50

Lab Clean Column ×3 Sourced ×2 Well Actually ×1

small win: dual agonist stopped being a problem at week 50, and the part I actually want to talk about is at the bottom.

Week 7 was the first time the scale moved after a five-week stall. I changed nothing in that window.

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.

Not medical advice, obviously, and nothing here is approved for human use. One person with a spreadsheet.

3,433 up / 815 down81% upvoted58 commentsid 18684q1 Sep 2024

58 comments

30 in this archive, depth 5

best — the order this archive was captured in

u/ferritin_low282 points·1 year ago

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.

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u/fatima_wojcik138 points·1 year ago

The 21% figure is a 72-week mean on the highest arm. Quoting it as what someone should expect by week 53 is not a fair reading.

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u/hair_shed_hannah248 points·1 year ago

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.

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u/marit_sandvik70 points·1 year ago

Agreed, and the trial number is a mean of a very wide distribution — the tails are enormous and nobody posts from the middle.

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u/hassan_nilsen25 points·1 year ago

Yes — 10mg being a genuine landing place for a lot of people is underrated. There is no medal for 15.

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u/kian_ekstrom59 points·1 year ago·edited

Small fix: SURMOUNT is the obesity programme, SURPASS is the type-2 programme. They are different endpoints and the numbers do not transfer.

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u/priya_guerrero45 points·1 year ago

Small fix: SURMOUNT is the obesity programme, SURPASS is the type-2 programme.

Agreed, with one qualifier: that is the mean of the top arm and the spread around it was enormous.

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u/samir_falk167 points·1 year ago·edited

Disagree with the conversion table. There is no validated equivalence between the two molecules and posting one as though there is does real damage.

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u/kian_ekstrom-29 points·1 year ago

Came off sema and onto tirz with a two-week gap. The first month was flat and I assumed I had made a mistake. Month two it moved.

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u/emil_okwuosaOP1 point·1 year ago

That percentage is body weight change, not body fat. Different measurement, and the distinction gets lost every time.

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[deleted]1 point·1 year ago

[deleted]

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u/neha_falk85 points·1 year ago

Are you comparing yourself with the trial mean or with the people who post the most?

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u/kaia_wojcik22 points·1 year ago

It is a dual GIP and GLP-1 receptor agonist, and the GIP arm is the part that has no equivalent in the semaglutide threads. That is why the side-effect profile reads differently rather than just milder.

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u/swirl_dont_shakereconstitution81 points·1 year ago

Switching from semaglutide, since three people asked in this thread alone.

There is no published dose equivalence between the two. The conversion tables that circulate are somebody’s arithmetic, not data. What people report here is that the first month after a switch is often flat, that the appetite effect feels differently shaped rather than simply stronger, and that starting at the bottom of the ladder again is the common approach.

None of that is a recommendation. It is what the threads say, and the threads are not a clinic.

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u/sofia_nascimento32 points·1 year ago

Careful with "everyone tolerates it better". The people it did not suit stop posting, which makes this board look calmer than the drug is.

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u/dexa_twice_yearlyMOD46 points·1 year ago

This is the fifth "should I go up" post today and they are all welcome — but no member here can answer it for you.

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u/thyroid_tangent34 points·1 year ago

2.5mg is a four-week starting dose, not a maintenance dose. Worth being precise since people search these threads.

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u/crosspost_bot_no27 points·1 year ago

2.5 is the starter dose and it is not meant to be the dose that works

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u/amara_halonen29 points·1 year ago

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.

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u/rania_marchand19 points·1 year ago

Have you held a step for longer than the four-week minimum at any point?

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u/piotr_nascimento11 points·1 year ago

stepping every four weeks is a ceiling on speed, not a schedule you must hit

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About c/tirzepatide

Tirzepatide-specific discussion: the dual-agonist pharmacology, the 2.5 → 15mg ladder, the appetite profile people describe as different from semaglutide, and the SURMOUNT/SURPASS trial programme. Comparisons with semaglutide are welcome as long as they are specific about dose equivalence being unknown.

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