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c/semaglutide·posted 3 months ago by u/customs_seizure_sid

4 months in and plateau is still the thing I get wrong

Meta Receipts ×2 Cold Box ×3

4 months in and plateau is still the thing I get wrong. This is a description of what happened to me and not a plan for anybody else.

Figures up front so nobody has to dig: 4 months.

The mental model that finally made this click for me: there are two curves, and people watch the wrong one.

The first is exposure, which is set by the dose and smoothed by a week-long half-life. It changes when you change the dose and then settles over about a month. The second is body weight, which is exposure filtered through appetite, food, water, sleep, training and the scale itself, and which moves in steps rather than a line.

Almost every "it stopped working" post is somebody watching curve two over a fortnight and drawing conclusions about curve one. If the appetite effect is still there, exposure is fine. Wait the month.

injection-site soreness made the first fortnight rough at each step up, then flattened out. Predictable enough that I started planning around it.

Tell me where this is wrong. That is the useful part of posting it.

1,544 up / 248 down86% upvoted54 commentsid 1ebqgw6 Apr 2026

54 comments

28 in this archive, depth 6

best — the order this archive was captured in

u/ines_castellanos-33 points·3 months ago

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.

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u/aleksi_grimaldi1 point·3 months ago

Research-use-only material is not approved for human use, so anything in this thread about how a compounded or research vial "should" behave is a chemistry discussion, not a dosing one.

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u/ahmed_abubakar1 point·3 months ago

2.4 is a ceiling, not a target

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u/nausea_notesside effects1 point·3 months ago

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.

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u/arne_restrepo1 point·3 months ago

Sat at 2.4mg for four months because it was doing the job. Everyone told me to go up. The one time I did, the only thing that changed was the early fullness.

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u/titration_marshalMOD108 points·3 months ago

Retitled to match the body. The original promised a comparison the post does not make.

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u/ewan_tulloch57 points·3 months ago

Does food noise track the day after the shot, or is it there all week?

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u/zeynep_zielinski37 points·3 months ago

protein first, then everything else gets easier

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u/runa_wikstrom0 points·3 months ago

Retitled to match the body.

titration_marshal is describing the standard shape here and it matches the trial data better than most anecdotes do.

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u/kaplan_meier_kim76 points·3 months ago

First month I lost almost nothing and nearly quit. Month two and three were where it all happened.

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u/quiet_moderatormod50 points·3 months ago

I would push back gently. Going up because the scale paused is the single most common mistake described on this board.

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u/ferritin_low50 points·3 months ago

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 quiet with side effects you can live with is the dose, and for a lot of people on this board that has been 1.7mg for a very long time.

The counter-argument, which is fair: some people genuinely do need the top of the range, and staying low out of caution costs them months. That is a conversation with someone who knows your history, not with us.

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u/viktor_nkemelu37 points·3 months ago

Careful. A four-week stall is inside normal variation and treating it as failure is how people escalate for no reason.

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u/noor_hovland11 points·3 months ago

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.

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u/ffmi_watcher8 points·3 months ago

Small correction: 2.4mg is the maintenance ceiling on the label, not the starting maintenance dose. The distinction matters for anyone reading this later.

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u/coa_janitormod · c/coa6 points·3 months ago

Sceptical of the mechanism you are proposing. Gastric emptying slows, it does not stop, and the timings you describe do not follow from it.

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u/kenji_demir3 points·3 months ago

Yes. Week 56 is when almost everybody writes the "is it still working" post, and almost everybody is fine.

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u/nikhil_teixeira2 points·3 months ago

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.

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u/wanjiru_varga27 points·3 months ago

stalling at 1.0mg is information, not a verdict

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u/nadia_bakker21 points·3 months ago

My stall was eleven weeks. Eleven. Then it moved again without me changing anything at all.

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u/endpoint_creep11 points·3 months ago

What I would tell week-one me, in order of how much time it would have saved.

One: the first month is a tolerance check. You are finding out whether you can take this, not how much you will lose. Two: write down the dose, the day and the waist measurement. Three: a stall of under six weeks is weather, not climate. Four: constipation that arrives the day after the shot and fades by day four is the ordinary pattern and it usually settles at a stable dose.

None of that is advice about what you should do. It is the shape of the thing, which nobody explained to me and which the wiki explains better than I just did.

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u/customs_seizure_sidOP5 points·3 months ago

Are you measuring anything other than weight? Waist is usually the one that keeps moving.

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u/customs_seizure_sidOP3 points·3 months ago

staying at 1.7mg for an extra month is a legitimate plan

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u/two_mil_or_one2 points·3 months ago

Not convinced. You changed the dose and the week at the same time, so you cannot attribute the change to either.

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u/hamza_weiss1 point·3 months ago

if 0.5mg is working there is no prize for going up

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u/customs_seizure_sidOP3 points·3 months ago

Minor fix — the half-life is about a week, not about a day. The rest of your point stands.

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u/plain_titration1 point·3 months ago

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.

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u/leila_silva4 points·3 months ago

STEP-1 averaged just under 15% at 68 weeks, so a 10% year is not a failure

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