[Meta] the SURMOUNT rule is doing its job and people should stop complaining
the SURMOUNT rule is doing its job and people should stop complaining. Nothing about this affects the ranking maths, before anyone asks.
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.
Week 18 was the first time the scale moved after a five-week stall. I changed nothing in that window.
The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.
Corrections welcome, especially the pedantic ones. Pedantry is how this board earns its reputation.
best — the order this archive was captured in
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.
hold the dose that works, the ladder is not a leaderboard
I would separate the two claims. That the GIP arm exists is uncontroversial; that it explains your early fullness pattern is a guess.
2.5 is the starter dose and it is not meant to be the dose that works
The 21% figure is a 72-week mean on the highest arm. Quoting it as what someone should expect by week 31 is not a fair reading.
week 2 is early to draw any conclusion at all
Weekly dosing again, half-life in the same neighbourhood as sema, so a step change takes about a month to reach steady state. Judging a new step at day five is judging noise.
pens and vials are the same molecule, the price is the difference
Cosigning the four-week thing. It is a minimum interval, and treating it as a schedule to keep up with is how people end up miserable at 12.5.
Does food noise follow the day after the shot, or is it spread across the week?
Not sure that follows. You went up a step and changed your training in the same fortnight.
SURMOUNT-1 landed around 21% at 72 weeks on the top arm
Trial identifiers corrected in the title. SURMOUNT and SURPASS are different programmes.
Are you comparing yourself with the trial mean or with the people who post the most?
Sulphur burps for the first eight days after each step, then nothing. Predictable enough that I planned my week around it.
This matches mine. Milder early fullness than I expected, and what there was settled inside a fortnight of each step.
Held 7.5 for five months. Everyone kept asking when I was going to 10. The answer was never, because 7.5 was working.
What step are you on and how long have you been there?
zepbound and mounjaro are the same compound with different labels
Careful with "everyone tolerates it better". The people it did not suit stop posting, which makes this board look calmer than the drug is.
What is the waist doing? That is usually the number still moving during a scale stall.
Small fix: SURMOUNT is the obesity programme, SURPASS is the type-2 programme. They are different endpoints and the numbers do not transfer.
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.
Which week did the appetite change actually land for you?
Have you held a step for longer than the four-week minimum at any point?
Right. And the sema-to-tirz "conversion" people post is invented. There is no published equivalence.
stepping every four weeks is a ceiling on speed, not a schedule you must hit
a lot of people plateau nicely at 10mg and never need 15
Appetite effect for me is flat across seven days. On sema it was a wave. Same person, different molecule.
- 1Trial identifiers corrected in the title. SURMOUNT and SURPASS are different…10 comments in this branch · started by u/titration_marshal
- 2I would separate the two claims. That the GIP arm exists is uncontroversial;…6 comments in this branch · started by u/customs_seizure_sid