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c/tirzepatide·posted 7 days ago by u/emil_okwuosa

why is nobody talking about the SURPASS-CVOT readout

Lab Clean Column ×6 Long Haul ×2

Asking properly rather than in a comment on somebody else’s thread: why is nobody talking about the SURPASS-CVOT readout.

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.

Held 7.5 for five months. Everyone kept asking when I was going to 10. The answer was never, because 7.5 was working.

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.

Screenshot none of this. Read the whole thread, including the parts where I am told I am wrong.

2,065 up / 344 down86% upvoted39 commentsid 1ow2da23 Jul 2026

39 comments

25 in this archive, depth 4

best — the order this archive was captured in

u/customs_seizure_sid115 points·5 days ago

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.

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u/elin_ferrari33 points·5 days ago

Yes. I stepped to 12.5 because the calendar said so, not because anything needed fixing, and I regretted it for a fortnight.

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u/emil_okwuosaOP-12 points·5 days ago

What is the waist doing? That is usually the number still moving during a scale stall.

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u/incretin_ivyMOD81 points·5 days ago

Left up, flair changed to Discussion. It is an opinion post and that is fine as long as it is labelled.

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u/dexa_twice_yearlybody comp40 points·4 days ago

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

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u/zeynep_ndiaye72 points·6 days ago

a lot of people plateau nicely at 10mg and never need 15

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u/gustav_vermeulen53 points·6 days 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/laila_wikstrom50 points·6 days 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/emil_okwuosaOP29 points·6 days ago

What step are you on and how long have you been there?

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u/b12_baseline46 points·6 days 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/bastian_eriksen28 points·5 days ago

Research-use-only material is not approved for human use.

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

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u/zeynep_zielinski11 points·5 days 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/thyroid_tangent4 points·5 days ago

pens and vials are the same molecule, the price is the difference

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[removed]20 points·5 days ago

[removed by moderator]

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u/coring_the_stopper23 points·5 days ago

Week 81 was the first time the scale moved after a five-week stall. I changed nothing in that window.

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u/blunt_coldbox2932 points·6 days ago

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.

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u/nordic_pricing13 points·6 days ago

I would separate the two claims. That the GIP arm exists is uncontroversial; that it explains your nausea pattern is a guess.

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u/emil_okwuosaOP10 points·6 days ago

I would separate the two claims.

This. The step interval is a floor, and reading it as a timetable is the most expensive mistake in the thread.

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u/sten_bhattacharya10 points·6 days ago

the food noise profile is genuinely gentler than people expect coming from sema

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u/ahmed_fonseca21 points·6 days ago

Same experience with the appetite effect being flatter across the week rather than front-loaded.

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u/teodor_szabo12 points·5 days ago·edited

Same experience with the appetite effect being flatter across the week rather than front-loaded.

Not sure about this bit. The GIP arm being real does not tell you that it is what caused your particular week.

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u/slow_logbook_ftw6 points·5 days ago

Correction to my own post above — I said 15mg and I have been on 2.5mg since the spring. Same argument, wrong number.

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u/ignacio_vanhecke9 points·5 days ago

Right. And the sema-to-tirz "conversion" people post is invented. There is no published equivalence.

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u/elin_ferrari14 points·5 days ago

5kg over 23 weeks, never went past 10mg, and early fullness stayed mild the whole way. Posting because the loud threads are all 15mg.

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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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