u/yusuf_ramos

tier 3 waiting lists are measured in years, not months

Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.

I would not read that in vitro number across to a person. The conditions are nothing like physiological.

not approved anywhere, which is the single most important fact in this board

the appendix is where the interesting tables live

Yes — hair shedding tracks the rate of loss and it is temporary. That reassurance is worth repeating.

Fertility changed faster than I expected with the weight loss. Nobody had raised it and I wish somebody had.

Did you write anything down at the time?

Correction: that trial did not enrol the population being discussed, so it cannot support the claim.

Insulin resistance is a common feature in PCOS, which is why the metabolic conversation overlaps so heavily with this board. A diagnosis and a finding are still different things and the distinction matters for what the evidence says.

The phase 2 readout ran to 48 weeks in a few hundred participants with a slow escalation.

lurker_for_years is right about the escalation being the variable. It explains most of the difficult reports here.

Is that intention-to-treat or completers?

a mechanism you can state is not a mechanism you have demonstrated

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

The early fullness profile felt different rather than worse. Hard to describe and impossible to quantify, so take it as an impression.

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.

Same. The thing that went wrong for me was procedural and boring and it cost me a lot.

Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.

6kg over 25 weeks, never went past 10mg, and reflux stayed mild the whole way. Posting because the loud threads are all 15mg.

the MHRA supply notices are published, read them before the panic threads

Quoted a figure here confidently, got asked whether it was ITT, went and checked, and it was not. Learned something.

Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.

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.

the trials titrated on a calendar, real people titrate on symptoms

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

How fast was the escalation? That is usually the variable that explains the reports.

That is a relative risk reduction. Quoting it without the absolute numbers overstates the case considerably.

Read a press release and the publication three months apart. The hedging in the second one was substantial.

Right, and it bears repeating that nothing here is approved anywhere and research material is not for human use.

Yes — the interval is the finding. A point estimate with a wide interval is a hypothesis in a nice font.

read the discussion section, that is where the honesty lives

Agreed.

Disagreeing with this line: that is a relative reduction and the absolute numbers are considerably less dramatic.

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

Hormonal variation across the cycle affects appetite, fluid retention and subjective symptom intensity independently of anything else, which is why an unannotated log can look mysterious.

Glucose-dependent insulin secretion is why hypoglycaemia risk is low as monotherapy: the effect scales with glycaemia rather than acting unconditional

Adding the caveat the paper itself makes in its limitations section, which is stronger than anything in this thread.

Scotland, Wales and Northern Ireland have their own arrangements. An answer that begins with "in England" should say so, and most of the confusion here comes from answers that do not.

Cosigning on fertility changing with weight loss. It catches people who were not expecting it at all.