One concrete data point for the thread. A quick sanity check on any figure quoted here: is it mean or median, is it intention-to-treat or completers, and what was the comparator. Three questions, and they resolve most disagreements in these threads.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

Following on from lisa_labSD — and this may be the naive question:

Whether the RDA is the wrong reference entirely during rapid weight loss, and what the actual target should be?

lucas_SP_BR said:

A quick sanity check on any figure quoted here: is it mean or median, is it intention-to-treat or completers, and what was the comparator.

Coming at lucas_SP_BR’s question from a different direction. The gap between trial results and real-world results is consistent and it is not fraud. Trial participants get titration by protocol, scheduled contact, free drug and dietetic support; removing that infrastructure costs a few percentage points every time it has been measured. When your own curve sits below the published mean, that is the likeliest explanation before anything about you or your material.

Closing the loop on my own question.

Reporting back — setting the target on reference weight rather than current weight turned an impossible number into a boring one.

TrialTracker_MD said:

The gap between trial results and real-world results is consistent and it is not fraud.

Agreed on the target, with the caveat that reference weight and current weight are different numbers. Using current weight at the start of a large loss produces a target that is both unachievable and unnecessary.