BariatricNurseD said:

Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third…

Agreed, though "tolerable" needs defining. A dose you tolerate by eating almost nothing is not tolerated, it is being paid for somewhere else — usually in lean mass, sometimes in adherence three months later.

Happy to go further on any of that.

JessicaH_TX said:

Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

Genuinely useful, thank you. I had the facts and not the framework. Printing the relevant bit and taking it with me.

BariatricNurseD said:

Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third…

I read this differently from BariatricNurseD, on substance rather than tone. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.

Happy to go further on any of that.

Adding the numbers, since they settle part of this. Worth stating the units and the reference range whenever you post a number here. A large fraction of the apparent disagreement in these threads is two people using different units and both being right.

Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. No action needed from anybody.