sarah.morrison said:

The OASIS programme put 50mg oral in the same territory as 2.4mg injectable — around 15% mean weight loss — but it needed a dose 20 times larger to…

I do not accept that the fasting window is a minor inconvenience. Adherence data on daily orals with timing requirements is consistently worse than weekly injections, and a drug you take imperfectly is a lower dose than the one on the box.

Adding the numbers, since they settle part of this. 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.

Dr.SurgeonPGH said:

I do not accept that the fasting window is a minor inconvenience.

Coming at Dr.SurgeonPGH’s question from a different direction. Read four things before the headline number. The population, because trial populations are selected and supported in ways that real cohorts are not. The comparator, because "better than placebo" and "better than the current standard" are different claims and get reported identically. The primary endpoint as pre-registered, because a secondary endpoint promoted after the fact is a hypothesis rather than a finding. And the completion rate, because a large effect in the half of participants who finished is a different result from a large effect in everybody enrolled.

A narrower follow-up, since the general answer is now clear:

How much of the oral variability is the SNAC absorption window and how much is dose, because the two get conflated constantly?

OP back with an update, since a thread like this is useless without one.

Follow-up: moving the tablet to the moment I wake, before anything else, was the whole fix. The dose never changed.