jim_asheville said:

The mechanism that matters here is not stomach emptying, it is central.

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

B12Beth said:

Agreed, though "tolerable" needs defining.

This is exactly what I could not find anywhere else.

jim_asheville said:

The mechanism that matters here is not stomach emptying, it is central.

I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.

dave_SLC said:

Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

6 month update on cardiovascular risk: down 63 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.

Moderator note: the sourcing question belongs in the vendor section and has been split out. No action needed from anybody.