Taking the question as asked, rather than the general version of it. The pharmacokinetics explain nearly every practical question asked here. Albumin binding above 99% slows clearance enough to make weekly dosing possible; a terminal half-life near a week means four to five weeks to steady state and therefore a four-week titration interval; subcutaneous bioavailability around 89% means injection site barely matters. Those three facts answer most timing questions before they are asked.

julia.endo said:

The pharmacokinetics explain nearly every practical question asked here.

Agreed, and the adaptation point cuts both ways: tachyphylaxis to gastric emptying is why tolerability improves, and it is also why people who were relying on physical fullness feel the effect fade while the appetite effect is still working.

wanda_boise said:

I have a family history that makes the labelling relevant to me rather than theoretical, and I want to know what it actually rules out.

Adding a me-too, because a thread of one person's experience is not much use.

Clinical perspective, offered as context rather than as advice.

Thyroid cancer screening labs for thyroid monitoring — addressing the boxed warning concern with actual data:

Calcitonin level: 3.0 pg/mL (normal <10). Checked at baseline, month 6, and month 12. Rock stable, no upward trend.

Thyroid ultrasound: normal, no nodules at month 12.

The MTC risk from rodent studies has not been confirmed in human post-marketing data across millions of patient-years. The boxed warning is a regulatory precaution based on animal data. While monitoring is prudent, the clinical risk appears to be negligible.