Answering the narrow version, because the broad one does not have a single answer. 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.

NeuroNate 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.

I would rather be corrected than agreed with, if it comes to it.

bri_stats said:

My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

This is my experience too, for whatever a second data point is worth. Nothing to add that would improve it.

Clinical perspective, offered as context rather than as advice.

Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history. Results were encouraging:

• NT-proBNP: 58 pg/mL (normal, cardiac function preserved)
• Lp(a): 38 nmol/L (genetic, unchanged — expected)
• ApoB: dropped from 138 to 98 mg/dL (excellent response)
• Coronary calcium score: 0 (unchanged from baseline — reassuring)

The ApoB reduction is particularly meaningful — it's considered the best single predictor of cardiovascular risk. GLP-1 therapy seems to improve this consistently.