roxy_nash said:

The gap between trial results and real-world results is consistent and it is not fraud.

No disagreement, though the timescale matters more than the mechanism here. Most of what looks like a difference in kind turns out to be a difference in how long somebody waited.

Worth separating that from the trial evidence, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

Dr.SportsMedIN said:

The phase 2 numbers were about 24% mean weight loss at 48 weeks on the top dose, with the curve still descending at the end of the study.

Genuinely useful, thank you. I had the facts and not the framework. Sending this to two other people who asked me the same thing last week.

roxy_nash said:

The gap between trial results and real-world results is consistent and it is not fraud.

I read this differently from roxy_nash, on substance rather than tone. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

One concrete data point for the thread. If you are going to change something, change one thing and give it long enough to express itself. Four weeks is the usual minimum for anything pharmacological on this board, and two weeks of data has told you almost nothing.

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