JessicaH_TX said:

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

This is where I part company with the consensus forming above. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.

Adding the numbers, since they settle part of this. Worth knowing that the injection site changes very little. Abdomen, thigh and upper arm are bioequivalent for semaglutide, so a site change is not a plausible explanation for a bad week.

Dr.GutHealth said:

The trial means are being read too generously in this thread.

Coming at Dr.GutHealth’s question from a different direction. The useful move here is to separate what is established from what is widely repeated. Those two sets overlap less than the confident tone of most write-ups suggests, and the second set is where nearly all the disagreement on this board comes from.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

One thing that is still open after hannah_MT’s answer:

What would you measure differently if you were starting again?

Closing the loop on my own question.

Six weeks on from posting: I stopped reading the weekly number and started reading a four-week average, and the "stall" I opened this thread about was a 1.8kg loss I could not see.