JenPlateau said:

The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either.

That holds for the injectable. The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people quote them as if they were.

Dr.AddMedPHL said:

The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people…

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.

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

Dr.AddMedPHL said:

The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people…

Adding the part of the answer the thread has not reached. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

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.

Happy to go further on any of that.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Tagging this one for the weekly digest.