Dr.PeteFamMed said:

Steady state is the thing most people miss.

This answered a question I did not know how to ask. I will report back once I have actually tried it.

From the other side of the consultation, briefly.

Dr.MetabolicMD said:

...but the FDA says semaglutide...

Interesting point. I want to add some regulatory nuance: the FDA labeling reflects the specific clinical trial data submitted for approval. Real-world clinical practice often extends beyond the FDA label based on emerging evidence and clinical judgment.

Example: semaglutide was first approved for diabetes (Ozempic), then obesity (Wegovy). The molecule didn't change — our understanding of its applications expanded. Similarly, semaglutide may evolve as more data accumulates.

EndoResFellow said:

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

I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.

The figures, for anyone assembling their own picture. Worth stating the units and the reference range whenever you post a number here. A large fraction of the apparent disagreement in these threads is two people using different units and both being right.

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.