PharmD_Rodriguez said:

The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.

Agreed, and for anyone with an eating-disorder history this needs a clinician in the loop rather than a forum. The same drug can be therapeutic in binge-eating disorder and actively harmful in a restrictive disorder.

ZaraB_AL said:

Agreed on the target, with the caveat that reference weight and current weight are different numbers.

This is exactly what I could not find anywhere else. Adding it to my notes with a link back to this thread.

PharmD_Rodriguez said:

The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.

This is where I part company with the consensus forming above. I would be careful about how confidently the flatness reports get attributed. Rapid weight loss, a large deficit and disrupted sleep produce low mood on their own, and separating that from a drug effect is genuinely hard.

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

Adding the numbers, since they settle part of this. The boring version of this is the one that works, and the boring version is: measure a baseline, change one variable, wait, measure again under the same conditions. Nobody wants that answer and it is still the answer.

Moderator note: the sourcing question belongs in the vendor section and has been split out. Carry on.