One concrete data point for the thread. 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.

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

Correct me if the detail matters more than I have assumed.

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

What the dose-response curve actually looks like above 1.7mg, because the trial means hide how few people account for the extra loss?

HPLC_Greg said:

Worth knowing that the injection site changes very little.

Coming at HPLC_Greg’s question from a different direction. The mechanism that matters here is not stomach emptying, it is central. GLP-1 receptor agonism in the arcuate nucleus stimulates POMC neurons and suppresses AgRP/NPY signalling, which is why the effect is appetite and food salience rather than physical fullness. Delayed gastric emptying largely tachyphylaxes over the first months; the appetite effect does not.

OP back with an update, since a thread like this is useless without one.

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.

Dr.SleepRoch said:

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

That is correct as far as it goes, and here is where it stops going. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.

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