Short answer first, then the reasoning. The pharmacokinetics explain nearly every practical question asked here. Albumin binding above 99% slows clearance enough to make weekly dosing possible; a terminal half-life near a week means four to five weeks to steady state and therefore a four-week titration interval; subcutaneous bioavailability around 89% means injection site barely matters. Those three facts answer most timing questions before they are asked.
Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
What I am trying to establish is how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.
Happy to be told the question itself is wrong.
TirzTom said:The pharmacokinetics explain nearly every practical question asked here.
Agreed, and the adaptation point cuts both ways: tachyphylaxis to gastric emptying is why tolerability improves, and it is also why people who were relying on physical fullness feel the effect fade while the appetite effect is still working.
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View ResultsZaraB_AL said:Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
Mine went the same way, slower. The detail I would add is minor and it is already implied above.
From the other side of the consultation, briefly.
Senior perspective on cardiovascular risk: I'm 64 years old and started this journey skeptically. My internist recommended it after years of failed interventions.
8 months later: down 42 lbs, more mobile, pain reduced, medications simplified. My quality of life has improved dramatically. I wish this existed 20 years ago.
To other older adults hesitating: the SELECT trial proved benefit in our age group. You deserve to feel good in your body regardless of age.