SURMOUNT-5: Tirzepatide vs semaglutide head-to-head — my results so far

Dr.PulmRoch said:

Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

Agreed, though "tolerable" needs defining. A dose you tolerate by eating almost nothing is not tolerated, it is being paid for somewhere else — usually in lean mass, sometimes in adherence three months later.

PharmacoVig_BOS said:

True, though the ladder is longer and that is not a neutral detail — six dose steps means six opportunities to stall on the way up, and plenty of…

Bookmarking. The distinction being drawn above is the one nobody else makes. Sending this to two other people who asked me the same thing last week.

Dr.PulmRoch said:

Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

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. Say what you would expect to see if you were wrong, before you look. It is a small discipline and it changes what you notice.

Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source.