Dr.KarenChen said:The mechanism that matters here is not stomach emptying, it is central.
Thank you for spelling out the reasoning rather than just the conclusion. Taking it to my next appointment.
Adding the clinical framing, because it changes how the question reads.
Admin 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.
Dr.LeslieOBGYN said:The dose-response is real but shallow at the top.
This is where I part company with the consensus forming above. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.
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Browse GL BiochemOne concrete data point for the thread. Give anything pharmacological four weeks before you judge it, and give anything measured weekly a four-point rolling average before you call it a trend.
Moderator note: two posts asking for a source have been merged into one. Please search the thread before asking again. Thread quality here is what the rules are for. Keep it up.