Nausea incidence by dose tier — STEP and SURMOUNT meta-analysis

VendorMark said:

The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either.

Agreed on the mechanism, with the caveat that the head-to-head used semaglutide 1mg, not 2.4mg. It is still the best direct evidence available, but it is not the comparison most people think they are citing.

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

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.

Happy to go further on any of that.

One thing that is still open after Dr.AddMedPHL’s answer:

How much of the tirzepatide advantage is the GIP component and how much is simply that the dose ladder goes higher in receptor-occupancy terms?

LabKate said:

Say what you would expect to see if you were wrong, before you look.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. This treats a plausible mechanism as a demonstrated one. Plausible is where you start looking, not where you stop.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Carry on.