Planning the end of this rather than the middle of it, which nobody around me seems to want to talk about while it is still going well.
What I actually want to know is whether extending the interval works as well as reducing the dose, since they are not the same intervention pharmacologically.
Practical detail welcome, however dull — the duller the better.
Short answer first, then the reasoning. One third of STEP 4 participants held most of their loss without the drug, and nobody has convincingly characterised who they are. That subgroup is the most interesting unanswered question in the field and it is routinely flattened into the two-thirds headline.
pete_manc_UK said:One third of STEP 4 participants held most of their loss without the drug, and nobody has convincingly characterised who they are.
STEP 5 long-term data on maintenance dosing: the 104-week (2-year) extension showed sustained weight loss of -15.2% with continued semaglutide vs weight regain in the discontinuation group[1].
Key insight: weight loss continued to accrue between weeks 68 and 104 in many patients, suggesting the nadir may not occur until year 2+. The 68-week primary endpoint in most trials may underestimate maximal efficacy.
This supports long-term, open-ended treatment rather than fixed-duration "courses" of therapy.
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Browse GL BiochemAttorneyGrant said:Planning the end of this rather than the middle of it, which nobody around me seems to want to talk about while it is still going well.
This matches mine closely enough to be worth saying so. Extending the interval and reducing the dose are pharmacologically different. Reducing the dose lowers the whole exposure curve evenly; extending the interval keeps the peak and drops the trough. Since the appetite effect tracks the trough, interval extension tends to give you good days and bad days rather than a uniformly smaller effect, which most people find harder to live with.
Clinical perspective, offered as context rather than as advice.
Maintenance phase reality on maintenance dosing: reached my goal 7 months ago and now I'm in maintenance. It's a different mental game.
During weight loss, the scale going down is constant positive reinforcement. In maintenance, the scale staying the same is... just... nothing. It's anticlimactic. The dopamine hit is gone.
What keeps me going: lab improvements, physical capabilities, how I feel, fitting in clothes I love, and the knowledge that regain happens when people stop being intentional. I'm staying intentional.