Dr.BariatricHTX said:The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either.
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.
Dr.ReproEndo said:The dose-response is real but shallow at the top.
Thank you — that is the clearest version of this I have read, and I have read a lot of them.
Dr.BariatricHTX said:The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either.
Pushing back on Dr.BariatricHTX here. 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.
Ask again with the specifics and you will get a better answer than this one.
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Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Report rather than reply if it drifts again.