Dose-response curves — semaglutide vs tirzepatide weight loss by dose

DeniseRN_TPA said:

The mechanism that matters here is not stomach emptying, it is central.

That reframing is the part I needed. Sending this to two other people who asked me the same thing last week.

Adding the clinical framing, because it changes how the question reads.

bri_stats 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.ObesityMed 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.

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

Adding the numbers, since they settle part of this. Practical numbers: half-life about 5 days, steady state 3 to 4 weeks, ladder 2.5 / 5 / 7.5 / 10 / 12.5 / 15mg, and the maintenance doses with published data behind them are 5, 10 and 15mg.

I would rather be corrected than agreed with, if it comes to it.

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