LabKate said:Four weeks is the pharmacokinetics, not caution.
I disagree that the ladder is purely tolerability. The maintenance and regain data cluster at the top doses, so a ladder abandoned halfway leaves you outside the evidence base for the part that matters most — keeping it off.
Happy to go further on any of that.
JenMemphis said:I titrated faster than the label because I felt fine, hit a wall at the third step, and had to come back down — which I now think was the predictable…
PSA for titration users considering the 0.25mg starting dose: this dose is NOT intended for weight loss. It's a titration dose to let your body adjust. Don't be discouraged if you don't lose much in the first month.
The therapeutic dose for weight management starts at 1.7mg (semaglutide) or 5mg (tirzepatide). Be patient with the ramp-up.
TrialNerd_Beth said:I disagree that the ladder is purely tolerability.
Coming at TrialNerd_Beth’s question from a different direction. It is worth asking what the claim would look like if it were false. If nothing would look different, it is not a claim about the world and no amount of discussion will settle it.
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Shop Reference StandardsOne thing that is still open after paul_denver’s answer:
Why the interval is four weeks rather than two, and whether a slower ladder gets to the same place?
Closing the loop on my own question.
I held the step an extra three weeks instead of stepping back down, and it settled. Same dose, same everything, just more time — which is exactly what was suggested upthread.