SURMOUNT-5: Tirzepatide vs semaglutide head-to-head — looking for input

hank_denver said:

For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

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.

Ask again with the specifics and you will get a better answer than this one.

hank_denver said:

For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

No disagreement, though the timescale matters more than the mechanism here. Most of what looks like a difference in kind turns out to be a difference in how long somebody waited.

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

hank_denver said:

For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

Genuinely useful, thank you. I had the facts and not the framework. Adding it to my notes with a link back to this thread.

From the other side of the consultation, briefly. The useful move here is to separate what is established from what is widely repeated. Those two sets overlap less than the confident tone of most write-ups suggests, and the second set is where nearly all the disagreement on this board comes from.

jim_asheville said:

The useful move here is to separate what is established from what is widely repeated.

Adding a me-too, because a thread of one person's experience is not much use.