Which results are findings and which are consequences of the weight loss
Three different explanations for the same abnormal number, and how to tell them apart.
Clinical Trials
Page 21 of 26 of this archive, newest first.
Page 21
STEP 4 misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
A year after stopping: what the trials found at the far end
The physiology of regain was described a decade before these drugs, and it explains the trajectory without invoking anything specific to them.
Seasonal use, holiday use, and the honest state of the evidence
An absence of evidence is not evidence of harm. It is also not a licence.
Lean mass is a compartment, not a tissue
A body-composition report gives four decimal places and no confidence interval. That is the whole difficulty in one sentence.
STEP 5 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Weight regain is not a failure of willpower and it is not a mystery
The variance around the mean regain trajectory is large and unexplained, exactly as it is for the weight loss.
STEP 3 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Why people actually stop, in the order they actually stop
A supply interruption is a discontinuation with no notice, no taper and no plan. That is a distinct clinical situation.
SURMOUNT-3 misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Seasonal use, holiday use, and the honest state of the evidence
The vocabulary is borrowed, the rationale is usually mechanistic, and the outcome data does not exist.
Why people actually stop, in the order they actually stop
A supply interruption is a discontinuation with no notice, no taper and no plan. That is a distinct clinical situation.
TRIUMPH-1 misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Bone density during rapid weight loss: what is known, which is less than you would hope
Density is a proxy for strength and an imperfect one, particularly when soft-tissue thickness over the measurement site is changing.
What a low result means when intake has halved
What the trials measured, which in the case of micronutrients is very little.
TRIUMPH-1 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
STEP 5 misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Not everybody regains at the same rate, and nobody knows why
Regain begins immediately, proceeds at a decelerating rate, and does not usually return to baseline within the observed follow-up. Each of those three clauses matters.
Grams per kilogram of what? The denominator problem in protein guidance
Where the familiar figures come from, what populations they were measured in, and how far the extrapolation reaches.
SURMOUNT-2 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.