The eighteenth month, and the conversation that should have happened in the third
Weight reduction in the long programmes flattens at roughly sixty to seventy-two weeks. The timing is consistent, predictable and almost never mentioned in advance.
Patient Notes in 2024
Page 7 of 10 of this archive, newest first.
What the new Australia guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
What the new France guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
South Korea pharmacy body issues counselling standards for tirzepatide initiation
The evidence base is thin and the document says so, which is to its credit.
The lowest effective dose is a real concept with almost no data behind it
Every withdrawal trial compared full dose against nothing. The clinically interesting comparison — full dose against a reduced one — has not been randomised.
What the new Saudi Arabia guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
What the trials counted as intolerance
We set out the questions that distinguish a symptom to manage from a dose to change.
The intramuscular injection nobody intended
A 4 mm needle at ninety degrees without a skin pinch is adequate for essentially all adults. The persistence of 12.7 mm needles in this market is habit, not reasoning.
Turkey pharmacy body issues counselling standards for liraglutide initiation
The evidence base is thin and the document says so, which is to its credit.
What the placebo arms of the withdrawal trials actually tell us
The evidence on stopping is better than the evidence on almost anything else in this field, because somebody deliberately randomised it.
Why people actually stop, in the order they actually stop
Cost is the modal reason for discontinuation in every dataset we have seen, and it is absent from the clinical literature.
Why "muscle-sparing" is a marketing term and not a measurement
The gap between a defensible recommendation and a confident one is where most of the harm in this subject lives.
What the new Spain guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
What the new Sweden guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
Vitamin D, adiposity, and a volume-of-distribution problem
Micronutrient guidance for this drug class is borrowed almost entirely from post-bariatric surveillance, where the anatomy is different and the deficiency mechanisms are not…
The mechanism behind the mechanism
A single drug producing both constipation and diarrhoea looks contradictory until the motility data is read properly.
What the new Ireland guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
Ireland pharmacy body issues counselling standards for semaglutide initiation
The evidence base is thin and the document says so, which is to its credit.
Sarcopenia is a diagnosis, not a synonym for losing lean mass
The gap between a defensible recommendation and a confident one is where most of the harm in this subject lives.
Spain pharmacy body issues counselling standards for semaglutide initiation
The evidence base is thin and the document says so, which is to its credit.