+1 to amsterdam_pete. Especially the point about "Re: SUSTAIN-6 to SELECT 12 month — the ..." — I have seen the same in my own experience with SUSTAIN-6 to SELECT 12.
Want to share my personal experience related to SUSTAIN-6 to SELECT 12 month since I think it might help others in a similar situation.
I started my GLP-1 journey in March 2025 at 278 lbs with metabolic syndrome. My telehealth provider prescribed semaglutide 0.25mg to start.
Now, 8 months later: I am down 73 lbs, my labs have normalized, and my sleep apnea has improved dramatically. The SUSTAIN-6 to SELECT aspect specifically was something that made a big difference in my journey.
This forum was my go-to resource throughout.
Dr.GastroMayo — that is really helpful context on SUSTAIN-6 to SELECT 12. Follow-up question: did you change anything about your diet at the same time?
I am in a similar situation (month 2) and trying to set realistic expectations.
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Shop Reference StandardsTo answer MarkLI_maint's question specifically:
From a clinical standpoint, SUSTAIN-6 to SELECT 12 month is well-supported by the literature.
The short answer: follow the standard titration protocol and reassess at 4-6 weeks.
The longer answer involves pharmacokinetic considerations around steady-state concentrations, which I am happy to elaborate on if helpful.