Just wanted to say — for anyone reading this US-based vendors thread who is feeling discouraged: it gets better. The first few weeks are the hardest. Hang in there. 💪

InsuranceTom's experience with US-based vendors charge resonates deeply with mine. I went through almost the identical process — starting dose, titration timeline, side effects, everything.

The main difference: I titrated faster. But the overall trajectory has been remarkably similar. Down 64 lbs in 9 months.

One thing I would add that InsuranceTom did not mention: the relationship with food fundamentally changed.

Saving this for reference. Quality thread.

As a healthcare provider, I want to add some clinical context to this discussion on US-based vendors charge 4-5x more are.

Building on what InsuranceTom said — the evidence base here is well-established. The key publications to reference are from the SURMOUNT program[1].

Key clinical points:

1. Efficacy is dose-dependent and typically requires 4-5 weeks to reach steady state
2. Side effect profile is predictable and usually manageable with standard protocols
3. Monitoring should include baseline labs and follow-up at 3-month intervals
4. Patient education significantly improves outcomes and adherence

Standard disclaimer: this is educational, not individualized medical advice.

Subscribing to this thread. US-based vendors charge is exactly what I've been researching. 🙏