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What to Expect in Months 7-11 Essentially no side effects: Appetite suppression continues (desired effect), but GI symptoms gone Weight loss velocity slows: From 0.8kg/week (months 3-6) to 0.3-0.5kg/week Plateau around week 40-48: Weight stabilizes, no longer losing despite continued medication Total weight loss: Average 20-24% from baseline (matching or exceeding surgical outcomes) Focus shifts to maintenance: Accepting current weight, preventing regain Plateau frustration: Not a side effect but an emotional challenge 2 Final Strategies for Months 7-11 20

Methotrexate was continued through the course of the trial, and the clinical response was the same in patients with or without concomitant methotrexate use (Figure 7-12)

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