Follow-up: History of disordered eating and why it changes the conversation posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
Coming back to post #32, because the follow-up matters more than the original answer.
Reporting rather than recommending, on History of disordered eating. What happened is above. Whether it should have is a different question and not one I am qualified to answer.
Post #32 is right about the mechanism and I think understates the practical bit.
Nothing in this subcategory is medical advice and the questions asked here are precisely the ones that need an individual assessment.
Reporting the observation and leaving the explanation open deliberately.
Taking post #35 at face value and following it one step further.
Medullary thyroid carcinoma history: an absolute contraindication because of the preclinical findings in rodent toxicology. The history (personal or family, especially multiple endocrine neoplasia type 2) is an important screening question.
I read post #35 twice before replying, because I had assumed the opposite.
Being outside the studied population does not mean a treatment is unsafe. It means the usual evidence is not available and the reasoning has to be explicit.
Adding the caveat now so it does not have to be extracted later.
Agreed on all of that, and I have nothing to add to it.
Post #35 put the caveat in the right place and I want to underline it.
Pancreatitis history: the compounds can rarely trigger pancreatitis. A history of pancreatitis makes monitoring for recurrence more important during titration.
Adding this to the thread rather than to the wiki, because I am not confident enough for the wiki.
Collapsed as off-topic by two members at trust level 3 or above
Building on post #39 rather than restating it.
Post-surgical populations, particularly after procedures affecting the gastrointestinal tract, interact with a delayed-emptying mechanism in ways that need specialist input.
I would put this at better than even and not much better.
Everything in post #39 holds. The case it does not cover is the one I have.
Pancreatitis history: the compounds can rarely trigger pancreatitis. A history of pancreatitis makes monitoring for recurrence more important during titration.
The number is defensible. The precision I gave it is not.
The failure mode on History of disordered eating is boring rather than dramatic. It is almost always the step everyone assumes was done correctly because it is too simple to get wrong.
Collapsed as off-topic by two members at trust level 3 or above
The arithmetic in post #44 is right; the assumption feeding it is the part to check.
Since History of disordered eating keeps coming up, it should probably be a maintained page rather than a recurring thread. I am happy to draft it if someone with more direct experience will review it.
Gastroparesis: pre-existing severe delayed gastric emptying can worsen with compounds that slow it further. Discussion with a clinician is prudent if this history exists.
What I can speak to on History of disordered eating is narrow, so I will keep it narrow rather than generalising from it. Beyond that boundary I do not know.
Reading back through, this was answered upthread and I missed it. My fault.
Answering the question post #49 raises rather than the one it answers.
Medullary thyroid carcinoma history: an absolute contraindication because of the preclinical findings in rodent toxicology. The history (personal or family, especially multiple endocrine neoplasia type 2) is an important screening question.
That matches what I was told, which is not the same as knowing it.
The most useful contribution here is usually a citation to whichever published document comes closest, with a plain statement of how far it is from the question.
Adding thanks rather than a view. I do not have a view worth the space.
Being outside the studied population does not mean a treatment is unsafe. It means the usual evidence is not available and the reasoning has to be explicit.
What would change my mind on History of disordered eating is a second dataset collected by someone with no stake in the first. Until then I hold it loosely and I would rather say so than pretend to more.
Post #54 put the caveat in the right place and I want to underline it.
A request rather than an answer: could whoever has the primary source for History of disordered eating post it? I have seen the claim three times this month and each version had lost a qualifier.
Building on post #57 rather than restating it.
Body weight at the extremes of the studied range affects exposure and the trials rarely reported enough to say by how much.
Not the whole picture, but the part of it I can speak to.
On History of disordered eating, the part that usually goes wrong is that the question is asked as though it has one answer. It has a range, and the width of the range is the interesting bit.
If you can post the two or three numbers you are working from, several people here will check the arithmetic rather than argue about the conclusion.
Picking up post #57: that is the part I would want checked first.
I would rather this thread reach "we do not know" about History of disordered eating than reach a confident answer that nobody can support when asked.