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### The STEP 5 Study: Long-Term Adherence The STEP 5 two-year extension study (*Nature Medicine*, 2022) showed: - Patients who maintained consistent dosing for 2 years sustained an average weight loss of 15.2% - Adherence was the strongest predictor of long-term success - Patients who missed occasional doses (but did not discontinue) still achieved meaningful results - The difference between "perfect" adherence and "good" adherence (missing 12 doses per quarter) was relatively small **Key takeaway**: Don't panic about occasional missed doses

Step 3: Receive at home

Patients with gastroparesis are characterized by nausea with or without vomiting, and often also similar symptoms as in FD, with a significantly delayed gastric emptying in the absence of mechanical obstruction

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