NCT07794579 recruiting 2001 — why bigger than the 3127 obesity trial?

You’re not reading it wrong. NCT06186622 had 50 healthy overweight/obese folks; that smells like an early PK/tolerability cohort. NCT07794579 at 2,001 is a different question entirely.

But different question doesn’t explain why 2,001 for overweight-at-risk when the obesity-with-comorbidities trial has 3,127. Both are big. I’d expect the risk cohort to be smaller.

Maybe endpoint drives n. Progression to class 1 obesity vs weight-related comorbidity outcomes. You can’t compare enrollment without the primary outcome.

I sat in a trial info session last month and the coordinator basically said the same thing about endpoints. They’re not fishing for the same signal. My screening labs were fasting 99 and A1c 5.6, so I got told I was borderline for the overweight-risk category. The 2,001 number actually made more sense after that. Still, I wish the listings showed more than enrollment status.

The pediatric listing NCT06672549 is 125. That feels like the number I’d expect for a focused cohort, not 2,001.

I keep a little note file on these. NCT06584916 completed with 376, NCT06186622 completed with 50, and the two big ones are 3,127 and 2,001. To me that suggests they’re running parallel programs: small early cohorts plus huge confirmatory/prevention ones. The recruiting one might be sized for event-driven endpoints rather than just weight change. Could be totally off, but the numbers aren’t random.

Fourteen weeks into the same spreadsheet habit, and I basically stopped reading enrollment numbers as a signal once I noticed the 50-person one wrapped up in about six months while the giant ones drag on for years — size tracks endpoints and how many extra sites they need to power a secondary outcome, not which version anyone's excited about. What I track religiously is my own boring stuff: Tuesday and Saturday weigh-ins, waist at the navel, and whether my 34-waist jeans need a belt, and I'm down 2.5 inches at week 14 with fasting glucose sitting in the low 90s instead of that 103. The annoying part is nothing budged the first five weeks, then it moved fast enough that I had to rebuy two pairs of pants, which my wallet did not appreciate. Honestly if you're in that overweight-with-risk bucket and shopping listings, I'd ask whether you can actually commit to the visit schedule before you get hung up on the N — a 2,000-person study with clinic trips every few weeks is a part-time job, and a smaller one might fit your life better.

Fourteen weeks of tracking sounds about right, and I'll give you a weird one — my waist is a way better predictor for me than the scale ever was. I'm down about 3/4 inch on the tape since I started paying attention to this stuff, and the scale has been flat for almost three weeks. But my morning fasting glucose has actually ticked up on days after I eat lower carb, which is the opposite of what I expected. I pulled a lab slip just to check because I thought I was imagining it: 112 fasting after a low-carb dinner, versus 98-104 when I have rice or potatoes with dinner. Same sleep, same walk. My GP shrugged and said some of us get a dawn phenomenon spike from the liver dumping glucose when we're running on low glycogen, but I'm curious if anyone else doing all this tracking has seen their fasting number go the wrong direction while their waist keeps shrinking. Are you logging fasting glucose and waist side by side, or mostly leaning on the A1c and scale?

Funny thing is the 50-person listing was the only one I’d have actually cleared—my BMI was 31.4 and A1c 5.9, but the big 3,127 one screened me out because I hadn’t been on a stable BP med for 3 months yet, which I found out after a phone screen and a lot of wasted excitement. That flipped my whole assumption that bigger equals more relevant; the enrollment number tells you almost nothing about whether you fit the exclusion list. My odd pivot was sleep: weeks I averaged 6h15m, my fasting glucose sat 8-10 points higher and my waist stuck at 39.5 inches, but two weeks of 7h30m with the same food and walking moved the tape to 38.25. So now I read the criteria first and the 2,001 target last.