ingrid_STO said:Dizziness and cardiovascular risk: I was lightheaded for the first 2 weeks.
Thank you for spelling out the reasoning rather than just the conclusion.
Adding the clinical framing, because it changes how the question reads.
I want to bring up the cardiovascular angle on cardiovascular risk.
The SELECT trial demonstrated a 20% reduction in MACE with semaglutide 2.4mg[1]. This is practice-changing because the CV benefit appears to be independent of the degree of weight loss — suggesting direct vascular and anti-inflammatory mechanisms.
For cardiovascular risk, this means we need to think beyond the primary outcome and consider the cardiovascular implications. The all-cause mortality reduction (HR 0.81) is the most clinically meaningful signal.
[1] Lincoff AM, et al. N Engl J Med. 2023;389(24):2221-2232.
hans_munich said:CRP reduction on cardiovascular risk — this is the lab result that excites me most: Baseline hsCRP: 11.0 mg/L (high cardiovascular risk) Month 6…
hans_munich said:...we don't know the long-term effects of cardiovascular risk...
This is a fair point, and I think intellectual honesty requires acknowledging it. GLP-1 agonists in their current form have ~8-10 years of human exposure data. That's not nothing, but it's not 30+ years either.
However: the risk-benefit calculation should also consider the KNOWN long-term effects of untreated obesity — diabetes, cardiovascular disease, cancer, joint destruction, reduced lifespan by 5-10 years.
Uncertainty about GLP-1 long-term safety vs certainty about obesity consequences. The calculus seems clear to me, but reasonable people can disagree.
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Browse GL BiochemRickReta_CO said:SELECT is the trial that changed the framing of this class, because it was an outcome trial rather than a weight trial: about a 20% relative reduction…
Senior perspective on cardiovascular risk: I'm 70 years old and started this journey skeptically. My internist recommended it after years of failed interventions.
8 months later: down 43 lbs, more mobile, pain reduced, medications simplified. My quality of life has improved dramatically. I wish this existed 20 years ago.
To other older adults hesitating: the SELECT trial proved benefit in our age group. You deserve to feel good in your body regardless of age.
Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. Tagging this one for the weekly digest.