My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.
Relative versus absolute is the distinction that gets lost: a 20% relative reduction on a high baseline risk is a large absolute benefit, and the same relative figure on a low baseline risk is a small one.
The bit I cannot resolve on my own is how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.
Tell me what I have not thought of.
NurseLeah_Nash said:My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.
6 month update on cardiovascular risk: down 53 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.
Dr.SurgeonPGH said:6 month update on cardiovascular risk: down 53 lbs, off blood pressure meds, A1C normalized.
Metabolic syndrome resolution on cardiovascular risk: I went from meeting 5 of 5 diagnostic criteria to meeting ZERO after 13 months of treatment.
The 5 criteria (and my journey):
- Waist circumference: 52" → 34" ✅ Resolved
- Triglycerides: 260 → 110 ✅ Resolved
- HDL: 36 → 52 ✅ Resolved
- Blood pressure: 140/94 → 118/72 ✅ Resolved
- Fasting glucose: 125 → 88 ✅ Resolved
Metabolic syndrome reversal is, in my view, the most medically significant outcome of GLP-1 therapy.
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View ResultsNurseLeah_Nash said:My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.
Mine went the same way, slower.
Adding the clinical framing, because it changes how the question reads.
NurseLeah_Nash 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.