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Evidence-based GLP-1 & peptide discussion since 2023
ForumsPublic SquareI just want to eat pizza again is that too much to ask Page 2

I just want to eat pizza again is that too much to ask

TomFromTexas Fri, Jan 9, 2026 at 4:22 PM 31 replies 1,064 viewsPage 2 of 7
pete_manc_UK
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Jan 9, 2026 at 6:08 PM#6
kate.chem said:
Relative and absolute effects need reading together.

Pushing back on kate.chem here. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

23 18TrialNerd_Beth, HPLC_Greg, LibrarianMeg and 20 others
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DoseLogDan
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Jan 9, 2026 at 6:49 PM#7
TomFromTexas said:
My own curve sits about four points below the published mean and I spent two months assuming that meant something was wrong with me or with my…

Propensity score matching studies and the trial evidence: when RCTs aren't available for a specific question, propensity score-matched observational studies can provide useful evidence.

A recent PSM study of 12,000 GLP-1 users vs matched controls showed reduced MI incidence (HR 0.78) over 3 years of follow-up[1].

These results complement the RCT data and suggest the benefits translate to real-world populations.

References:
[1] Registry-based cohort study, pre-print 2024.
Last edited: Jan 9, 2026 at 7:49 PM
22 17Dr.AddMedPHL, newstart_MO, mia_MS2 and 19 others
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claudia_zurich
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Jan 9, 2026 at 7:30 PM#8
pete_manc_UK said:
I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them.
pete_manc_UK said:
...regarding the trial evidence...

I think this is an underappreciated point. To expand on it with some data:

A recent meta-analysis of 22 RCTs (n=18,900) found that the trial evidence was associated with a consistent effect size across diverse patient populations[1].

The NNT was 20, which is comparable to antihypertensives for stroke reduction. That's a strong clinical argument for this approach.

21 16Dr.LipidDallas, alex_tucson, kevin_tulsa and 18 others
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sophie_paris
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Jan 9, 2026 at 8:11 PM#9

Following on from VanRx_Mike — and this may be the naive question:

How would you tell the difference between that and the alternative explanation?

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TomFromTexas
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Jan 9, 2026 at 11:30 PM#10

OP back with an update, since a thread like this is useless without one.

Update — my curve sits below the published mean and the explanation is that the trial arm had support I do not have. That was reassuring rather than otherwise.

40 15BiostatsBrad, PeptideSynthNJ, Dr.KarenChen and 37 others
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