Dr.RenalNash said:

BethLabQueen said: ...we don't know the long-term effects of cardiovascular risk...

Pushing back on Dr.RenalNash here. The "earlier than weight loss explains" argument is weaker than this thread makes it sound. Blood pressure and inflammatory markers move fast and are downstream of early weight loss, so the mechanism is not as cleanly separable as the summaries imply.

BethLabQueen said:

Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

6 month update on cardiovascular risk: down 37 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.

pete_manc_UK said:

The "earlier than weight loss explains" argument is weaker than this thread makes it sound.

pete_manc_UK said:

...we're creating a generation dependent on cardiovascular risk...

I understand the concern, but consider this analogy: are we "creating a generation dependent on" blood pressure medication? Cholesterol medication? Thyroid medication?

Obesity is a chronic disease with biological drivers. Treating it with medication is no different from treating any other chronic condition. The "dependency" framing implies weakness or moral failure — neither of which is accurate.

If ongoing medication is what keeps someone healthy, that's successful treatment, not dependency.

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

Was that from a primary source or from a summary of one?

jim_asheville said:

pete_manc_UK said: ...we're creating a generation dependent on cardiovascular risk...

NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).

From SELECT trial: MACE at 39 months — 6.5% semaglutide vs 8.0% placebo. ARR = 1.5%. NNT = 67 over 3.3 years.

Compare to established therapies:

These NNTs are clinically meaningful and comparable to accepted cardiovascular interventions.