Dr.BariatricHTX said:

Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 →…

Metabolic syndrome resolution on cardiovascular risk: I went from meeting 3 of 5 diagnostic criteria to meeting ZERO after 11 months of treatment.

The 5 criteria (and my journey):

1. Waist circumference: 50" → 34" ✅ Resolved
2. Triglycerides: 264 → 99 ✅ Resolved
3. HDL: 34 → 56 ✅ Resolved
4. Blood pressure: 144/90 → 122/76 ✅ Resolved
5. Fasting glucose: 129 → 86 ✅ Resolved

Metabolic syndrome reversal is, in my view, the most medically significant outcome of GLP-1 therapy.

matt_MKE said:

Fair, but phase 2 tolerability figures rarely survive contact with phase 3 scale.

Bookmarking. The distinction being drawn above is the one nobody else makes. Taking it to my next appointment.

Dr.BariatricHTX said:

Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 →…

I would rather people stopped quoting the 24% as if it were a licensed outcome. It is a phase 2 result in a few hundred participants with no cardiovascular endpoint and no long-term safety data, and this board has a habit of treating pipeline numbers as settled.

Worth separating that from retatrutide, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

SleepDoc_PDX said:

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

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.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Carry on.