My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.
So the question, as narrowly as I can put it: how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.
Happy to be told the question itself is wrong.
pete_manc_UK said:My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.
Metabolic syndrome resolution on cardiovascular risk: I went from meeting 4 of 5 diagnostic criteria to meeting ZERO after 12 months of treatment.
The 5 criteria (and my journey):
- Waist circumference: 51" → 35" ✅ Resolved
- Triglycerides: 277 → 117 ✅ Resolved
- HDL: 35 → 59 ✅ Resolved
- Blood pressure: 147/91 → 120/74 ✅ Resolved
- Fasting glucose: 127 → 87 ✅ Resolved
Metabolic syndrome reversal is, in my view, the most medically significant outcome of GLP-1 therapy.
PurityPaulOR said:Metabolic syndrome resolution on cardiovascular risk: I went from meeting 4 of 5 diagnostic criteria to meeting ZERO after 12 months of treatment.
SUSTAIN-6 was the first CVOT to show cardiovascular benefit with semaglutide, relevant to cardiovascular risk. In 3,297 T2DM patients with high CV risk: MACE HR 0.74 (95% CI 0.58-0.95, p=0.02)[1].
Notable: the retinopathy signal in SUSTAIN-6 (HR 1.76) was subsequently attributed to rapid A1C reduction in patients with pre-existing retinopathy — not a direct drug effect. This has been confirmed in longer-term follow-up studies.
[1] Marso SP, et al. N Engl J Med. 2016;375(19):1834-1844.
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View Resultspete_manc_UK 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. Nothing to add that would improve it.
From the other side of the consultation, briefly.
6 month update on cardiovascular risk: down 54 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.