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.
What I am trying to establish is how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.
If the honest answer is that nobody knows, that is a useful answer and I would rather have it.
james_edin said:My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.
Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 → elevated homocysteine → increased cardiovascular risk marker.
The connection: B12 is a cofactor for homocysteine metabolism. Without adequate B12, homocysteine accumulates. This is ironic — taking a CV-protective medication while developing a CV risk factor from reduced nutrition.
Solution: comprehensive vitamin supplementation and regular lab monitoring. Don't let the medication's benefits be undermined by nutritional deficiencies.
DataDave said:Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 →…
Continuous metabolic monitoring dashboard for cardiovascular risk — I track everything in a spreadsheet and here's the month-over-month trend for my key markers:
Weight: consistent downtrend, -1.5 lbs/week average
Fasting glucose (finger stick): stable at 82 mg/dL
Blood pressure (home): 115/72 average
Resting heart rate: 62 bpm (down from 78)
Waist circumference: down 12 inches total
The resting heart rate improvement correlates with cardiovascular fitness gains. Everything is moving in the right direction.
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Browse GL Biochemjames_edin 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. I had assumed I was the exception until I read this.
Clinical perspective, offered as context rather than as advice.
james_edin said:...cardiovascular risk is just another fad...
I understand the skepticism — we've all seen "miracle" weight loss solutions come and go. But consider what makes GLP-1 agonists different:
- Phase 3 RCTs with thousands of participants (not 20-person pilot studies)
- Published in NEJM, JAMA, Lancet (not press releases)
- Replicated across multiple independent research groups
- Proven cardiovascular and renal benefits beyond weight loss
- Biological mechanism fully characterized at the receptor level
This isn't a fad — it's a new drug class supported by the highest level of clinical evidence. The comparison to past fads is understandable but inappropriate.