Clinical perspective, offered as context rather than as advice.

anders_CPH 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.

DebRD_ATL said:

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

Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history. Results were encouraging:

• NT-proBNP: 60 pg/mL (normal, cardiac function preserved)
• Lp(a): 40 nmol/L (genetic, unchanged — expected)
• ApoB: dropped from 135 to 85 mg/dL (excellent response)
• Coronary calcium score: 0 (unchanged from baseline — reassuring)

The ApoB reduction is particularly meaningful — it's considered the best single predictor of cardiovascular risk. GLP-1 therapy seems to improve this consistently.

DebRD_ATL said:

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

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.

DebRD_ATL said:

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

This answered a question I did not know how to ask. Adding it to my notes with a link back to this thread.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Carry on.