Dr.GutHealth said:

6 month update on cardiovascular risk: down 60 lbs, off blood pressure meds, A1C normalized.

I read this differently from Dr.GutHealth, on substance rather than tone. 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.

Dr.LeslieOBGYN said:

My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

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.

Dr.SurgeonPGH said:

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

Senior perspective on cardiovascular risk: I'm 68 years old and started this journey skeptically. My cardiologist recommended it after years of failed interventions.

14 months later: down 56 lbs, more mobile, pain reduced, medications simplified. My quality of life has improved dramatically. I wish this existed 20 years ago.

To other older adults hesitating: the SELECT trial proved benefit in our age group. You deserve to feel good in your body regardless of age.

One thing that is still open after RickReta_CO’s answer:

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

Dr.Martinez said:

Senior perspective on cardiovascular risk: I'm 68 years old and started this journey skeptically.

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.