One thing that is still open after Dr.GutHealth’s answer:

What would you measure differently if you were starting again?

NicoleRaleigh said:

6 month update on cardiovascular risk: down 37 lbs, off blood pressure meds, A1C normalized.

Dizziness and cardiovascular risk: I was lightheaded for the first 3 weeks. Root cause was a combination of reduced caloric intake and mild dehydration.

Fix: minimum 80-100oz water daily, don't skip meals even if you're not hungry (eat small protein-rich snacks), and stand up slowly from sitting/lying positions. Also check your blood pressure — GLP-1-induced weight loss can make BP meds too strong, requiring dose reduction.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. No action needed from anybody.

NicoleRaleigh said:

6 month update on cardiovascular risk: down 37 lbs, off blood pressure meds, A1C normalized.

Genuinely useful, thank you. I had the facts and not the framework. Printing the relevant bit and taking it with me.

From the other side of the consultation, briefly.

Positive "side effect" of cardiovascular risk: my blood pressure dropped so much that I'm now off lisinopril entirely! My cardiologist is thrilled.

If you're on BP meds and losing weight on a GLP-1, monitor your BP at home regularly. Hypotension symptoms (dizziness, lightheadedness when standing) mean your BP meds may need reduction. Don't wait for your next scheduled appointment — call your doctor.