My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.
The bit I cannot resolve on my own is 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.
DataDave 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.
Dr.RenalNash said:Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 →…
Mendelian randomization evidence supporting GLP-1 pathway modulation for cardiovascular risk: genetic variants in the GLP1R gene region associated with lower BMI also show associations with reduced cardiovascular risk, confirming a causal pathway[1].
This "natural experiment" (people born with genetically higher GLP-1 signaling being leaner and healthier) provides orthogonal evidence supporting the pharmacological approach. When genetic epidemiology, clinical trials, and mechanistic studies all converge, confidence in the therapeutic approach is high.
[1] Zheng SL, et al. Lancet Diabetes Endocrinol. 2023;11(12):869-879.
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View ResultsDataDave said:My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.
Can confirm. Same sequence, different timescale. Nothing to add that would improve it.
From the other side of the consultation, briefly.
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, -2.3 lbs/week average
Fasting glucose (finger stick): stable at 82 mg/dL
Blood pressure (home): 118/72 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.