Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
The narrow version of the question is how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.
Practical detail welcome, however dull — the duller the better.
kate.chem said:Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
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.
DebRD_ATL said:Dizziness and cardiovascular risk: I was lightheaded for the first 3 weeks.
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.
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CRP reduction on cardiovascular risk — this is the lab result that excites me most:
Baseline hsCRP: 7.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 1.5 mg/L (moderate risk)
Month 12 hsCRP: 0.6 mg/L (low risk)
This level of inflammatory marker reduction is comparable to what you'd see with statin therapy. Combined with the weight loss, my 10-year ASCVD risk score dropped from 14% to 4%. My cardiologist is genuinely impressed.