Has anyone dealt with select trial: 20% mace reduction?

Clinical perspective, offered as context rather than as advice.

lisa_labSD 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.

pete_nash said:

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

This matches mine closely enough to be worth saying so out loud. Posting only so the count is not one.

pete_nash said:

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

Adding the part of the answer the thread has not reached. The gap between trial results and real-world results is consistent and it is not fraud. Trial participants get titration by protocol, scheduled contact, free drug and dietetic support; removing that infrastructure costs a few percentage points every time it has been measured. When your own curve sits below the published mean, that is the likeliest explanation before anything about you or your material.

pete_nash said:

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

Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling, reduces NLRP3 inflammasome activation, and decreases monocyte/macrophage adhesion to endothelium[1].

Clinical correlates: hsCRP reduction of 30-60% (consistently seen across trials), reduced carotid intima-media thickness, and decreased coronary plaque inflammation on PET imaging.

These anti-inflammatory effects likely contribute to the cardiovascular benefit seen in SELECT — and may explain benefits beyond what weight loss alone would predict.

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

How would you tell the difference between that and the alternative explanation?