SOUL trial preliminary data — November 2025

BariatricNurseD said:

Relative and absolute effects need reading together.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

JenMemphis said:

My own curve sits about four points below the published mean and I spent two months assuming that meant something was wrong with me or with my…

Propensity score matching studies and the trial evidence: when RCTs aren't available for a specific question, propensity score-matched observational studies can provide useful evidence.

A recent PSM study of 18,000 GLP-1 users vs matched controls showed reduced all-cause mortality (HR 0.81) over 4 years of follow-up[1].

These results complement the RCT data and suggest the benefits translate to real-world populations.

mike.trainer_LA said:

I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them.

Forest plot interpretation for the the trial evidence meta-analysis: when reading the pooled estimate, pay attention to:

1. Point estimate (HR/RR/OR) — center of the diamond
2. Confidence interval width — precision of the estimate
3. I² statistic — heterogeneity across studies
4. Individual study weights — are results driven by one large trial?
5. Prediction interval — range of plausible true effects in future settings

The the trial evidence meta-analysis shows a pooled RR of 0.80 (95% CI 0.65-0.90), I²=38%. This is a robust and consistent effect.

A narrower follow-up, since the general answer is now clear:

What would you measure differently if you were starting again?

OP back with an update, since a thread like this is useless without one.

Follow-up: I read the paper rather than the summary and the qualifier I was missing was in the second paragraph of the results.