NNT for MACE prevention — what worked for you?

Dr.KarenChen said:

I want to bring up the cardiovascular angle on cardiovascular risk.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The "earlier than weight loss explains" argument is weaker than this thread makes it sound. Blood pressure and inflammatory markers move fast and are downstream of early weight loss, so the mechanism is not as cleanly separable as the summaries imply.

That is the short version; the long version is somebody else's post.

Dr.LipidDallas said:

Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

Dr.LipidDallas 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.

sarah.morrison said:

The "earlier than weight loss explains" argument is weaker than this thread makes it sound.

I'm 55 years old and want to share my perspective on cardiovascular risk as an older member of this community.

My doctor was initially hesitant because of my age, but the SELECT trial included patients up to 72 and showed consistent benefit across age groups. We started at the lowest dose with closer monitoring.

8 months later: down 55 lbs, off atorvastatin, A1C from 7.0% to 5.4%. My cardiologist is thrilled. cardiovascular risk is absolutely relevant for older adults — don't let anyone tell you otherwise.

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

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

CarlaRPh_TPA said:

I'm 55 years old and want to share my perspective on cardiovascular risk as an older member of this community.

6 month update on cardiovascular risk: down 51 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.