Hormonal
Medical weight management (MWM) using older obesity medications and lifestyle modification does not significantly reduce the risk of major adverse cardiovascular events (MACE) compared to usual care in patients with obesity and type 2 diabetes.
If you have obesity and type 2 diabetes, using older weight loss medications (like liraglutide or exenatide) along with lifestyle changes did not significantly lower your risk of major heart events compared to standard care in this study. This does not mean the medication is useless for weight loss, but do not rely on it for heart protection. Newer medications (semaglutide, tirzepatide) might have different outcomes, but for now, focus on sustainable weight loss and managing diabetes.
Among 2,100 patients with class 2 or 3 obesity and T2D seen from 2010 to 2021 in a U.S.-based academic healthcare system, we found no statistically significant differences in MACE risk between those seen in MWM clinics and those receiving UC over a median 3.2-year follow-up.
Why this rating
Retrospective cohort study with propensity score matching; limited by short follow-up (median 3.2 years) and exclusion of newer, more potent GLP-1/GIP agonists.
Source
Major Adverse Cardiovascular Event Outcomes in Patients With Obesity and Type 2 Diabetes Undergoing Medical Weight Management
Nirjhar Dutta et al. · Cureus · 2025
DOI 10.7759/cureus.94070
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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