Hormonal
Intentional weight loss via GLP-1 receptor agonists (liraglutide, semaglutide) and SGLT2 inhibitors (empagliflozin) reduces cardiovascular events and mortality in type 2 diabetes patients, contradicting the 'obesity paradox' which suggests higher BMI is protective.
If you have Type 2 Diabetes, medications like GLP-1 agonists (e.g., liraglutide, semaglutide) or SGLT2 inhibitors (e.g., empagliflozin) are proven to help your heart and reduce weight. Do not rely on the 'obesity paradox' to justify carrying excess weight; these drugs actively reduce cardiovascular risk and mortality.
Recent cardiovascular (CV) outcome trials of treatments for type 2 diabetes mellitus (T2DM) including Glucagon like peptide -1 (GLP-1) receptor agonists and Sodium-glucose co-transporter-2 (SGLT2) inhibitor have shown beneficial effects on both CV outcomes and body weight.
Why this rating
Based on large-scale, randomized, double-blind Cardiovascular Outcome Trials (CVOTs) like LEADER, SUSTAIN-6, and EMPA-REG.
Source
Can we reconcile ‘the obesity paradox’ with recent cardiovascular outcome trials in diabetes?
Andrew C. Jamieson et al. · Clinical Obesity · 2017
DOI 10.1111/cob.12217
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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