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The need for additional lumbar fusion was associated with both semaglutide use (17.0 % vs. 6.4 %, p < 0.0001) and duration (28.3 % vs. 4.8 %, p < 0.0001).

Surgeons should consider the potential for increased surgical interventions in patients using semaglutide.

Genetic variation within the leptin-melanocortin pathway may predict response to endoscopic interventions and guide personalized treatment selection.

Understanding genetic factors can help tailor obesity treatments to individual patients.

Sitagliptin elicited modest glycemic improvements without substantial alterations in lipid composition.

Sitagliptin may be less effective than semaglutide for lipid management in T2DM patients.

Atherogenic dyslipidemias are a major contributor to ASCVD within the CKM framework.

Recognize and address dyslipidemias in patients with obesity to mitigate cardiovascular disease risk.

Moorehead-Ardelt scores were higher in the bypass group at 2 years but showed no statistically significant differences later on.

Practitioners should note that while bypass may improve certain quality of life metrics initially, this effect may not persist long-term.

Erectile dysfunction (ED) affects up to three out of four individuals with diabetes.

Healthcare providers should be aware of the high prevalence of ED in diabetic patients.

Preliminary reports have raised concerns about a possible association between GLP-1 RA use and erectile dysfunction.

Clinicians should monitor erectile function in patients using GLP-1 RAs.

GLP-1 RA users had a higher incidence of delayed wound healing (18.5% versus 7.5%) compared to nonusers.

Practitioners should monitor GLP-1 RA users for delayed wound healing post-surgery.

GLP-1 RA users had lower seroma rates (4.9% versus 14.0%) compared to nonusers.

Practitioners may consider GLP-1 RAs for potentially reducing seroma formation post-surgery.

GLP-1 RA users had higher rates of type 2 diabetes (55.6% versus 29.5%) compared to nonusers.

Understanding the diabetes status of patients may inform perioperative management strategies.

Microneedle (MN)-based technologies provide a painless drug delivery approach that targets adipose tissue directly, minimizing systemic exposure and reducing the required dosage.

Practitioners may consider MNs as a viable alternative for delivering anti-obesity medications effectively.

The use of nano-based medications through transdermal delivery is important for effective obesity treatment.

Practitioners should consider incorporating nano-based medications for better treatment outcomes.

The goal of management in T2D patients with significant fibrosis is to slow the progression of liver disease and reduce associated clinical events.

Clinicians should aim to adapt therapies to manage liver disease progression in diabetic patients.

There is a significant multiplicative interaction of cardiovascular autonomic neuropathy (CAN) and sex on both mortality outcomes.

Understanding the interaction between CAN and sex can improve risk assessment and management strategies in diabetes care.

Gastrointestinal adverse events (AEs) are common with incretin-based therapies (IBTs), with placebo-subtracted incidences of 5–39% for nausea, −7–39% for diarrhea, 2–31% for constipation, 0–26% for vomiting, and 2–20% for abdominal pain.

Clinicians should be aware of the high incidence of GI AEs when prescribing IBTs.

Most adverse events (AEs) associated with incretin-based therapies (IBTs) are mild or moderate and mainly occur during dose escalation.

Clinicians should monitor patients for mild to moderate AEs, especially during dose increases.

Only 2 out of 41 studies (approximately 5%) reported or assessed dietary intake or evaluated diet changes secondary to GLP-1/GIP RA medication use.

Practitioners should be aware of the lack of dietary assessment in studies involving GLP-1/GIP medications.

The quality of dietary assessment methods used in the studies was categorized as 'poor' and 'acceptable'.

Practitioners should consider the quality of dietary assessment methods when interpreting study results.

The review highlights a major gap in the evidence requiring urgent attention for high-quality research on dietary impacts of GLP-1/GIP medications.

There is a critical need for more rigorous studies to assess dietary changes associated with these medications.

Metabolic adaptation in energy expenditure (adaptive thermogenesis) was unrelated to the energy cost of weight and fat mass gains.

Weight gain responses may not be influenced by changes in metabolic rate during overfeeding.

Injectable pharmacotherapies are effective strategies to manage obesity by targeting metabolic pathways.

Practitioners can consider injectable pharmacotherapies as a viable option for obesity management.

Significant weight loss can lead to aesthetic challenges such as skin laxity.

Practitioners should be aware of potential aesthetic issues in patients after significant weight loss.

GLP-1RA use was associated with increased fracture risk in nondiabetic patients who were overweight or obese (3.05% vs. 2.61%, OR 1.19, CI [1.09 to 1.31]).

Practitioners should consider the increased fracture risk when prescribing GLP-1RAs to overweight or obese nondiabetic patients.

In patients with a BMI ≥40, fracture risk was significantly increased with GLP-1RA use (3.15% vs. 1.91%, OR 1.26, CI [1.04 to 1.52]).

Higher BMI patients may require closer monitoring for fracture risk when prescribed GLP-1RAs.