Two sessions a week, and the evidence behind the prescription
The older-adult diet-and-exercise trials are the closest analogue to rapid pharmacological weight loss, and they are twenty years old.
Gabriel Ntonga
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34 piecesTolerability is the ceiling, and the ceiling is personal
An effect is dose-limiting when it prevents adequate intake, prevents normal activity, or produces a risk of its own. Discomfort alone is not the test.
What we would need to randomise to answer this properly
One randomised trial has combined a GLP-1 receptor agonist with supervised exercise. Its result is the single most useful piece of evidence in this area.
Percentage of loss, absolute kilograms, and the sleight of hand between them
The trials measured mass. Nobody measured whether the participants got weaker.
Why "muscle-sparing" is a marketing term and not a measurement
Grading six widely repeated claims against the studies actually behind them.
Why "muscle-sparing" is a marketing term and not a measurement
The rule that a quarter of weight lost is lean tissue has been in textbooks for decades and does not survive close reading.
The effect profile, predicted from an expression map
Delayed gastric emptying is a mechanism that becomes an adverse effect above a threshold. It is not a complication in the ordinary sense.
Reflux, early satiety, and the volume the stomach will accept
The receptor populations that produce satiety and the ones that produce nausea overlap substantially. That is why the ceiling of this drug class is where it is, and it is…
Why "muscle-sparing" is a marketing term and not a measurement
The rule that a quarter of weight lost is lean tissue has been in textbooks for decades and does not survive close reading.
Gallstones during rapid weight loss: drug, or weight loss?
Pancreatitis is rare, was adjudicated in the outcome programmes, and did not show the imbalance early case reports suggested.
Escalating onto a rising curve
What the published pharmacokinetics permit, what the labels state, and where the two diverge.
Why "muscle-sparing" is a marketing term and not a measurement
The gap between a defensible recommendation and a confident one is where most of the harm in this subject lives.
Percentage of loss, absolute kilograms, and the sleight of hand between them
A substudy powered to describe a mean is not a substudy powered to detect a clinically meaningful individual change.
The ceiling is a tolerability finding, not an efficacy one
Where the curve flattens, what flattens with it, and what does not.