Early Benefit: By week 20, MACE rates had already diverged (HR 0.58, 95% CI 0.410.81), suggesting rapid onset of cardioprotective effects, well before maximal weight loss is achieved
The difference comes down to calorie and protein adequacy
Multiple controlled trials using indirect calorimetrythe gold standard for measuring energy expenditurehave demonstrated that GLP-1 therapy does not elevate RMR beyond what would be expected from changes in body composition
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