Each week, Weight & Measure highlights studies worth your attention, explains their findings, and puts their limits into plain language.
Earlier diabetes care may improve the chance of remission after metabolic & bariatric surgery
A study published October 20 in Diabetes Care offers an important look at the long-term relationship between metabolic & bariatric surgery and type 2 diabetes remission. Researchers analyzed outcomes from 262 people who had participated in randomized trials comparing metabolic & bariatric surgery with medical and lifestyle management. Over a median follow-up of 11 years, 58% of participants assigned to surgery experienced diabetes remission at some point, compared with 3% assigned to medical and lifestyle care. The researchers also identified characteristics associated with a greater likelihood of remission. People who had lived with diabetes for a shorter period and those who were not using insulin before treatment were more likely to experience remission. That finding reinforces an important conversation about access to comprehensive obesity care. Waiting until diabetes has progressed may reduce the likelihood of achieving remission, even when effective treatment becomes available.
There are important limitations. Remission was not necessarily permanent, and some participants experienced a return of diabetes after initially achieving remission. Additionally, the medical treatments available during the original trials differ from today’s options, including newer obesity management medications. The findings support discussing treatment options earlier, but they do not mean surgery is the appropriate choice for every person living with obesity and type 2 diabetes.
Worth reading: Original peer-reviewed study ↗ · Related Weight & Measure guide →
CagriSema showed substantial weight reduction in women during perimenopause
New findings presented at The Menopause Society’s annual meeting are raising questions about how obesity treatment may intersect with different stages of menopause. In a post hoc analysis of the phase 3 REDEFINE 1 trial, investigators examined weight reduction among women receiving investigational CagriSema, a combination of cagrilintide and semaglutide. After 68 weeks, researchers reported estimated average weight reductions of 26.7% before menopause, 24.8% during perimenopause, and 23.1% after menopause. The corresponding placebo reductions were 2.1%, 1.7%, and 2.6%, respectively. These findings matter because perimenopause can bring changes in body composition, weight distribution, and metabolic health, yet reproductive life stage is often overlooked in conversations about obesity treatment. For people navigating both obesity and perimenopause, the results provide a reason to ask whether treatment responses, nutritional needs, and long-term outcomes should be studied more carefully across different stages of reproductive life.
These are preliminary conference findings, not a peer-reviewed publication of the menopause subgroup analysis. Menopause categories were assigned after the original trial using available information rather than prospectively confirmed at enrollment. The analysis also did not establish that differences between menopause stages were statistically meaningful. The reported percentages should not be interpreted as proof that CagriSema works better before, during, or after menopause. CagriSema remains investigational, and these results should be viewed as encouraging questions for future research rather than established treatment guidance.
Worth reading: Original conference abstract (page 24) ↗ · Related Weight & Measure guide →
What is actually in compounded GLP-1 prescriptions?
A research letter published October 22 in JAMA examined dispensing patterns for compounded GLP-1 medications using prescription monitoring records from Nebraska. The researchers looked at how compounded weight-loss medications were being dispensed, including whether prescriptions were paid for out of pocket, filled across state lines, and formulated with additional ingredients such as vitamin B12. The findings are relevant because compounded medications are not necessarily identical to FDA-approved products, and patients may not always understand exactly what ingredients they are receiving. The addition of vitamin B12 is particularly worth examining. Although some compounded GLP-1 products include B12, the presence of an additional ingredient does not establish that the combination is more effective, better tolerated, or safer than an approved medication. For clinicians and patients, the study reinforces the importance of understanding the specific formulation being dispensed, the source of the medication, and the evidence supporting its use.
The study describes dispensing patterns in one state and cannot establish how frequently similar practices occur nationwide. Nor can prescription records determine whether a particular compounded formulation caused benefits or adverse effects. The research does not demonstrate that all compounded medications are unsafe. Instead, it highlights gaps in transparency and evidence that deserve closer attention as compounded GLP-1 products remain part of the broader obesity treatment conversation.
Worth reading: Original peer-reviewed study ↗ · Related Weight & Measure guide →
What we're watching
Three different research developments point toward a common theme: effective obesity care requires more than looking at a single number on the scale. The diabetes remission study reinforces the importance of treatment timing and long-term follow-up. The CagriSema analysis highlights how much we still need to learn about obesity treatment across reproductive life stages. And the compounded GLP-1 research raises practical questions about medication transparency and patient safety. The strength of the evidence differs considerably: long-term follow-up of randomized trials, a peer-reviewed descriptive analysis, and preliminary conference findings. For Weight & Measure, the perimenopause findings are particularly worth following, without assuming the science has already answered those questions. More science. Less stigma.
Weight & Measure translates obesity science for the people living it. Educational information only, not personal medical advice.