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Weight loss goals are now disease-driven, not cosmetic 5% minimum meaningful benefit 10% required for most metabolic conditions 15% often needed for OSA, HFpEF, MASH, and severe obesity Medication choice is guided by comorbidities GLP-1 receptor agonists and dual GIP/GLP-1 agents are prioritized in patients with: Prediabetes & type 2 diabetes ASCVD Heart failure with preserved EF Metabolic liver disease Obstructive sleep apnea Cardiovascular outcomes now matter Semaglutide 2.4 mg demonstrated a significant reduction in major cardiovascular events even in people without diabetes