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Metabolic Resistance Point GLP-1 therapy is most strategically introduced when patients exhibit metabolic adaptations that counteract behavioral interventions: Plateau Effect: GLP-1 should be considered when patients adhering to a caloric deficit and exercise program experience a weight plateau, indicating a reduction in Total Daily Energy Expenditure (TDEE) as a physiological defense

For most adults with newly diagnosed type 2 diabetes without cardiorenal disease, metformin plus lifestyle modification remains initial therapy, with GLP-1 agonists as preferred second-line agents

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2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines