Both of these studies are observational and retrospective, meaning they can only show a correlation between GLP-1 use and reduced (or at least less severe) infections, not prove a direct cause-and-effect relationship. At the same time, these are the only latest pieces of evidence pointing to a genuine germ-busting benefit from GLP-1 drugs.
I wonder if the likelihood that people taking a GLP-1 are probably better off financially, have a health care provider willing to spend on the drugs (and therefore probably a better medical system) or a combination of these and other traits are the real reason there are fewer infections.
Unfortunately this is rarely clean. Its also easy to make mistakes. Sometimes two arms are fundamentally incomparable. The quality and rigor of the comparison is often determined by a lot of extra checks and validations, and different journals demand different levels of rigor. I need to read it carefully to judge if this is good or not.
I haven't worked on these designs, but I remember the methodologist that taught me this in grad school giving us a lecture about this.
EDIT: the BMJ article (laudably) provides access to the analyis code, although I won't have time to review it:
github.com/nilskruger/Tirzepatide-and-the-Risk-of-Atherosclerotic-Cardiovascular-Events
Given the size of the dataset, the effect size, significance and sensitivity testing they did I think it’s very strong evidence for GLP1s causing this and it would be very very surprising to me to see the effect disappear even if they had perfect socioeconomic data.
Otherwise, it's just a waste of our time.
(I am not a medical doctor)
(You can look this up regarding biofilms, I just did today.)
If you’re okay with just being probably sure, the price is a lot lower.
The grey-market price from China, is about $100 for 10 x (30mg/mL, 10mL) vials of Tirzepatide. Semaglutide is cheaper.
At the highest dose of 15mg/wk, that's 20 weeks for $100.
Severely cutting calories while staying sedentary trashes the immune system, disrupts hormones, impairs reproductive function, and strips away bone density and muscle?
If this happens to high-performing athletes, there is no reason to believe sedentary folks are immune. The research behind Relative Energy Deficiency in Sport breaks down these exact mechanisms: https://en.wikipedia.org/wiki/Relative_energy_deficiency_in_...
GLP medications blunt your appetite so you eat less, but you still end up feeling completely drained because your body lacks fuel. The goal should never be just blindly slashing calories. You have to feed your body what it needs rather than solely cutting what it craves, and GLP drugs cannot distinguish between nutrient-dense meals and the junk food binges you are trying to avoid.
They do not fix metabolism, either. Any claimed "metabolic boost" has never been proven beyond a minor 100 kcal increase in resting metabolic rate (RMR). Most people pushing that claim rely on an older study where glucagon raising RMR was merely an interpolation by the authors. To put that in perspective, a 100 kcal bump is less than two slices of bread, which sit around 130 kcal.
Being healthy is not just about avoiding excess body fat. Look at retired sumo wrestlers: they carry significant weight, yet their health markers crater once they stop training while keeping their diet identical. Real body fat reduction requires higher activity levels, but most GLP users fixate entirely on scale weight. Crashing your intake on high doses also sets you up for serious bile and gallbladder complications down the road.
Give it a few years, and we will look back on handing GLP prescriptions to people who are only 10 to 20 kg overweight as a major mistake. You do not have to gorge yourself to gain weight. Dropping into a sedentary lifestyle reduces muscle mass, lowers your RMR, and tanks your daily energy expenditure, pulling your maintenance baseline down with it. Once your maintenance drops, running a tiny surplus of just 100 kcal a day for four years will easily pack on 20 kg of fat.