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These include potentially inappropriate application of effects observed in populations with high cardiovascular risk in more general populations with type 2 diabetes, and risking double counting of benefits in modeling analyses where changes in surrogate physiological parameters that affect the incidence of cardiovascular complications (such as HbA1c, blood pressure, serum lipids and BMI) have already been applied (as the mechanisms of action behind the benefits observed in CVOTs are not yet understood) [55, 56]

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They also concluded: As obesity is a chronic and relapsing condition, prolonged treatment with weight management medications may be required to sustain the health benefits