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These combined mechanisms underpin their efficacy for both weight reduction and cardiometabolic protection ( In recent years, the remarkable efficacy of tirzepatide, a dual GIP/GLP-1 receptor agonist, has emerged ( However, these benefits are accompanied by concerns about side effects, cost, long-term sustainability and, above all, the loss of lean mass, which may be mitigated by concurrent exercise ( Exercise and lifestyle interventions remain foundational for obesity and metabolic disease management, offering broad health benefits, but are often limited by adherence and modest long-term weight loss ( Recent randomized controlled trials and meta-analyses suggest that combining GLP-1RAs with exercise may yield additive or synergistic effects on weight loss and metabolic syndrome severity as well as on oxidative stress and inflammation

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p = 0.002) and lowered NT-proBNP concentration throughout (HR: 0.85

Study variability Many of the studies assessed were of relatively low quality (case studies or small study groups) and were therefore underpowered, and potentially had selection biases due to unmeasured confounders

Risk of bias was rated low for the RCT in most domains [14]

Kidney Outcomes with Glucagon-Like Peptide-1 Receptor Agonists Versus Other Glucose-Lowering Agents in People with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Real-World Data