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It tracks closely with the metabolic deterioration that characterizes the third and fourth decades of life: rising fasting insulin, expanding visceral adipose tissue, declining mitochondrial density in skeletal muscle, and blunted exercise adaptability

Insurance Coverage Predictions CagriSema (Advantage: Semaglutide Component): Leverages Wegovy's established coverage "Combination of proven medication + new molecule" easier sell to insurers Predicted coverage: 50-60% of commercial plans initially Retatrutide (Challenge: Novel Molecule): Entirely new drug class, no established coverage Higher efficacy but also higher side effects Will likely require trial-and-failure of cheaper options Predicted coverage: 40-50% of commercial plans initially Clinical Trial Populations and Indications CagriSema: Diabetes Focus REDEFINE-1: Obesity without diabetes (3,417 participants) REDEFINE-2: Obesity WITH type 2 diabetes (1,206 participants) REIMAGINE Program: Additional diabetes-focused trials Advantage: Strong diabetes data positions CagriSema for dual obesity + diabetes indications, like tirzepatide (Mounjaro/Zepbound)