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However, the appetite suppression and GI side effects often outweigh potential benefits in patients with poor nutritional status or active disease, requiring careful risk-benefit assessment

For example, a prospective study of CVD in a multiethnic cohort of 4,014 individuals from six US communities, aged 45-84 years and free of clinical CVD at enrolment, recruited between 2000 and 2002, found that discrimination of the ACC/AHA PCE was suboptimal in MASLD (c-statistic 0.69), especially in moderate-to-severe steatosis (0.65), while calibration was poor and largely driven by overestimation in the highest-risk groups [17]