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this could be partly due to differences in baseline BMI and age, because patients with T2D enrolled in trials on obesity show, on average, a lower BMI and a higher age than patients without T2D

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Cancer (2020)

GLP-1 receptor agonists are intended for adults with obesity (BMI 30) or those who are overweight (BMI 27) with associated metabolic conditions such as hypertension, dyslipidaemia, or type 2 diabetes

I would say the primary concern is tolerability

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