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Bottom line: these drugs overpromise and can make medium-term weight gain worse if you stop (which half of people do within a year in real-world data)

Metformin targets Foxo1 to control glucose homeostasis

ACS Chemical Biology

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Ideally incorporate rigorous baseline and follow-up assessments: DEXA, body composition, visceral fat, renal function, endocrine panels, inflammatory biomarkers (IL-6, TNF-, SASP markers if available)

The American College of Rheumatology (ACR) recommends early aggressive therapy to prevent irreversible joint damage and achieve remission or low disease activity using a treat-to-target approach with regular monitoring of disease activity measures