SELECT trial explained: does semaglutide reduce cardiovascular risk because of weight loss, or is something else going on? In this video, I break down the SELECT trial and the follow-up analysis examining whether the cardiovascular benefit of semaglutide was directly mediated by weight loss. The answer matters, because the data suggest the reduction in major adverse cardiovascular events was not simply a function of people losing more weight.

I’m a board-certified vascular surgeon focused on cardiometabolic prevention, and in this video I walk through what the SELECT trial actually showed, what the subsequent analysis adds, and why this changes how we think about GLP-1 receptor agonists, obesity, heart disease, and prevention. If you’ve been wondering whether semaglutide’s heart protection is just about the number on the scale, this is where we separate mechanism from marketing.

In this video, I cover:
• The SELECT trial design and main cardiovascular outcomes
• How semaglutide affected heart attack, stroke, and cardiovascular death risk
• The follow-up mediation analysis on weight loss
• Why the cardiovascular benefit does not appear to be explained by weight loss alone
• What this may mean for inflammation, metabolism, and vascular protection
• How I think about semaglutide clinically in the bigger picture of cardiometabolic health

If you care about semaglutide, GLP-1 drugs, cardiovascular disease prevention, obesity medicine, insulin resistance, plaque, and the real mechanisms behind cardiometabolic risk reduction, you’re in the right place.

Question for you: when you think about semaglutide, do you mainly think “weight loss drug,” or has the cardiovascular data changed your view?


Sign up for more information on my own practice here: https://corsighthealth.com/

High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start

Other tools for optimal health (note these are affiliate links):
Home BP Cuff: https://amzn.to/49Cq7rh
Sonicare Toothbrush: https://amzn.to/3KllfMS
WaterPik: https://amzn.to/4894Xi8
Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d
Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS
Intake Breathing Nasal Support: https://amzn.to/48dfQQ1
Personal Blender: https://amzn.to/4pyNGGl
True Nutrition Protein: https://oken.do/q2xzqeqw
Glass Meal Prep Containers: https://amzn.to/4ocEPJ2
Sleep Mask: https://amzn.to/48fSJV5
Air Purifier: https://amzn.to/4puzTQZ

___________________________
🧬 About Dr. Lily Johnston

Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

#MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #minnesota

When people hear “poor circulation,” they often assume the answer is a procedure. Not so fast. In this episode of Knife Down, Dr. Jacqueline Majors and I talk about when opening a blocked artery helps, when it backfires, and why the real work of saving legs often starts long before the operating room.

We get into what patients with poor circulation, blocked leg arteries, leg pain with walking, smoking-related vascular disease, and diabetes actually need to know. We talk about when a procedure helps, when it can make things worse, why not every blockage should be opened, and how lifestyle change, medical therapy, and careful decision-making can sometimes save a limb better than another stent.

We also talk about what vascular surgery training gets right and what it misses, how Dr. Majors built a limb salvage-focused private practice, why strength training matters for vascular patients, and how to help people make meaningful changes without shame, perfectionism, or all-or-nothing thinking.

Dr. Jacqueline Majors, MD is a board-certified vascular surgeon, Co-Owner, and Director of Limb Salvage at Zenith Vascular & Fibroid Center in Memphis, Tennessee. She is CEO of Vascular Excellence, PLLC, a consulting firm spanning expert witness work and locum tenens. She is also Founder and CEO of AnatomyPad, a patient education and operative planning product. She has performed multiple first-in-state procedures in Tennessee, including absorbable stents, retrievable BTK stents, advanced thrombectomy, and intravascular lithotripsy.

Dr. Majors is a two-time Castle Connolly Top Doctor and multiple Top Doctor in Tennessee award recipient. She serves as an industry KOL, speaking nationally on drug-coated balloon therapy, intravascular lithotripsy, carotid disease, and limb salvage. She hosts Center of Excellence courses in Memphis, is the Vice Chair of the Young Physicians Association for the Tennessee Medical Association, and serves on the Board of the Memphis Medical Society.

A former Division I athlete and nationally licensed soccer coach, she brings that same discipline to medicine, business, and patient care. Her philosophy: excellence is not an outcome. It is a discipline.

Find Dr. Majors here:
https://www.instagram.com/zenithmemphis/
https://www.linkedin.com/company/zenith-memphis/
https://www.facebook.com/zenithmemphis

This episode is for education only and is not personal medical advice. If you have symptoms of poor circulation, a nonhealing wound, rest pain, or concern for blocked arteries, please talk with your own physician.

Chapters
00:00 Introduction
00:18 Why prevention matters in vascular surgery
04:07 Nutrition, sleep, stress, and the athlete mindset
08:07 Why she chose vascular surgery
10:57 Talking to patients about new procedures
14:13 What vascular training misses about lifestyle
16:43 Nutrition philosophy: from “eat healthy” to low-carb Mediterranean
22:38 Patient stories: saving limbs without rushing to procedure
27:12 Why not every blocked leg artery should be fixed
31:24 Why poor circulation is underrecognized
34:35 Building a limb salvage-focused private practice
43:24 Social media, physician education, and the modern doctor
49:59 How Dr. Majors approaches food, exercise, and habit change
57:05 Walking, strength training, and insulin resistance
01:01:00 Helping patients who aren’t ready to change
01:05:44 Smoking, diabetes, and whether all plaque is the same
01:08:05 What medical management vascular surgeons should own
01:11:34 How to get screened for poor circulation
01:13:53 The top 3 ways to prevent blocked leg arteries
01:15:15 Favorite procedures, resources, and AnatomyPad
01:19:30 Where to find Dr. Jacqueline Majors

Sign up for more information on my own practice here: https://corsighthealth.com/

High Quality 3rd-party tested suppl

Are supplements safe? Not automatically. In this video, I explain why supplements are really drugs, why the industry has so little oversight, which products worry me most, and how I think about using supplements more safely in real life.

I’m a board-certified vascular surgeon specializing in cardiometabolic prevention, and I do use supplements in practice — but in a targeted, evidence-informed way. Here I walk through the biggest myths about supplements, the real risks people ignore, the categories I side-eye hardest, and the framework I use to help patients choose products that are actually worth taking.

If you’ve ever assumed that “natural” means safe, that a big retailer means quality, or that more supplements must mean better health… this one’s for you.

Disclosure: Some links in this description may be affiliate links, which means I may earn a small commission at no extra cost to you. I only recommend sources I trust.

➡️ Search for NSF sport certification here: https://www.nsfsport.com/certified-products/
➡️ Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start

If this video helped you, please subscribe and share it with somebody whose supplement cabinet is starting to look a little wild.

Chapters
0:00 Supplements are drugs
1:22 What makes a supplement different from a prescription drug
4:21 Myth #1: Supplements are more noble than Big Pharma
6:24 Myth #2: Over-the-counter means safe
9:01 Myth #3: Big retailers mean high quality
10:38 Why I still use supplements in practice
13:56 The right way to use supplements
16:17 Who should not self-prescribe supplements
17:23 How I choose safer, better-tested supplements
19:17 The highest-risk supplement categories
19:57 How to verify a supplement is actually helping
21:06 Why I use Fullscript

Other tools for optimal health (note these are affiliate links):
Home BP Cuff: https://amzn.to/49Cq7rh
Sonicare Toothbrush: https://amzn.to/3KllfMS
WaterPik: https://amzn.to/4894Xi8
Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d
Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS
Intake Breathing Nasal Support: https://amzn.to/48dfQQ1
Personal Blender: https://amzn.to/4pyNGGl
True Nutrition Protein: https://oken.do/q2xzqeqw
Glass Meal Prep Containers: https://amzn.to/4ocEPJ2
Sleep Mask: https://amzn.to/48fSJV5
Air Purifier: https://amzn.to/4puzTQZ

___________________________
🧬 About Dr. Lily Johnston

Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

#MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota