Dr. Dan | Obesity Expert
Dr. Dan | Obesity Expert
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Orforglipron: A Needle-Free GLP-1 Option for Weight Management | Dr. Dan | Obesity Expert
Is Orforglipron the Obesity Weight Loss Breakthrough We've Been Waiting For? Is it better than Rybelsus and Oral Wegovy?
If you need assistance in your journey to reach your weight loss goals, book a consultation with me: calendly.com/drdanconsult/he
Join this channel to get access to perks:
ua-cam.com/channels/nQiofnuXFcloJRoJTsc1FQ.htmljoin
Download my FREE GLP-1/GIP Medication Information Sheet: eepurl.com/gdB2qn
Try my fancy dancy Total Daily Energy Expenditure (TDEE) Calculator: healthevolved.co/tdee-calculator/
Subscribe to the channel: www.youtube.com/@theofficialdrdan?sub_confirmation=1
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I have great news for those who dislike needles or prefer a daily reminder to engage in positive behaviors. There’s a new oral GLP-1 molecule making its way to market called Orforglipron!
Currently, Rybelsus is the only oral GLP-1 available, approved for diabetes management up to a dose of 14mg once daily. Rybelsus contains semaglutide, found in Ozempic and Wegovy, but it’s not yet approved for weight management.
Orforglipron, on the other hand, is a game-changer. It’s an oral nonpeptide GLP-1 receptor agonist that can be taken without regard to food, drink, or other medications. It’s designed to be absorbed easily through the digestive tract, without needing an absorption enhancer like Rybelsus. This makes it much more convenient for daily use.
So, how effective is Orforglipron?
The Phase 2 RCT trial involved 272 participants with obesity, split into groups receiving either 12mg, 24mg, 36mg, or 48mg of Orforglipron daily, or a placebo. Participants received basic counseling on healthy eating and exercise.
The study found that participants, mostly female with an average age of 54, weight of 108.7kg, and BMI of 37.9, saw impressive results. Those on 45mg daily of Orforglipron lost 14.7% of their baseline weight after 36 weeks, and the weight loss trend hadn’t plateaued yet. For reference, this is comparable to results from the OASIS Trial with oral semaglutide at 50mg daily, which led to a 15.1% weight loss after 68 weeks.
Safety-wise, the side effects were typical for GLP-1 receptor agonists: nausea, vomiting, diarrhea, and constipation. Nothing out of the ordinary here.
Orforglipron is a promising new oral GLP-1 RA that might offer a more convenient and potentially more effective option for weight management. Its smaller molecule size might also mean a cheaper alternative, though time will tell.
Thanks for watching and always remember: small tweaks lead to massive peaks!
- Dr. Dan
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Watch my previous videos about how to fight obesity and about the best medicine for weight loss:
▪️ Rybelsus: Oral Ozempic?: ua-cam.com/video/-BWqLrPOuBc/v-deo.html&t
▪️ Watch This Before Taking Mounjaro: ua-cam.com/video/BmkVtGgejhk/v-deo.html
▪️ From Ozempic to Mounjaro: ua-cam.com/video/L9e46iFWwIs/v-deo.html
▪️ Muscle Loss with Ozempic, Wegovy & Mounjaro: ua-cam.com/video/lnEH-v64aG0/v-deo.html
▪️ Managing Nausea from Ozempic, Wegovy and Trulicity!: ua-cam.com/video/3R1Fwhf02LE/v-deo.html
▪️ Ozempic: Stomach Paralysis Update: ua-cam.com/video/MPyROywaM0g/v-deo.html
▪️ Ozempic Paralyzed My Stomach: ua-cam.com/video/tj9thkkN5aM/v-deo.html
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Live in Alberta? Come see me at my Pharmacist-led Obesity Clinic at Apothecare Pharmacy - apothecarerx.ca
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Sign up for my newsletter: eepurl.com/gdB2qn
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Contact Me: healthcare.evolve@gmail.com
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Have questions or need support on your weight-loss journey? Book a consultation with me: calendly.com/drdanconsult/he
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For more about weight loss via habit mastery, visit www.healthevolved.co
Join me on social media:
▪️ theofficialdrdan
▪️ theofficialdrdan
▪️ threads.net/@theofficialdrdan
Disclaimer of Medical Liability. HEALTHCARE EVOLUTION INC. DOES NOT PROVIDE MEDICAL ADVICE. The content of this material is for general informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Reliance on any information provided here is solely at your own risk. Individual medical needs are very different; you should not assume that the information in this document concerning certain courses of treatment or outcomes will apply to you. Rather, you should evaluate your medical condition and make treatment decisions based upon consultation with your physician.
#Obesity #Orforglipron #Wegovy
Переглядів: 1 545

Відео

Bimagrumab and Obesity: Revolutionizing Fat Loss and Muscle Gain | Dr. Dan | Obesity Expert
Переглядів 1,4 тис.16 годин тому
Can Bimagrumab Help You Lose Fat and Gain Muscle? An Obesity Breakthrough! If you need assistance in your journey to reach your weight loss goals, book a consultation with me: calendly.com/drdanconsult/he Join this channel to get access to perks: ua-cam.com/channels/nQiofnuXFcloJRoJTsc1FQ.htmljoin Download my FREE GLP-1/GIP Medication Information Sheet: eepurl.com/gdB2qn Try my fancy dancy Tota...
Wegovy: Weight Loss Benefits vs. Kidney Health Risks | Dr. Dan | Obesity Expert
Переглядів 1,7 тис.14 днів тому
Understanding Wegovy and Kidneys: Protection or Potential Harm? If you need assistance in your journey to reach your weight loss goals, book a consultation with me: calendly.com/drdanconsult/he Join this channel to get access to perks: ua-cam.com/channels/nQiofnuXFcloJRoJTsc1FQ.htmljoin Download my FREE 7-day food journal: eepurl.com/gdB2qn Subscribe to the channel: www.youtube.com/@theofficial...
Why Losing Weight is Difficult with Type 2 Diabetes | Dr. Dan Obesity Expert
Переглядів 91721 день тому
Diabetes and Weight Loss: Why Does Type 2 Diabetes Makes Weight Loss So Challenging? If you need assistance in your journey to reach your weight loss goals, book a consultation with me: calendly.com/drdanconsult/he Join this channel to get access to perks: ua-cam.com/channels/nQiofnuXFcloJRoJTsc1FQ.htmljoin Download my FREE GLP-1/GIP Medication Information Sheet: eepurl.com/gdB2qn Subscribe to ...
Does Wegovy and Increased Insulin Equal Weight Loss?? | Dr. Dan | Obesity Expert
Переглядів 1,7 тис.28 днів тому
Does Wegovy and Increased Insulin Equal Weight Loss?? | Dr. Dan | Obesity Expert
Weight Loss with GLP-1s: Understanding Weight Loss Meds and Strategies | Dr. Dan | Obesity Expert
Переглядів 3,2 тис.Місяць тому
Weight Loss with GLP-1s: Understanding Weight Loss Meds and Strategies | Dr. Dan | Obesity Expert
Wegovy & Weight Loss: Understanding Why Progress Slows Down | Dr. Dan | Obesity Expert
Переглядів 4,4 тис.Місяць тому
Wegovy & Weight Loss: Understanding Why Progress Slows Down | Dr. Dan | Obesity Expert
The 'Healthy' BMI Obsession: Why it Could Be Harmful to Your Health | Dr. Dan | Obesity Expert
Переглядів 1,3 тис.Місяць тому
The 'Healthy' BMI Obsession: Why it Could Be Harmful to Your Health | Dr. Dan | Obesity Expert
Cannabis, Obesity, and Weight Loss: Decoding the Science | Dr. Dan | Obesity Expert
Переглядів 837Місяць тому
Cannabis, Obesity, and Weight Loss: Decoding the Science | Dr. Dan | Obesity Expert
How Effective is Wegovy?: From Trials to Real Life | Dr. Dan | Obesity Expert
Переглядів 2,4 тис.2 місяці тому
How Effective is Wegovy?: From Trials to Real Life | Dr. Dan | Obesity Expert
Unlock Exclusive Access: Join My Inner Circle as an OG YouTube Member!
Переглядів 2042 місяці тому
Unlock Exclusive Access: Join My Inner Circle as an OG UA-cam Member!
How to Safely Come Off Wegovy: Decoding the Transition | Dr. Dan | Obesity Expert
Переглядів 2,9 тис.2 місяці тому
How to Safely Come Off Wegovy: Decoding the Transition | Dr. Dan | Obesity Expert
Can Ozempic Help with Menopausal Weight Gain? Exploring the Evidence | Dr. Dan | Obesity Expert
Переглядів 1,9 тис.2 місяці тому
Can Ozempic Help with Menopausal Weight Gain? Exploring the Evidence | Dr. Dan | Obesity Expert
The Truth About Jardiance for Weight Loss: Does Jardiance Help Lose Weight | Dr. Dan Obesity Expert
Переглядів 8 тис.2 місяці тому
The Truth About Jardiance for Weight Loss: Does Jardiance Help Lose Weight | Dr. Dan Obesity Expert
The Science Behind "Diet Starts Monday": How to Achieve Your Health Goals | Dr. Dan Obesity Expert
Переглядів 7142 місяці тому
The Science Behind "Diet Starts Monday": How to Achieve Your Health Goals | Dr. Dan Obesity Expert
CAGRISEMA: Breaking Down NEW Weight-Loss Solution | Obesity Medicine | Dr. Dan Obesity Expert
Переглядів 4,7 тис.3 місяці тому
CAGRISEMA: Breaking Down NEW Weight-Loss Solution | Obesity Medicine | Dr. Dan Obesity Expert
What You Have to Know About Compounded Ozempic: Watch This Before Taking It | Dr. Dan Obesity Expert
Переглядів 2,9 тис.3 місяці тому
What You Have to Know About Compounded Ozempic: Watch This Before Taking It | Dr. Dan Obesity Expert
The Truth About Ozempic for PCOS Treatment | Dr. Dan | Obesity Expert
Переглядів 4,1 тис.3 місяці тому
The Truth About Ozempic for PCOS Treatment | Dr. Dan | Obesity Expert
NEW Weight-Loss Drug: Retatrutide Revolutionizing Obesity Treatment? | Dr. Dan Obesity Expert
Переглядів 25 тис.3 місяці тому
NEW Weight-Loss Drug: Retatrutide Revolutionizing Obesity Treatment? | Dr. Dan Obesity Expert
Ozempic Made Me Depressed: Update | Dr. Dan Obesity Expert
Переглядів 2,4 тис.4 місяці тому
Ozempic Made Me Depressed: Update | Dr. Dan Obesity Expert
Weight Regain after Wegovy or Zepbound: Unveiling the Truth | Dr. Dan | Obesity Expert
Переглядів 10 тис.4 місяці тому
Weight Regain after Wegovy or Zepbound: Unveiling the Truth | Dr. Dan | Obesity Expert
Why Is Losing Weight So Difficult? - According to Obesity Expert | by Dr. Dan
Переглядів 1,7 тис.4 місяці тому
Why Is Losing Weight So Difficult? - According to Obesity Expert | by Dr. Dan
Should you choose Wegovy? Heart Health and Obesity | Dr. Dan | Obesity Expert
Переглядів 14 тис.4 місяці тому
Should you choose Wegovy? Heart Health and Obesity | Dr. Dan | Obesity Expert
How to CORRECTLY set a weight loss goal in 2024 | Dr. Dan | Obesity Expert
Переглядів 1,8 тис.5 місяців тому
How to CORRECTLY set a weight loss goal in 2024 | Dr. Dan | Obesity Expert
Weight Loss Drugs 2024: What to Expect in the Obesity Medicine Space | Dr. Dan Obesity Expert
Переглядів 2,9 тис.5 місяців тому
Weight Loss Drugs 2024: What to Expect in the Obesity Medicine Space | Dr. Dan Obesity Expert
This is the Best Drug for Weight Loss in 2024 | Dr Dan | Obesity Expert
Переглядів 6 тис.6 місяців тому
This is the Best Drug for Weight Loss in 2024 | Dr Dan | Obesity Expert
How to Inject Mounjaro: step-by-step tutorial | Dr. Dan | Obesity Expert
Переглядів 23 тис.6 місяців тому
How to Inject Mounjaro: step-by-step tutorial | Dr. Dan | Obesity Expert
Weight Fluctuations: Why it's happening and what to do? Dr. Dan | Obesity Expert
Переглядів 1,2 тис.6 місяців тому
Weight Fluctuations: Why it's happening and what to do? Dr. Dan | Obesity Expert
How to Switch from Ozempic (or Wegovy) to Mounjaro | Dr. Dan | Obesity Expert
Переглядів 13 тис.6 місяців тому
How to Switch from Ozempic (or Wegovy) to Mounjaro | Dr. Dan | Obesity Expert
Watch This Before Taking Mounjaro | Dr Dan | Obesity Expert
Переглядів 102 тис.7 місяців тому
Watch This Before Taking Mounjaro | Dr Dan | Obesity Expert

КОМЕНТАРІ

  • @willtj24
    @willtj24 13 годин тому

    Can you take this if you are on 2mg ozempic?

  • @beardy7124
    @beardy7124 13 годин тому

    Hoping to start this soon since my insurance wont cover my Wegovy any more.

  • @xb3330
    @xb3330 14 годин тому

    I can only get saxenda approved by insurance. Is ozempic better because it’s continuos action? I can’t find any videos explaining why ozempic is better? Is the sexanda mechanism the exact same on pancreas/liver?

  • @DennisBolanos
    @DennisBolanos День тому

    “The bad news is these drugs aren’t getting any easier to pronounce.” LMFAO. 🤣

  • @pinkcrystals535
    @pinkcrystals535 День тому

    Thanks!

  • @Aki-wq6xh
    @Aki-wq6xh День тому

    I love your work and channel ❤ So, I live in Asia and ppl here will do anything for weight loss and regulation is super loose. I saw a (highly unethical , but common practise here alas) company promoting THREE Rybelsus a day for patients. And loads of ppl commented to say it works etc. So they are suggesting ppl take one before each meal on an empty stomach. I doubt they even stress that 30 mins thing enough but … Yup. I wonder what you think 😅

  • @embemw
    @embemw День тому

    I gave up after 2 weeks as I felt so nauseated and cold for 2 weeks.

  • @Spatoes
    @Spatoes День тому

    Thank you 🙏🥰🥰🥰

  • @embemw
    @embemw День тому

    So awful! Saxenda made me feel nauseated all day for 2 weeks until I stopped taking it. Just not worth it.

  • @johnlee-fg8ij
    @johnlee-fg8ij День тому

    Thank you for the update. Excellent as usual. I don’t have any trouble with using a needle. Like many people, my main trouble is accessing the drug. And knowing that there is some continuity of supply. It can be stressful. It’s also very difficult when I can’t get the drug and have to go on half strength until it’s available. Weight gain is almost inevitable as the munchies reallykick in.

    • @suzyqb1975
      @suzyqb1975 День тому

      I hear ya, I have faced the same obstacles. Now with Wegovy and other drugs coming out, hopefully this won’t be an issue. I’m happy that I maintained on a lower dose, but looking forward to getting the scale moving again

  • @KatrinaTrys
    @KatrinaTrys День тому

    First I want to say you are an amazing teacher!!! Second, subbed for the blunt honest! Fuck it 😂😂 THIS issss me!!

  • @KatrinaTrys
    @KatrinaTrys День тому

    Exactly what i was looking for before i speak to my dr .. Would it be wise to use the same dosage but every other week?

  • @gretchengriffith1718
    @gretchengriffith1718 День тому

    I think I made a mistake with the first dose and didn't get the medicine. I only turned one click. Should I retake the first dose?

  • @dancepassion4life
    @dancepassion4life 2 дні тому

    Is this still relevant for PCOS + Mounjaro? Since Mounjaro is a GP-1 and GIP?

  • @tinalee6038
    @tinalee6038 2 дні тому

    Since these 2 drugs can be split in half, why can’t contrave? I keep reading not to do this as it’s time released, is this true of naltrexone and bupropion?

    • @theofficialdrdan
      @theofficialdrdan 2 дні тому

      Technically yes the naltrexone component is sustained release with Contrave. It can still be used as an individual ingredient. We may just dose TID for some, but the immediate release commercially availble formulation still works well

  • @MrSuperconnecticut
    @MrSuperconnecticut 2 дні тому

    Ozempic doesn’t work for emotional eaters.

    • @theofficialdrdan
      @theofficialdrdan 2 дні тому

      Most eating is emotional to some degree. It can certainly work for people in this regard. It depends what is the underlying driver of the emotions and comorbid conditions.

    • @MrSuperconnecticut
      @MrSuperconnecticut 2 дні тому

      @@theofficialdrdan in my case, I tried Mounjaro and Ozempic. It made me feel full and nauseous if I ate but my stress eating desire stayed the same. So I vomited like crazy and was more anxious because I couldn’t eat. Turns out contrave is a much better fit for me at least and for a lot of people I know that has this stress eating disorders.

  • @PyrrhicPax
    @PyrrhicPax 2 дні тому

    My physician just tells me to eat less and exercise more...but the dietician said I have one of the healthiest diets he's ever seen, and I often work over 12 hour long shifts on my feet, so I'm too tired to workout outside work. In addition, my brother, father, AND grandfather are clinically obese, so my family has a history of male obesity. Still, my doctor insists my over 300lbs body weight is "due to not being active enough".

  • @kimbe910
    @kimbe910 2 дні тому

    👌🏽

  • @Teresa-pv9zq
    @Teresa-pv9zq 2 дні тому

    Why though if people are just trying to loose weight they cant just exercise and eat better. Eventually youd have to anyway. Exercise can be invigorating for the mind as well. The doctors are getting kickbacks off medications.

  • @Spatoes
    @Spatoes 3 дні тому

    Thank you 🙏🥰

  • @bloodkoi
    @bloodkoi 3 дні тому

    We need more people like this on youtube

  • @cazsoccerrox
    @cazsoccerrox 3 дні тому

    I live in SWFL. thanks for showing a visual chart of where I can inject myself. Most of the other videos I’ve been seeing have not been helpful at all. Greatly appreciate it!

  • @mbredline7603
    @mbredline7603 3 дні тому

    Started at 230, over 7-8 months lost to 180. Stopped taking the shot. Lost down to 175 over the first month after stopping. Maintained 175 for the next month. I completely changed my lifestyle, started eating better, started exercising 4-5 days a week.

  • @yudithvazquez6160
    @yudithvazquez6160 3 дні тому

    Why can we stay at .25 ?

  • @laurahodgson6531
    @laurahodgson6531 3 дні тому

    How about it you increase the amount of fibre in your diet (or take supplement) alongside Orlistat? Wouldn't that offset many of the digestive issues?

  • @PagliaCappello
    @PagliaCappello 4 дні тому

    Wonder how much is this guy getting paid to post about bimagrumab all the time

    • @theofficialdrdan
      @theofficialdrdan 4 дні тому

      Am I supposed to be getting paid?! Is it a cheque? Etransfer? I can work with any of the above.

    • @cloakster
      @cloakster 4 дні тому

      @Paglia What channel are you watching? ‘Cuz it sure ain’t this one.

  • @Soshi701
    @Soshi701 4 дні тому

    Could you say more about the pregnancy contraindications - and why the Ozempic Baby phenomenon happens? That's super interesting.

  • @RisaBeesa
    @RisaBeesa 5 днів тому

    I used to obsess over the BMI calculator… now I only occasionally obsess over it, even though I know better. 😧

  • @Neenjapork
    @Neenjapork 5 днів тому

    Can you still develop these hormones on your own after stopping wegovy?

    • @theofficialdrdan
      @theofficialdrdan 4 дні тому

      Yes, your body still produces GLP-1. However, it will just return to the baseline level that it produced prior to drug.

  • @Francesca-fz6nb
    @Francesca-fz6nb 5 днів тому

    Hey can you take antipsychotics (aripiprazole and Olanzapine) and Wegovy ?

    • @theofficialdrdan
      @theofficialdrdan 5 днів тому

      Technically yes.

    • @Francesca-fz6nb
      @Francesca-fz6nb 4 дні тому

      What do you mean by technically? I hope you can! Thanks for the reply 😊

    • @theofficialdrdan
      @theofficialdrdan 4 дні тому

      We always need to take into account the individual factors which needs to be done by you clinician to confirm that it is OK for you to take in combination with your medications.

  • @RisaBeesa
    @RisaBeesa 5 днів тому

    I’m so glad you mentioned that we are not going to lose every week. That happens every now and again for me and then I start losing again. It’s certainly not linear for me. 💚🐝

  • @cloakster
    @cloakster 5 днів тому

    Well, let’s see… Kinda bad side effects? Check. Expensive? Check. The muscle add doesn’t add strength? Check. You have to take it via IV drip? Check. Why am I not overwhelmed? Why am I not even whelmed? 🤔 I guess if the added muscle is helpful in burning calories (as normal muscle tends to be), then it could be good for increased fat loss perhaps, and for maintenance. But I’m kinda not seeing the major attraction Lilly or whomever might have for bimagrumab. What am I missing? 🤷‍♂️

    • @gymjake7619
      @gymjake7619 4 дні тому

      I’m with you on this. Seems like it’s nothing more than a money grab for pharma. There are plenty of other highly researched and studied drugs to preserve muscle with much less risks.

    • @theofficialdrdan
      @theofficialdrdan 4 дні тому

      You and me both. I am curious what the outcomes will look like if one adds resistance training.

    • @ras351
      @ras351 4 дні тому

      Yep, I think I will stay zepbpund and hit the gym for muscle mass.

  • @alettagracesmith2845
    @alettagracesmith2845 6 днів тому

    Can we talk about Metformin nightmares 😂 I have been on a crazy adventure since i started taking the meds. The sad thing is, i am always the villian and literally fighting for my survival in every dream.

  • @leahv76
    @leahv76 6 днів тому

    Just started 4 days ago stomach cramps ate horrible. Is there anything to help. Hope it helps with my diabetes

  • @kanel-2555
    @kanel-2555 6 днів тому

    the xocas

  • @zehavak5373
    @zehavak5373 6 днів тому

    How do you ween off it

  • @joanski786
    @joanski786 6 днів тому

    Thanks!

  • @sychophantt
    @sychophantt 6 днів тому

    Doctors are drug dealers nothing more. You have to stay sick or they don't make money.

    • @theofficialdrdan
      @theofficialdrdan 4 дні тому

      I must be doing something wrong then. Or is a cheque on its way? Would love to start paying off my student loans!

  • @pinkcrystals535
    @pinkcrystals535 6 днів тому

    Question: does the lean mass increase even without any resistance training while taking it?

  • @Natalie.D
    @Natalie.D 7 днів тому

    I’ve been on wegovy over a year, reached my goal: a healthy bmi, and have been on maintenance successfully for four months. I dropped many percentage points down in body fat% and increased muscle mass%. I work monthly with a registered dietician and exercise regularly.

    • @RisaBeesa
      @RisaBeesa 5 днів тому

      What is the maintenance dose? Just curious about the mg, thanks so much and congrats on your success!💚🐝

    • @Natalie.D
      @Natalie.D 5 днів тому

      @@RisaBeesa maintenance dose is different for every person. For me, I take 1.0 every 14 days.

    • @RisaBeesa
      @RisaBeesa 5 днів тому

      @@Natalie.D awesome! I’ve only been on the max dose for 3 weeks now and wondered how long I’d be on it before I start a maintenance dose, and what that dose might be. I hope I can get to my goal too one day! Thanks for answering my question. ☺️

  • @jayjuggrnaut
    @jayjuggrnaut 7 днів тому

    Data point of one: I was getting semaglutide shots from The B12 Store here in Georgia. I started at the lowest dose and noticed minimal weight loss and no stomach paralysis after 4 shots. I had the nurse up the dosage and saw about 5lb weight loss as well as inches off my stomach within 4 weeks. After the last shot, I started experiencing stomach paralysis. Very difficult bowel movements. I haven't had any shots in about a week and a half and I'm hoping my situation will improve. No more semaglutide for me.

  • @sandinarice6321
    @sandinarice6321 7 днів тому

    Love your honest humor breakdown😅keep it real thanks for the info! And everyone’s honest comments

  • @johnlee-fg8ij
    @johnlee-fg8ij 7 днів тому

    Thanks.

  • @tommyleejohnson7308
    @tommyleejohnson7308 7 днів тому

    Are there any foods/supplements or combinations which can mimic this new drug? That is the question I ask myself about any and all of the new obesity drugs. Any thoughts?

    • @johnlee-fg8ij
      @johnlee-fg8ij 7 днів тому

      Excellent question

    • @robertusga
      @robertusga 6 днів тому

      The answer is no. Why? Endogenous GLP-1 that these supplements purportedly generate has a half life of minutes. Semaglutide and tirzepatide: 1 WEEK. Don't fall for gimmicks. Also, supplements are not FDA regulated and not subject to the rigors and scrutiny of randomized controlled trials.