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In countries with well-established national registries, with standardised end points and little missing data, RRCTs offer a viable alternative to RCTs for generating high-quality clinical evidence.7 By addressing issues of end point validity and adjudication, and decreasing the proportion of missing data, smaller disease or procedure-focused registries might be able to improve the quality of their evidence, and in turn become a viable alternative platform than more costly RCTs.7 For this reason, it may be advantageous to initially embed RRCTs into registries that are already well established.7 Internationally, registry data are becoming increasingly important in regulatory assessments, especially for postmarketing safety and effectiveness studies.27 The key pillars when considering embedding a RRCT are outlined in figure 2

benefit without human studies

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For weight loss, though, its key advantage is metabolic flexibility : it helps the body switch to burning fat stores and may reduce insulin resistance, attacking one root cause of weight gain