In the gastrointestinal tract, GLP-1 delays gastric emptying through vagal activation and effects on smooth muscle, increases beta cell proliferation and survival as well as glucose-dependent insulin secretion, suppresses glucagon secretion, and reduces hepatic fat accumulation through fatty acid oxidation as well as hepatic gluconeogenesis [43]
When the pharmacological appetite suppression is reduced or withdrawn, the caloric threshold required to maintain their new weight is lower than expected, but their appetite, shaped by the neurological reward pathways that GLP-1s modulate, does not stay suppressed indefinitely without ongoing treatment
Maximum results are typically observed at 4-6 months of consistent use
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