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Pure GLP-1 receptor agonists work through four mechanisms: Slowed gastric emptying (the primary satiety signal) Increased insulin secretion in response to glucose Reduced glucagon secretion (glucagon raises blood sugar) Central appetite suppression via hypothalamic GLP-1 receptors The weight loss ceiling for pure GLP-1 agonists appears to be around 15% to 17% of baseline body weight at maximum tolerated dose over 68 weeks (the STEP 1 and STEP 5 trial endpoints for semaglutide 2.4 mg)
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