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These benefits are now also evident in people with obesity at high CVD risk (or with known vascular disease) but without T2D, as shown by the favorable effects of semaglutide in the Semaglutide Effects on Heart Disease and Stroke in Patients with Overweight or Obesity (SELECT) clinical trial 36

The medications resist being degraded by DPP-4, which is the enzyme that breaks down naturally produced GLP-1 within a few minutes

However, the weight loss effect often stalls shortly after starting, and upon discontinuation (whether planned or due to difficulties in accessing the medication or its cost), weight often returns to previous levels, and sometimes even higher, very quickly

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Enabling behaviors often stem from a desire to alleviate the persons distress or anxiety, but they can inadvertently reinforce the cycle of obsessions and compulsions