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Many people describe the drugs effects not simply as appetite suppression, but as a quieting of persistent food noise. But as clinical trials expand and preclinical research continues, evidence is accumulating that these medications exert much broader physiological effects than previously thought

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For example, the DURATION-8 study demonstrated that mean bodyweight loss with the combination of exenatide (GLP1-RA, which suppresses appetite) once weekly and dapagliflozin (SGLT2 inhibitor) once daily in patients with T2D was greater than that with the monotherapies alone [17]

Further research identified GLP-1 in L cells of mammalian gut mucosa and later, it was proved that GLP-1 enhances insulin secretion in response to nutrient ingestion (7, 10, 11)

Overall, leptin control of orexin neurons is complex but required for appropriate energy balance