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This creates a frustrating cycle where, over time, your ratio of "bad" visceral fat to "less bad" subcutaneous fat gets worse, leading to that "old man lean" look where someone might have visible abs but still has a protruding belly

In these studies, all participants followed a reduced-calorie diet and increased exercise

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In some subgroups, mood outcomes actually improved alongside metabolic improvements, though researchers noted this may be driven by the physical health changes rather than a direct neurological effect of semaglutide

Mechanisms underlying the anorexigenic effects of dual GIPR/GLP-1R agonists GIPR/GLP-1R dual agonists induce significantly greater weight loss than GLP-1RAs alone in both animal models and human [29, 30]