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The increased -MSH activates the melanocortin four receptor (MC4R) (140), which in turn mobilizes the sympathetic nervous system, inhibits insulin secretion, enhances hepatic insulin sensitivity (141), and suppresses appetite by modulating NPY/AgRP neurons that promote insulin (142)

Branded Zepbound and Mounjaro remain the primary access path for most patients

The effect was selective for visceral fat with little change in subcutaneous fat or BMI

Dermatol Clin 2012

(Credit: Michael Siluk/UCG/Universal Images Group via Getty Images) But researchers had far less understanding of how small-molecule GLP-1 drugs worked inside the brain