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Unlike the consistent inhibition seen with GLP-1 analogues, Ex-4 has shown variable effects on adipogenic differentiation

The benefits exceed what would be expected from glucose control alone, suggesting direct protective effects beyond metabolic improvement

Microbial metabolites also affect anxiety, dysphoria, and stress reactivitycore drivers of craving and relapse

Eisenberg D, Shikora SA, Aarts E, et al

For example, the SELECT trial showed a 20% improvement in major cardiovascular events (i.e., heart attacks, strokes, and deaths from those cases) in adults on weekly semaglutide who were overweight or obese (without diabetes) and with preexisting cardiovascular disease, as well as an improvement in all-cause mortality of 19%