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STEP 1: In this pivotal trial, non-diabetic adults with a BMI of 30 or higher received a weekly 2.4mg dose of semaglutide (Wegovy) or a placebo
They stimulate glucose-dependent insulin secretion from pancreatic beta cells, suppress inappropriate glucagon release from alpha cells, slow gastric emptying, and promote satiety through central nervous system effects
L-carnitine also reduces lactic acid concentrations in muscles
This is also seen in medications for depression (SSRIs), which increase serotonin to help regulate mood and are known to cause low libido and delayed/anorgasmia as well
2 Gradual dose reduction not abrupt cessation Most trials (STEP-1 extension, SURMOUNT-4) stopped therapy abruptly at high dose
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