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Unlike PDE-5 inhibitors, it acts directly on the central nervous system via melanocortin pathways

GIP receptor activation: Augments insulin secretion, promotes adipocyte lipid uptake under fed conditions, and may contribute to central appetite modulation through pathways distinct from GLP-1R

However, the putative liver toxicity of methotrexate should be evaluated in the context of advances in our knowledge of the pathogenesis and natural history of liver disease, especially non-alcoholic fatty liver disease (NAFLD)

We asked UNC Health endocrinologist Michael Porter, DO, why you may not be losing as much weight as you hoped and what to do about it