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According to the Summary of Product Characteristics (SmPC), the most frequently reported adverse effects include: Vomiting (reported in around 24% of patients) Constipation (occurring in approximately 24% of individuals) [1] [3] Abdominal pain and dyspepsia These gastrointestinal symptoms typically emerge during dose escalation and often diminish over time as the body adapts to the medication

The primary mechanisms of action include: Enhanced insulin secretion : GLP-1 receptor agonists stimulate glucose-dependent insulin release from pancreatic beta cells, improving glycaemic control without causing hypoglycaemia when glucose levels are normal Suppressed glucagon secretion : These agents inhibit inappropriate glucagon release from pancreatic alpha cells, reducing hepatic glucose production Delayed gastric emptying : By slowing the rate at which food leaves the stomach, GLP-1 medications prolong satiety and reduce postprandial glucose excursions Central appetite regulation : GLP-1 receptors in the hypothalamus and brainstem mediate reduced appetite and food intake, leading to decreased caloric consumption Regarding visceral fat specifically, some imaging substudies suggest GLP-1 receptor agonists may reduce visceral adipose tissue alongside subcutaneous fat

This approach allowed us to visualise an intimate association between GLP-1R-positive endosomes and ERMCSs over time, validating our hypothesis