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Primary mechanisms of action include: Enhanced insulin secretion : GLP-1 receptor agonists stimulate glucose-dependent insulin release from pancreatic beta cells, meaning insulin secretion increases when blood glucose is elevated but not when glucose levels are normal or low, reducing hypoglycemia risk Suppressed glucagon secretion : These medications inhibit glucagon release from pancreatic alpha cells, decreasing hepatic glucose production Delayed gastric emptying : GLP-1 receptor activation slows the rate at which food leaves the stomach, moderating postprandial glucose excursions Central appetite regulation : GLP-1 receptors in the brain, particularly in areas controlling satiety and food reward, are activated, leading to reduced appetite and caloric intake These combined effects result in improved glycemic control in patients with type 2 diabetes and significant weight loss in both diabetic and non-diabetic individuals

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However, when a third of the participants were switched to a placebo for the following year, they regained 7% of the weight they had lost

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