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A combined effect that is bigger than just decreasing calories is thought to be at play when looking at the effects of activating the GLP-1 receptor.[ref] In overweight adults aged 45+, a 4-year-long study using semaglutide for weight loss also prevented HbA1c from rising over time, which was seen in the placebo arm

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This cycle may contribute to continued blood-vessel irritation and plaque progression