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The drug reduces appetite and in some cases increases energy expenditure

Indeed, gut bacteria play a central role in this metabolic framework by expressing BSH and downstream enzymes that deconjugate primary bile acids (synthesized from cholesterol in the liver) and transform them into secondary bile acids, profoundly modifying their physicochemical properties, intestinal reabsorption, and receptor signaling (80)

That conceptual shift has profound implications for how these drugs are prescribed, evaluated, and reimbursed

We demonstrated that GLP-1 enhances physical endurance by inducing skeletal muscle remodeling, which may be mediated by GLP-1R/AMPK signaling.389 Overall, GLP-1 secretion is induced by exercise

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