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There are a few reasons why real-world use and efficacy may differ from observed impacts in GLP-1 clinical trials

GLP-1 plays several critical roles in glucose and appetite regulation: it stimulates insulin release from the pancreas, inhibits glucagon secretion to prevent excess glucose production, slows gastric emptying to moderate post-meal blood sugar spikes, and promotes satiety by acting on hunger centers in the brain (6)(23)

And I think that is the beginning of the evolution of microdosing as standard of care

The most common side effects of GLP-1 and GLP-1/GIP microdose therapy are related to the digestive system and typically occur as your body adjusts to treatment

Engagement is happening, but resolution-style replies are rare

The collaborative culture of the Merrifield laboratory supported Mojsovs success in synthesis where many had failed, and the multifaceted biomedical research environment at MGH brought out the world-changing implications of the chemical techniques and insights that Mojsov brought from New York