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The key mechanisms include: Appetite suppression: Semaglutide acts on hypothalamic centers in the brain to reduce hunger and increase satiety Delayed gastric emptying: Food moves through the stomach more slowly, prolonging the feeling of fullness Improved insulin sensitivity: Better glucose regulation reduces insulin-driven fat storage Reduced food reward signaling: Semaglutide appears to decrease the neurological reward response to food In the STEP 1 clinical trial, participants receiving semaglutide 2.4 mg weekly lost an average of 14.9% of their body weight over 68 weeks compared to 2.4% with placebo (Wilding et al., 2021, New England Journal of Medicine )