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But given just how miraculous semaglutide is for obesity, and given the miraculous anecdotes , I dont see how to spin this paper as anything but a letdown

In trials (DURATION program), once-weekly exenatide 2 mg showed slightly more A1c reduction (~1.5% drop from baseline 8.3%) than Byetta BID (~1.0% drop) with fewer GI side effects after initial weeks ( [6] )

Specific dietary modifications can substantially reduce GLP-1-associated nausea

Several human studies are underway to investigate if GLP-1 RAs directly attenuate plaque formation or at least modulate the composition of plaques to a more passive or stable phenotype (Table 3)